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DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Home Safety: Help Families Avoid Common Injury Hazards at Home
These days, many parents childproof their homes before a baby is even mobile. You will see an array of electrical outlet covers, bumpers on the corners of the coffee table and safety latches on the cupboards.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
December, 2011, Vol. 11, Issue 12
Learning from Harm
By Keith Eric Grant, PhD, NCTMB
In 2003, Ernst and Grant separately reviewed the medical literature for reports of harm from massage therapy. Both papers were consistent with Ernst's conclusion that, "Massage is not entirely risk free.However, serious adverse events are probably true rarities." I want to briefly point out and review four case reports added to the literature since those two reviews. First, let me add some motivating comments.
As noted by Cohen and Nelson (2011), the legal basis for the regulation of health care practices by the states is protection of the public from harms of incompetence and malfeasance. The latter is primarily a function of oversight and discipline. The first, ensuring competence within scope of practice, has elements both of training and of monitoring for capacity to practice. Here, I'm focusing on the aspect of training.
The importance of a scope of practice is to define what tasks a practitioner is expected to competently perform, in what contexts, and the presence of what co-morbidities. Looking at case reports of injuries might provide a window on flaws in the expected competencies. However, It isn't enough just to know that an injury occurred. We need to identify the nature of the risk and determine if specific changes in training and practice protocols can eliminate or reduce it.
Aksoy et al. report the case of a 38-year-old woman with complaints of persistent right shoulder pain and limited range of motion (ROM) after a single session of deep tissue massage. There were no predisposing factors or specific muscle pains prior to massage. During a deep tissue massage for purposes of relaxation, she felt pain on the left side of her neck and at the top of her left shoulder radiating toward her arm while work was being done along her neck and shoulders. The pain continued afterward, and the patient noted that her left arm felt "long and heavy" while standing. She also had difficulty lifting her arm up and reaching back. There was no numbness or tingling during or after the deep tissue massage. Subsequent diagnosis indicated injury to the spinal accessory nerve, resulting in weakness of the trapezius muscle and scapular winging. While pain resolved, two years after injury recovery of strength was only partial. While a cautionary note for deep work at the neck and shoulder, no details are given that allow technique evaluation. Any sudden pain during massage treatment follow by subsequent indications of motor impairment should be taken as a clear indication for referral.
Crump and Paluska report a case of venous thromboembolism (VTE) following vigorous deep tissue massage in a previously healthy 67-year-old man with no identifiable risk factors other than his age. The authors note that physicians are often either unaware of or fail to follow evidence-based guidelines for the prevention and treatment of VTE. In this case, there was a five-day delay between initial medical examination at an emergency room and initiation of treatment subsequent to a second exam by his primary care physician. The patient reported a history of right calf pain and swelling, which had preceded the onset of his back pain by five days. The right calf symptoms had begun the day after receiving a vigorous deep tissue massage (for nonmedical reasons), which had included the lower extremities. His calf symptoms had gradually improved over the next five days, at which time he developed the right upper thoracic pain that had prompted his initial visit to the emergency department. The reporting physicians' conclusions are simply cautionary.
This case report suggests that nonpenetrating trauma to the legs, such as vigorous massage, is a potential risk factor that might be unrecognized and underreported. This report should not necessarily deter individuals without any known risk factors for VTE from receiving massage therapy. Additional research is needed to clarify the risks associated with nonpenetrating trauma to the legs, especially in older adults and other susceptible groups.
Wu and Wang report on a 40 year-old woman with injury to the posterior interosseous nerve (PIN) following a local friction massage for tennis elbow (lateral tendinosis). A detailed review of history and physical examination did not reveal any other possible etiology other than the friction massage. The technique anomaly in this case appears to be extension of the friction massage to more than 4 cm below the epicondyle. The authors note that such extension exposes the PIN to risk of damage via compression in its path through the supinator muscle. They recommend that friction massage not extend more than 4 cm below the epicondyle.
Lee et al. report on a cervical cord injury after massage in a 47 year-old male. In this case, the massage was for relaxation. He lied supine without a pillow under his neck, and passive range-of-motion exercise was applied as warm-up movements for his arms. The operator then applied oil on his body, followed by gliding and compression over his anterior thorax and bilateral neck. Suddenly, he felt acute weakness of all four limbs. The weakness remained even though the massage was stopped immediately. He needed moderate to maximal assistance to stand and walk.
There is nothing particularly striking in the description of the techniques themselves. The authors note that the mechanism of injury is not clear. However, the client had a history of cervical spine degenerative disease and had also experienced far more limited muscle weakness following a previous massage. The report underscores the need for taking a history and in obtaining medical clearance for massage where there are factors predisposing toward serious injury.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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