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Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
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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