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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.
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.
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).
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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?
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?'
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.
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.
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.
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.
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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