resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
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.
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.
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.
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!
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.
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.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
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.
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.
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.
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.
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.
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.
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:
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.