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Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
November, 2011, Vol. 11, Issue 11
Patients with Fibromyalgia Find Comfort in Massage Myofascial Release Therapy
By Massage Therapy Foundation Contributor
A recent article published in the journal, Evidence-Based Complementary and Alternative Medicine, described the "Benefits of Massage-Myofascial Release Therapy on Pain, Anxiety, Quality of Sleep, Depression, and Quality of Life in Patients with Fibromyalgia."
This article, authored by Castro-Sanchez and colleagues, defined fibromyalgia as "a chronic syndrome characterized by generalized pain, joint rigidity and intense fatigue. Other frequently associated symptoms are sleep alterations, headache, spastic colon, anxiety and depression." The authors suggest fibromyalgia often leaves patients feeling incapable of performing basic daily life activities, even resulting in painful symptoms and conditions such as, "myofascial trigger points, degenerative joint disease, inflammatory joint disease, bursitis, tendinitis, development alterations, hypermobility syndrome, neuropathic pain, injuries, traumas, repeated muscle pulls, visceral pain, disk herniation, spinal stenosis and recurrent cephalalgia (headaches)."
To date, there is no known cure for fibromyalgia, thus treatment is focused on symptom control. Myofascial release therapy is commonly used to treat the symptoms of fibromyalgia. Myofascial release therapy, a soft tissue therapy, uses palpatory feedback to release myofascial tissue (the fascia that surrounds and separates layers of muscle). This accomplishes increased circulation, lymphatic drainage and relaxation of contracted muscles by stimulating the stretch reflex of muscles and overlying fascia. The purpose of this study was to "determine the benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia".
Castro-Sanchez and colleagues conducted a two-group (i.e., treatment and control) randomized controlled trial to determine the benefits of massage-myofascial release therapy in patients with fibromyalgia. Of the 64 fibromyalgia patients recruited, 59 participants completed the study; 30 in the treatment group and 29 in the control group. The treatment group received a 90-minute massage-myofascial release therapy session, weekly for 20 weeks. The treatment consisted of "massage-myofascial release at insertion of the temporal muscle, release of falx cerebri by frontal lift, release of tentorium cerebelli by synchronization of temporals, assisted release of cervical fascia, release of anterior thoracic wall, release of pectoral region, lumbosacral decompression, release of gluteal fascia, transversal sliding of wrist flexors and fingers and release of quadriceps fascia." The control group received a weekly 30-minute session of disconnected magnetotherapy for 20 weeks. Patients in the control group were unaware they were receiving a sham treatment.
Pain, anxiety, quality of sleep, depression, and quality of life were measured at baseline, after the last treatment session, and at one and six months after finishing treatment. Changes in scores for anxiety, pain, depression and quality of life were analyzed for group differences between the treatment and control group. After the twenty weeks of treatment, and when measured again one month post-treatment, anxiety levels, quality of sleep, pain and quality of life were significantly improved in the treatment group over the control group. At six months post intervention, there were only significant improvement in the quality of sleep measure.
Castro-Sanchez and colleagues demonstrated the effects of a 20-week massage-myofascial release treatment program for fibromyalgia patients, with significant improvements in pain, anxiety, quality of sleep and quality of life. Findings indicate the treatment reduced sensitivity to pain, particularly at the lower cervicals, gluteal muscles and near the greater trochanters. In this study the treatment resulted in no changes in depression scores.
Though this was a robust and rigorous study, the authors reported study limitations which should be considered when interpreting findings. First, the exclusion of eligible participants due to incompatibility of schedules may impact sample characteristics. Second, patients with less severe pain may have been able to improve more rapidly. Third, a longitudinal component with more than a six month follow up may be necessary for a more comprehensive analysis to examine the relationship between pain and depression in patients with fibromyalgia.
Despite study limitations, these findings provide important implications for this evidence-based practice. These findings suggest massage-myofascial therapy can be considered as an alternative and complementary therapy to achieve symptom improvement in patients with fibromyalgia. When marketing this treatment modality for consumers, practitioners can provide patients evidence of the benefits of massage-myofascial therapy in reducing pain, anxiety and improving quality of sleep and quality of life.
Castro-Sanchez and colleagues provide compelling data that in the case of fibromyalgia, where symptom control is the only current option, this evidence suggests patients can find comfort in massage-myofascial therapy.
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