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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!
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Drug War Rages in Wisconsin
Based on its actions over the past 15 years (review the sidebar in the app version of this article), controversy and the Wisconsin Chiropractic Association seem to go hand in hand.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
Correcting Dysfunctional Movement Patterns – Is Local Treatment Enough?
It is widely believed that mechanical, non-traumatic back pain is largely related to dysfunctional or compensatory movement patterns the body has adopted over time.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Giving Chiropractic Some Much-Needed PR
Public relations has not always been the chiropractic profession's strong suit, a shortcoming that has subjected the profession to countless attacks on its legitimacy and seemingly perpetual confusion among the public and the health care world as to the skills and services doctors of chiropractic provide.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
News in Brief
Foundation for Chiropractic Progress Enrolls Second Group Member; Focus on Chiropractic Education at WFC-ACC Conference in Miami; Are You Ready for Another "Have-a-Heart" Campaign?
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
The McGill Approach to the Lower Back (Part 1)
Stuart McGill, PhD, brings a unique combination of tools to the table. He is a scientist who also functions as a clinician. He describes himself as a medical consultant who is referred challenging patients. He is both evidence based and practical.
Alcohol Consumption Strongly Linked to Risk of Colorectal Cancer
Alcohol intake is one of the primary risk factors for many human cancers, and is strongly associated with cancers of the oral cavity, pharynx, larynx, esophagus, liver, breast, and notably, the colon and rectum.
The Bottom Line ... From a Surgeon Who Knows
Regardless of individual relationships between providers, there continues to be a type of Hatfield-McCoy feud between the philosophies of medicine and chiropractic, particularly when it comes to musculoskeletal ailments.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
"Turn, Turn, Turn"
Many people are credited with saying, "If you remember the '60s, you really weren't there." Given the fact I didn't become a teenager until 1970, I actually do remember the '60s (or at least part of it). And as a child of the '60s, I was, of course, influenced by the music.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
March, 2013, Vol. 13, Issue 03
Testing the Treatment Dose of Massage for Chronic Neck Pain
By Massage Therapy Foundation Contributor
Contributed By April V. Neufeld, BS, LMT, NCTMB; Jolie Haun, PhD, LMT; MK Brennan, MS, LMBT, RN, ACM
Researchers at the Group Health Research Institute in Seattle are improving the quality of research studies on massage therapy.This month's Massage Therapy Foundation's review is the Institute's latest project published in a recent BMC Complementary and Alternative Medicine publication, "Dosing study of massage for chronic neck pain: protocol for the dose response evaluation and analysis of massage [DREAM] trial."
"As with back pain, a plethora of options are available for treating neck pain, yet the most commonly used treatments lack consistent evidence of the effectiveness, especially for persons with chronic neck pain," write Sherman, et al. Although there have been a number of studies examining the benefits of massage for neck disorders, a review of the literature indicate the need for Sherman's study. "A major deficiency of previous studies [on massage therapy] has been their use of low ‘doses' of massage that massage therapists consider inadequate," in addition to the lack of massage as the primary treatment, treatment schedule, or descriptions of the type of massage used. And considering the lack of a standard protocol for evaluating massage therapy, it is not surprising that the benefits of massage therapy remain unspecific.
This study was designed to provide a foundation for rigorous research by evaluating three components of optimal dosing: 1) frequency of treatments per week; 2) length of each treatment session; and 3) total treatment period using a massage protocol that includes typically used techniques. Such research will determine the optimal minimal dose of massage for chronic neck pain. Unlike many of the research studies reviewed in this column, this study has not been completed; however it outlines the ideal methods for determining the optimal dose of massage therapy on chronic neck pain, providing details about protocol and treatment regimen not often published in massage related research. This addition to the massage therapy literature will contribute to advancing this area of research.
To start, the authors ran a small, randomized pilot trial to determine if clinical significance was seen among massage recipients by four weeks when receiving one 60 minute massage per week. In this subsequent research, the research team will recruit 228 participants with neck pain to receive different weekly doses of massage for four weeks to determine the optimal dose. The study was set up so the research team could evaluate five doses over several frequencies/week ( two or three 30-min treatments or one, two, or three 60-min treatments). Using the five dosing combinations, participants will be randomized to a wait-list control or treatment group to implement the study protocol. A second treatment period of six weeks with a weekly 60 minute massage or no treatment will follow the initial four weeks of study. This was chosen because, in the authors' previous trial, up to 10 treatments were given over a period of 10 weeks, allowing for evaluation of benefits of an additional six week treatment protocol.
Participants will include the general Seattle area population, of mixed race and gender, ages 20 to 64, who have had at least one primary care visit for neck pain within the previous 3 to 12 months and has a diagnosis of non-specific, uncomplicated neck pain. Exclusions include, but are not limited to, receiving massage for neck pain within the past year, or any massage in the last three months, mild neck (lasting less than three months) or complicated neck problems related to cervical radiculopathy, previous neck surgery, MVA within the past three months. Treatments will be performed by licensed massage practitioners at Group Health Research Institute, who have at least five years experience treating musculoskeletal pain, have practiced and are comfortable with the massage protocol.
A specific massage therapy protocol was written for both 30 min and 60 min sessions and includes: a Cervical ROM assessment; hands-on tissue warming; lymph drainage; neck work; LMP can address compensatory patterns found in upper body, upper and lower extremities, pelvis, etc. using supine, prone and/or side-lying positions; integration which may include cranio sacral techniques, stretching, rocking and other; and completion. Neck work is defined as skull through upper back/chest, C7/T1, clavicles to 2nd/3rd ribs and sternum. Massage strokes may include, in no specified order, friction on base of skull, long strokes down lamina from base of skull, slow friction of the anterior neck, slow friction to scalenes, deeper longitudinal stripping techniques running parallel to muscle fibers to encourage muscle lengthening, treatment of scar tissue along with areas affected by scar tissue, effleurage, petrissage of trapezius, paraspinals, spenius cervicus/capitus, levator scapula and SCM muscles as blending strokes between a-f above for relaxation and transition, stretching to finish and enhance soft tissue manipulation – including PNF, MET and any active assisted stretching.
Sherman, et al, will use the Neck Disability Index, a 10-item questionnaire, to assess neck pain and dysfunction and a pain index that will be provided at five weeks post treatment. Secondary measures will also be used to assess factors such as stress and days of restricted activity. A blinded telephone interview at five, 12 and 26 weeks post-randomization will be performed to determine the primary outcomes of neck-related dysfunction and pain. A further questionnaire on the Internet will be collected at 10, 16, 20 and 39 weeks to supplement the interviews. The study outlines data collection, processing and quality control with details on the protection of human rights, safety monitoring and what will occur should a participant experience adverse effects.
For readers aware of the many limitations of massage therapy research, this trial should be of great interest. Namely, the sample size is appropriately powered to provide a rigorous data set which will allow for interpreting findings in a conclusive manner. Further, the protocol and methods are clearly delineated, which will allow for subsequent replication of findings and be key for validating these study findings.
The publication of this rigorous research has several implications for the field of massage therapy research, the practice of massage and practitioners alike. First, a study of this caliber will advance the science of research in massage therapy by providing valid, reliable and ultimately conclusive findings. Second, using methods to demonstrate the mechanisms and dosages required to produce optimal benefits of massage therapy for conditions such as chronic neck pain will advance the practice in non-clinical and clinical settings as an integral part of integrative health care. Third, and maybe most critical for you the reader, this research provides a valid and reliable source for you to demonstrate evidence based practice for your clients, your students, health care providers and others who want to know how and why what you do works.
We look forward to the results of this trial being released and will report the findings in subsequent reviews sponsored by the Massage Therapy Foundation. Janet Kahn, PhD, LMT, one of the researchers who performed this study, will be presenting the keynote address on day three of the International Massage Therapy Research Conference – Presented by the Massage Therapy Foundation (IMTRC). Join us in Boston April 25-27, 2013, to hear Dr. Kahn present "Massage in 21st Century Healthcare: Let's Seize the Moment." Registration is now open.
Editor's Note: Want to hear more great research all in one place? Attend the International Massage Therapy Research Conference – Presented by the Massage Therapy Foundation April 25-27, 2013, in Boston, Massachusetts. Registration is now open. Learn more at www.imtrc.org.
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