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9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
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!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
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.
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.
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.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
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.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
January, 2013, Vol. 13, Issue 01
Dosage Affects Immune and Endocrine Response to Massage
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, MS CMT, Jolie Haun, PhD EdS LMT, Sandra K. Anderson, BA, LMT, ABT
If a weekly massage is helpful for stress relief and immune function, then two weekly massages must be twice as beneficial, right? The results might surprise you.The Massage Therapy Foundation's previous monthly research columns have reported research suggesting massage may reduce pain, stress, depression, anxiety and cortisol levels, and enhance certain immune function parameters. However, how massage produces these outcomes remains a largely unanswered question. In a new study published in The Journal of Alternative and Complementary Medicine, Dr. Mark Rapaport and his colleagues investigated the mechanisms of repeated massage.
The authors compared once and twice-weekly Swedish massage to two equivalent doses of light touch. Fifty-three participants were randomized to one of four intervention groups: five weeks of Swedish massage once-weekly or twice-weekly, or control light-touch once-weekly or twice-weekly. Eight of the 53 participants did not complete the five-week protocol for reasons unrelated to the study intervention, leaving 45 participants (22 male and 23 female). Therapy sessions of 45 minutes were performed by licensed massage therapists using a standardized, specified protocol with nonaromatic oils. The light-touch condition followed the same protocol as the Swedish massage except that the therapist used only light touch with the back of the hand. Blood neuroendocrine and immune samples and salivary cortisol samples were collected prior to and following the therapy sessions.
The twice-weekly massage group demonstrated greater changes in oxytocin, arginine vasopressin, ACTH, and cortisol than the twice-weekly touch group. Twice-weekly massage also increased mean pretreatment levels of CD56+ cells, but decreased all other circulating immune markers. Changes in pretreatment levels of cytokines in the once-weekly group were similar to the authors' previous study showing sustained decreases in many pro-inflammatory and other cytokines. Interestingly, these decreases in markers of inflammation were not observed in the twice-weekly intervention groups. The authors note that the weekly massages were separated by 7 to 8 days, while the twice-weekly sessions were separated by 3 to 4 days; therefore, observed differences may represent differences in length of time between sessions. Heart rate variability was also measured, but no differences were found between the groups. This is not surprising, since young, healthy (i.e. relatively unstressed) sample participants were studied.
Overall, the results can be summed up as follows: once-weekly massage demonstrated patterns of change in circulating lymphocyte markers and cytokines similar to what was observed after a single massage session. Once-weekly massage increased immune changes that were identified after a single session of massage, but had minimal effect on neuroendocrine function. By contrast, twice-weekly massage increased neuroendocrine changes with little effect on the immune markers studied.
These results are consistent with the authors' initial hypothesis that the positive effects of massage therapy might be mediated through oxytocin and arginine vasopressin. The authors conclude these may be sustained, cumulative, biologic effects caused by the massage and light touch interventions. As a whole, the current findings suggest that while these effects are sustained for several days, they were not merely additive; they effects are different depending on the dosage of the intervention. Another intriguing finding of this study is that the light touch condition, involving gentle, systematic, and comprehensive stroking of an individual for 45 minutes, does have impact on biologic activity. This finding calls into question the use of a light-touch group as a "placebo" for research.
These findings are compelling, but study limitations should be noted when interpreting results. The most pressing limitation of this study is the small sample size of the groups. However, this is often the nature of pilot studies. What is important is the results of this small sample warrant a larger follow-up study, which may provide findings that are more conclusive. The authors note that further investigation of dosage, length of treatment, and different massage techniques are needed. Another limitation is this study did not report measures of sympathetic and parasympathetic function, which could have been helpful for interpreting the findings.
These findings make a significant contribution to advancing the science of massage therapy research. Most therapists, and people in general, are aware that massage works but how it works and which dosages are optimal are questions that have remained largely unanswered and are continually being debated in the field. However, published data findings such as these are starting to provide some direction for finding answers to these massage therapy mysteries. These data provide a glimpse into the biological mechanisms of massage therapy and an indication of dosage response. Also notable from a research perspective, light touch does have a biological effect and is not the "placebo" it was believed to be in previously reported research. These findings can inform future studies use of biological outcomes measures, dosage protocols and the re-evaluation of what is an appropriate placebo.
So, what's the take home message? In general, these findings provide justification of repeated massage to promote sustained cumulative effects. However, it is important to be aware that different dosages of massage may result in different changes in biologic activity. Because of this, massage dosage may need to be adjusted based on the desired effect. For example, if immune function is a priority, once-weekly massage may be optimal for desired effect whereas, if neuroendocrine function is a priority, twice-weekly massage may be the best option. Massage therapists, and clinical providers who recommend repeated massage to their patients, can refer to research such as this article and other related research, to inform their dosage recommendations.
To learn more about previously reported research on the biological mechanisms and dosage effects of massage therapy, you can review the Massage Therapy Foundation website, read our previous articles in Massage Today, read accepted MTF Research Grant abstracts or search Pub Med for related massage therapy studies.
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