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Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
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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