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Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
July, 2012, Vol. 12, Issue 07
Additional Insights Into Massage for Peripheral Neuropathy
By Lauren Muser Cates, CMT, S4OM
I have written this as a sort of companion piece to Rita Woods' February article which beautifully explained a protocol to address chemotherapy-induced peripheral neuropathy (CIPN).I use a version of this protocol myself, as do many therapists in the oncology massage community. Much of what Rita shared in the article is good practice and the work that she and Charlotte Versagi have both done in the name of providing massage therapy for people affected by cancer is to be commended. Nevertheless, as the president of the Society for Oncology Massage, I am writing to share some additional background and practical considerations.
I want to start with the assertion about the cause of chemotherapy-induced peripheral neuropathy (CIPN). There is no doubt that many chemotherapeutic agents result in PN, but the exact mechanism is still unknown. There is no clear answer about why certain chemotherapeutic agents cause PN, or even why this protocol works well with PN caused by some agents and not with PN caused by others. The theory Rita proposes is reasonable and is supported by the anecdotal response rate, but the truth is that we really don't know what causes CIPN or why some people get it while others don't.
Working with a client who is suffering from CIPN is much bigger than simply the feet and/or hands that are affected. Safe application of this protocol with a client who is undergoing chemotherapy requires a good deal of consideration. Even a seemingly basic protocol like this one can have grave consequences for the client with cancer if proper precautions are not taken. When we talk about PN, it's also important to remember that there are other reasons a client affected by cancer treatment may be suffering from PN (tumor-related impingement and surgery-related primary nerve damage to name just two). In addition, there are a number of drugs used to treat cancer (thalidomide, velcade and methotrexate, for example) that do not respond well or at all to this protocol.
In my experience with this protocol, working "to the bone" is unnecessary and, in some cases, unsafe. A variety of cancer-specific concerns come to mind when I consider working this deeply. The four most serious are:
It is also important to note (and would be important to communicate to a client) that when CIPN has progressed to the point of total numbness, the application of this protocol will result in the return of pain before the return of normal sensation. Many people describe their CIPN as beginning with tingling and other degrees of paresthesia before it progresses to numbness. For some, it never progresses to numbness. If we imagine the progression of CIPN as a piece of thread going through the eye of a needle, we can imagine this protocol as pulling that thread back through and out of the eye of the same needle. As the protocol begins to take effect, sensation may be returned in reverse order of the way it was lost. Passing back through the eye of the needle, so to speak, can be painful at first.
In addition, it is possible that you may encounter swelling in the extremities. Swelling is a big question mark that can potentially point to serious considerations like vital organ compromise, infection or DVT with any client. When working with a client with a cancer treatment history, this question mark is even bigger.
In closing, it boils down to scope of practice and making good and ethical choices about what is and is not within one's scope. Addressing CIPN is certainly within the scope of practice for a massage therapist with a breadth and depth of knowledge that is appropriate to dealing with a compromised client. It is clearly outside the scope of practice for a massage therapist who does not have this background. It is simply not enough to "just work lightly" (as many therapists say they do with oncology clients) and it is unethical to blindly follow a protocol without a complete understanding of a particular client's medical condition.
Lauren Cates is the current President of the Society for Oncology Massage and an NCBTMB Continuing Education Approved Provider. For additional information related to working with clients with a cancer history, visit the Society for Oncology Massage website at, www.s4om.org. Lauren can be contacted at:
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