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University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
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.
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