resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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).
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.
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.
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.
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'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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
September, 2012, Vol. 12, Issue 09
Research Shows Acupressure Reduces Chronic Neck Pain
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, MS, CMT, April Neufeld, BS, LMT, NCTMB, Sandra K. Anderson, BA, LMT, ABT
In this month's Massage Therapy Foundation Research Column, we are taking a critical look at the effects of acupressure.Widely accepted in Japan, many Americans are unaware of the many benefits of manual acupressure. It is a noninvasive technique in which, instead of needles, the practitioner's fingers press on traditional acupuncture points. Acupressure has been shown to be calming, relieve pain and induce relaxation.
Lead author Dr. Takako Matsubara, PT, an Associate Professor in the Department of Rehabilitation at Nihon Fukushi University, Japan, and his colleagues studied an area of interest to most massage therapists - chronic neck pain. Their research article, "Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain" was published in the journal Evidence-Based Complementary and Alternative Medicine.
Matsubara and colleagues randomly allocated 33 female subjects (n=33) to three groups. Group one subjects received acupressure at three tender points consistent with local acupuncture points (LP) "Jianjing" (GB 21), "Jianwaishu" (SI 14), and "Jianzhongshu" (SI 15). These local acupuncture points align with tender points in the trapezius muscle with acupressure (see Figure 1). Group two subjects received acupressure at three distal acupuncture points (DP); in this study, distal meant points distal to the location of the neck pain. These points were "Hegu" (LI 4), "Shousanli" (LI 10), and "Quchi" (LI 11). These distal acupuncture points are traditionally associated with neck-shoulder-arm disorders in Chinese/Japanese traditional medicine (see Figure 2). A third group, termed the control, received no acupressure at all.
Subjects were assessed about pain intensity using a verbal rating scale (VRS); the intensity of neck pain or stiffness was evaluated on a numerical scale from 0 to 3 (0: no pain, 1: mild pain, 2: moderate pain, and 3: severe pain). Subjects were also assessed about pain-related disability using the Neck Disability Index (NDI), pain-related anxiety using State-Trait Anxiety Inventory-I (STAI-I), and about muscle hardness (MH) on bilateral trapezius muscles. Pain-associated stress was assessed using salivary alpha-amylase (sAA) activity and heart rate variability (HRV) to determine parasympathetic and sympathetic activity. Low electrical frequency fluctuations in heart are indicators of sympathetic and parasympathetic activity, and high electrical frequency fluctuations are indicators of parasympathetic activity.
Parasympathetic and sympathetic activity in the test subjects was measured because several previous reports showed that the effects of acupuncture and acupressure are due to influencing the autonomic nervous system. The acupressure treatment lasted about ten minutes per session. Three sets of acupressure were applied with thumb pressure in a rotary fashion at 20-25 cycles per minutes for 30 seconds on each of the three assigned local or distal points on the right side of the subject's body; the same procedure was followed on the left side. The same investigator applied acupressure in all cases.
There were no significant differences among the three groups pre-treatment. There were no measured changes in pain, stiffness or autonomic activity in the control group throughout the study. However, in the LP and DP groups, the VRS, STAI-I, and MH significantly decreased immediately following treatment, indicating a decrease in pain and stiffness. The next day, the NDI was significantly lower compared with pre-treatment in the LP and DP groups. The subjects' heart rates significantly decreased and high frequency component of HRV significantly increased, indicating a parasympathetic autonomic response, only in the LP group.
This study is notable for its use of both local and distal acupressure therapy. Both appear to be effective in relieving chronic neck pain in only a single ten minute session, with significant next-day effects on the NDI, a validated measure of pain-related disability. Interestingly, reduction in pain in the LP and DP groups as assessed by the VRS were not significantly different from the control group at the one day follow-up.
This study by Matsubara et al., is limited by the lack of longer term follow-up beyond one day, the small sample size of 11 participants per group, and the inherent inability to blind the practitioner and participants from knowing which treatment was administered or received. As a primary measurement of pain intensity, the authors could have used a 10-cm visual analog scale (VAS), which may have been more sensitive to differences between groups at the one-day follow-up. Also, the addition of a "sham acupressure" group would have helped rule out the possibility of placebo effects or effects stemming from touch, not acupressure per se. Finally, the sample used in this study only included women; men might respond differently to acupressure applied to the points used in this study.
In conclusion, acupressure to both local and distal acupuncture points significantly reduces chronic neck pain in this randomized, controlled trial. The researchers point out that most clinicians combine local and distal acupuncture points in clinical practice, and they suggest that further research should assess combinatorial effects. This Open Access journal article is freely available in PubMedCentral at www.ncbi.nlm.nih.gov/pmc/articles/PMC2952311/.
Author's Note: For additional research about accupressure, please see Robinson et al.'s 2011 Open Access review entitled, "The Evidence for Shiatsu: a systematic review of Shiatsu and acupressure" published in BMC Complementary & Alternative Medicine and available at www.biomedcentral.com.proxy.library.vcu.edu/1472-6882/11/88.
Editor's note: For more information about massage therapy research, visit the Massage Therapy Foundation at www.massagetherapyfoundation.org.
Click here for more information about Massage Therapy Foundation Contributor.
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