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Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
News in Brief
The American Association of Acupuncture and Oriental Medicine (AAAOM) board members recently met with the Korean Customs Service, which is similar to the FDA, to discuss herbal safety and importation issues.
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
Helping Patients With Parkinson's Disease
Parkinson's disease (PD), a long-term degenerative disorder of the central nervous system that mainly affects motor function, has a slow onset over time.
Waist Circumference: A Conversation Starter
New estimates suggest more than two-thirds of Americans are either overweight or obese. The medical significance of this statistic is astounding.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
Paperwork Done Wrong, Done Right
I was visiting a doctor's office recently and a member of his staff brought a stack of forms to his private office and laid them on the doctor's desk. She informed him he needed to complete the forms for patients and a few third parties.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
February, 2012, Vol. 12, Issue 02
Massage Therapy Reduces Low Back Pain
By Massage Therapy Foundation Contributor
Non-specific low back pain is one of the most common muscular-skeletal issues reported by patients/clients seeking pain relief. Massage therapy is recognized in clinical practice as an effective treatment.However, the Massage Therapy Foundation is always looking for scientific evidence to support clinical recommendations. This month's review illustrates study findings supporting the use of massage therapy to manage chronic low back pain.
A controlled trial was recently published in the Annals of Internal Medicine. Dr. Daniel C. Cherkin and his colleagues at the Group Health Research Institute in Seattle, compared massage plus usual care to usual care alone in their study of participants, ages 20 to 65 years old (n=401). Study findings, "suggest that both relaxation massage and structural massage are reasonable treatment options for persons with chronic low back pain." Participants in the study received 10 weekly treatments at no cost, which consisted of either relaxation massage or structural massage, randomly assigned. Twenty-seven licensed massage practitioners, all of whom had a minimum of five years experience, received 1.5 days of protocol training and provided massage treatments. The LMPs knew which type of massage they were performing, which they did not disclose with participants. Additionally, participants were provided kinesthetic exercises to do in the home setting to help relieve their back pain between treatments.
Study findings suggest, "massage therapy improved function and decreased pain more than usual care in patients with uncomplicated chronic lower back pain [LBP] after 10 weeks." The participants who received massage in addition to usual care reported significantly lower Roland Disability Quotient scores (p=<0.001) and symptom bothersomeness scores (p=<0.001). The beneficial effects of massage lasted at twenty-six weeks (p=0.007) and fifty-two weeks (p=0.049) when measured by the Roland Disability Quotient. Symptom bothersomeness was only significantly reduced at the end of the ten-week trial. The authors note that "massage recipients were more likely than participants in the usual care group to experience clinically meaningful reductions" in functional limitations and low back pain symptoms.
Massage reduced self-reported medication use for LBP (p=0.006), including specifically NSAID use for LBP (p=0.027) at the end of the ten-week trial. However, the reduction in medication use did not persist by twenty-six weeks. Similarly, massage patients were able to decrease absenteeism to work or school caused by their LBP (p=0.018) at the ten-week mark, although these effects did not last either. Patients in the massage group were significantly more likely to be "pleased or delighted if LBP remained at the current level for the rest of life" at the end of the ten-week trial (p=0.007) than patients receiving usual care. In addition, massage patients were significantly more likely (p<0.001) to be "very satisfied with [their] LBP care" at ten weeks, twenty-six weeks and fifty-two weeks.
While some massage therapists are more skilled than others, the authors "found no evidence of differential effectiveness among the massage therapists." For the consumer, this implies that local massage therapists are a great choice for managing lower back pain. Also, the authors examined both relaxation and structural massage, but they "could not detect a clinically meaningful difference between the two types" of massage. This implies that structural massage - also known as neuromuscular and myofascial massage - may not be any more effective than relaxation massage at relieving nonspecific lower back pain. This is an exciting issue for future research to address.
A limitation to this study was that participants receiving only usual care were told that they were enrolling in a trial of massage therapy and received no massage therapy. In other words, they were not blinded to being in the control group. Also, these results may not be generalizable beyond the mostly-female group of mostly white individuals with nonspecific chronic low back pain. Persons with known causes of back pain, including disk herniation, were completely excluded from the study. Persons with these back issues represent a specific population and need, which may also be addressed in future research to expand on the findings of this study.
The researchers report that at this point, there's little evidence of which mechanisms explain the beneficial effects of massage. Mechanisms may be explained by therapeutic touch, relaxing environment, therapist care, increased body awareness, self-care advice, a generalized central nervous system response, local stimulation of tissue or a combination of these influencing factors. What can be clearly stated is this research provides evidence to support the therapeutic benefits of massage for managing chronic low back pain.
So what does this study contribute to the field of massage therapy? This study provides the evidence to support the clinical decision to use massage therapy to manage clients'/patients' chronic low back pain. Further, different types of massage therapy can be equally effective whether relaxation, neuromuscular and/or myofascial. Finally, because multiple therapists provided treatments, and no differences were found between therapists, findings indicate specialized skill is not necessary to provide clients/patients with effective treatments to manage symptoms of low back pain. Further, the authors of this study provide massage protocols for applying massage for low back pain, so these study results can be replicated in practice. Want to incorporate these proven techniques into your massage practice? The exact study protocols are available free online at www.trialsjournal.com/content/10/1/96.
Click here for more information about Massage Therapy Foundation Contributor.
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