resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
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.
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