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It's About the Word
The new patient was already a fan of chiropractic. "I liked the guy a lot," he said of the previous DC he had consulted. "But he is on the other side of town, and I just can't get there after work. So he sent me to you, since you're his buddy."
Beauty is Averageness
After seeing Kim Kardashian's face all over the Internet -and my inbox- following her posting on getting facial acupuncture, I recalled the work of Michael Cunningham who was at the University of Louisville when I was doing my doctoral work.
Extraordinary Vessels and Emotional Healing
In addition to the 12 primary Organ-related meridians in the body, there are other energy circulation channels that have been mapped out by Traditional Chinese Medicine. Probably the most significant of these are called the Eight Extraordinary (or Extra) Vessels.
Study: Acupuncture for Acute Low Back Pain More Effective Than Drugs
New research by Korean doctors of Oriental Medicine suggested that an acupuncture method could reduce acute lower back pain faster and more effectively than conventional drug injections.
Obesity is a Shen Problem
The expressions "obese" and "obesity" are not pejorative terms. They are scientific terms, determined solely by the Body Mass Index scale, which combines a person's height and weight in a mathematical formula. A number of 30 and above denotes "obesity."
Chiropractic Care for Veterans: Serving Those Who Served (Pt. 2)
To what extent do you think the role of chiropractors in the VA can serve as a model for greater chiropractic integration elsewhere in the American health care system? That's a very important question.
Treating Rib Joints to Protect Thoracic Stability
It is an exciting world that awaits us when we go to work every day. We deal with all types of people who present with varying health conditions we can (hopefully) help alleviate.
A Medication Primer for Alternative Health Care Practitioners (Part 2)
Morphine is arguably the greatest drug of all time, at least in the sense that it is so powerful in relieving pain.
10 Life Lessons That Will Change the Way You Practice
"What would you do if you knew you couldn't fail?" I have posed this question for years to groups I've spoken to across the country and around the world.
Weaving Eastern & Western Medicine Together: Q&A with Beijing's Dr. Kezhen Zhang
Dr. Kezhen Zhang M.D., is currently the founder and president of Beijing Taijitang Traditional Chinese Medicine Hospital.
The Monkey on Your Back
Many practitioners run their clinic without any extra help—at least initially. I've always been pretty good at multi-tasking. Having nine kids taught me how to wear multiple hats and juggle a lot of responsibilities. Running a clinic is similar.
Three Essential Herbal Products For Your First-Aid Kit
There are three Chinese patent medicines that belong in everyone's first aid kit. All three are for topical application, and all three provide extraordinary benefits unavailable from any domestic over-the-counter.
Keeping Up With Western Medicine Advancements: The Amazing World of Imaging Studies
When patients with neuromuscular problems come to you for treatment there is usually a lot you can do for them to improve their mobility or reduce their pain, whether it is a middle age woman with a frozen shoulder.
We Get Letters & E-Mail
The "Great Opportunity" for Chiropractic: Expanded Scope of Practice; The SOAP Note: An Effective Tool for Documentation; Treating Patients Goes Beyond Following Established Protocol.
If you visit the website of the JAMA and search on the word chiropractic, more than 200 results appear. If you sort that list chronologically and look at the oldest entry, you will find "Medical News" that includes the following.
News in Brief
In Remembrance: A Moment of Silence for Robin McKenzie (1931-2013); DC Re-Elected to Co-Chair AMA Code Review Board; WFC Celebrates 25 Years.
Healing the Qi: The Boston Marathon Bombing
On Monday, April 15 2013, locals and visitors from around the globe gathered for the world's largest marathon in the city of Boston. With 23,000 participating in the race and many more on the sidelines, the marathon represents a Boston institution.
Dry Needling is Acupuncture: But What of Education? What of Public Safety?
One of my patients told me recently, that their physical therapist used a "dry needle" and that it wasn't acupuncture. Apparently, physical therapists (PT) are taught to tell their patients that "only acupuncturists practice acupuncture."
The Physiology of Anger
Most of us recognize and have felt anger at some point in our lives. Anger can be seen as a natural response to some kind of pain, whether emotional or physical.
Maintaining Professional Boundaries in a Facebook World: Social Media Guidelines for DCs
A few months ago, I received an unexpected message on my Facebook account: "Hi Doc, do you remember me? I'm so happy to find you here on Facebook. It's been years since I have seen you and I'm glad to reconnect with you.
Becoming a Concussion Expert in Your Community: What You Need to Know (Part 2)
What makes an individual an expert in concussions? Obtaining education about concussions and treating concussed patients are two factors that lead to expertise.
Protein and Weight Loss
Recently I was asked by the staff at Dynamic Chiropractic to referee some of their water-cooler discussions regarding nutrition. Topping their list was this one about protein and weight loss: "Why is protein important for weight loss and how much should I eat?"
Weight Training: Are Cheat Reps Worth It?
While resting between exercises at the gym recently, a young lifter asked me for a spot on a set of barbell bench presses. The bar was loaded with a moderately heavy amount of weight that at first glance appeared to be too heavy for his frame.
A Solution for the Primary Care Crisis?
A white paper generated by the ACCAHC Primary Care Project and UCLA Center for Health Policy Research Senior Research Scientist, Michael Goldstein, PhD, addresses a clear oversight noted in recent workforce analyses designed to assess the nation's primary care needs.
Lateral Femoral Cutaneous Nerve Entrapments
The lateral femoral cutaneous nerve arises from the 2nd and 3rd lumbar nerves. It is formed in the psoas muscle and emerges from its lateral border to cross the iliacus muscle and exit the pelvis.
August, 2012, Vol. 12, Issue 08
How Much Massage Therapy is Enough?
By Massage Therapy Foundation Contributor
Contributed by Karen T. Boulanger, PhD, CMT; Jolie Haun, PhD, LMT; Derek R. Austin, MS, CMT
This month's research summary brought to you by the Massage Therapy Foundation features a study completed by Adam Perlman and colleagues entitled, "Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial." There are three things that we really like about this published research.First, it calls attention to a condition that most massage therapists address frequently. Second, it is the first study that looked at dose to inform how much massage is needed to achieve good outcomes for this condition. And third, it resulted in a massage protocol that was respectful of the individualized nature of practice.
Like many degenerative joint diseases, osteoarthritis (OA) of the knee is painful and limits function. Typical drug therapies are not always helpful and have unpleasant side effects. Six years ago, Dr. Perlman and his team reported the results of a pilot study that offered massage therapy as a feasible, safe and potentially effective treatment for the 27 million Americans that suffer from this condition. The purpose of the current study was to define the "optimal dose" of massage therapy for OA. Once determined, the optimal dose can be used in a more sophisticated study to expand on the current findings.
Participants in the study included 125 adults at least 35 years old with radiographically confirmed OA of the knee and pain rated between 4 and 9 on a 10-point visual analog scale. Along with a wait list control group (usual care), participants were randomized to one of four regimens in which time and frequency (dose) of massage varied:
Swedish massage was provided by licensed massage therapists who provided input to develop 30- and 60-minute full body massage protocols specifically for OA of the knee. Although the protocol specified the percentage of time allotted for each body region, the order of the application was flexible to accommodate practitioner and patient preferences. Outcomes were assessed at baseline and at 8, 16 and 24 weeks. Measurements included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), which assesses pain, function and joint stiffness; a visual analog scale (VAS) for pain; range of motion (ROM); and the amount of time needed to walk 50 feet.
After eight weeks of massage, there were significant changes in WOMAC global scores between the usual care group and the groups that received 60 minutes of massage, but there were no significant differences between the massage groups. There were also significant differences in the WOMAC pain and function subscales and VAS scores between usual care and the 60-minute doses. However, there were no significant between-group differences in the WOMAC stiffness subscale and time to walk 50 feet. ROM improved significantly only in the group that received the highest dose of massage (Group 4).
A dose-response curve was constructed using the WOMAC global scores after eight weeks. It demonstrated that as minutes of massage increased, improvement also increased, plateauing at the 480-minute dose. The optimal dose of massage to improve symptoms of OA of the knee was revealed to be 60 minutes once a week. This result is consistent with the results of their previous pilot study. Although massage ended after eight weeks, significant improvements in WOMAC global scores were observed in all massage groups after 16 and 24 weeks compared to baseline. This improvement was not observed in the usual care group. In addition, there were significant improvements in the WOMAC pain and function subscales in the groups receiving the three highest doses of massage after 16 and 24 weeks compared to baseline.
The National Center for Complementary and Alternative Medicine (NCCAM) has awarded Perlman and colleagues additional funds to continue their exploration of the efficacy of massage for osteoarthritis of the knee. Between-group differences after 16 and 24 weeks may be uncovered with larger sample sizes in their next study. Comparisons of massage to light touch, biological mechanisms (biomarkers) and cost effectiveness will also be explored in their next multi-site trial. The results of this study, particularly the optimal dose of massage, 60 minutes once weekly, are relevant to improving treatment for OA of the knee. Massage therapists can use these findings to support the effectiveness of massage to treat OA of the knee, and for making treatment recommendations based on time and frequency.
These findings also support the notion that the time and frequency of massage treatments is of significance, suggesting more studies are needed to inform the dose of massage for other conditions. Because this study was funded by NCCAM, the full text article is available at no cost to the public. This free full text includes the actual massage protocols used for the treatment of OA. If you are curious to see what other projects NCCAM is funding, you can visit http://nccam.nih.gov/research/extramural/awards and type "massage" in the "term search" box.
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