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Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
June, 2013, Vol. 13, Issue 06
Help in Understanding Parkinson's, Part 2
By Ann Catlin, LMT, NCTMB, OTR
In part one of this series from the April issue, I presented an understanding of Parkinson's disease (PD), its symptoms and current medical treatment.Now we'll take a look at how massage and other bodywork may play an important role in managing symptoms and offering those with PD a better quality of life.
I'd like to challenge you to ponder what it means for a person living with PD to have "quality of life." Most massage therapists immediately think of tremors and muscle stiffness when asked to name a symptom of Parkinson's disease (PD). What about symptoms that can't be seen but only experienced by the people living with this progressive neurological disease? The Parkinson's Outcomes Project reports that negative mood and depression have the greatest impact on health status and that 40% of people with PD experience depression and/or anxiety disorder.
These symptoms seem to have even greater impact on quality of life than motor symptoms. There's constant frustration from struggling to get through daily activities. But I've observed another invisible symptom – feeling isolated. One symptom of PD is a mask-like expression that comes from poor motor control of facial muscles. The subtleties we rely on for communication and social connection are gone. Imagine a man with PD at a social gathering, say a neighborhood picnic. Here's a man who can't move or walk well so will stay in one place and has a blank and staring expression on his face. Is this a person who will likely be approached by others? I suspect not. Strangers will misread the expression as boredom and withdrawal. Acquaintances may feel uneasy about what to say as they notice the changes that have occurred and avoid him. Closer friends may overcompensate for their uneasiness and dote or be overly helpful. Children may even be a little frightened of him. The end result is that few people will treat this man as they would have before PD. Satisfying social relationships must be hard to come by for many people living with the symptoms of PD.
I have a client who has, for many years, been an active board member of a community music guild. In his early seventies, he developed PD, however he continued to be involved on the board. During a recent session, he told me about the board meeting he attended last week. He said that hardly anyone spoke to him directly and he felt ignored. "I'm the same person," he told me. "Do I smell? I'll never go back." The more I think about this, the more I realize the full impact of his statements. He's been cut out of a community and he knows it. Now, he's left to wrestle with the loss and anger along with feelings of low self-worth. I don't think his situation is unique at all. So how can we, as massage therapists, make a positive difference?
Which modalities are most effective?
It's reported that up to 40% of individuals who have PD use at least one type of complementary therapy with herbal supplements, vitamins, massage and acupuncture most commonly used. I was curious about which bodywork modalities have proven most effective. The following is a survey of the literature along with my personal experience.
Alexander Technique: This educational method teaches the client how to change faulty postural habits to improve mobility, performance and alertness along with relief of chronic stiffness, tension and stress. Main benefits are coordination of the musculoskeletal system, improved breathing, vocal production and speed and accuracy of movement. One study demonstrated that following 24 lessons in Alexander Technique, people with PD had less depression and greater self-concept. These results were sustained for six months. Alexander Technique may have the greatest impact on these PD symptoms: bradykinesia, which means slow, deliberate movements and difficulty performing rapid alternating movements such as combing one's hair or clapping. Because Alexander Technique uses a cognitive approach to re-learning movement patterns it may also help develop new neural pathways in the brain to compensate for those no longer functioning properly. The client may also feel empowered by being actively involved in learning new movement patterns resulting in improved mood and feelings of confidence and self-worth.
Neuromuscular Therapy: This approach is described as soft tissue manipulation techniques including myofascial release, positional release and trigger point techniques. One study examined the effects of neuromuscular therapy on motor and non-motor symptoms of PD. Following treatments twice a week for four weeks, clients had significant decreased tremor and improved rapid alternating movements (finger tapping). However, clients did not have substantial changes in mood. It appears that neuromuscular therapy may be most beneficial for motor symptoms of PD, which would contribute to improved ability to perform activities of daily living.
Swedish Massage: In my experience, rocking broad compression and moderate pressure effleurage seem especially effective for PD symptoms. Rocking stimulates the vestibular system as well as the proprioceptor nerves in the skin, joints and muscles which may improve postural tone while promoting an overall relaxation response. Gentle, sustained compression applied to muscles that are rigid or hypertonic encourages "letting go" or relaxation of the muscle and increases range of motion at least temporarily allowing greater postural comfort for those who have advanced PD. Broad, slow-stroke effleurage on the full back seems especially helpful. Studies have shown that three minutes of slow-stroke back massage decreases blood pressure and heart rate while skin temperature increases. Slow-stroke back massage has been used as a common nursing intervention to help patients sleep. We've long understood the link between massage and improved mood. One study showed that Swedish massage increased serotonin and dopamine levels by 28% and 31% respectively while decreasing cortisol levels by 31%. This is important in understanding that massage changes the biochemistry of the body and decreasing stress reactions.
It's clear that touch therapies can be effective in easing the physical symptoms of PD which goes a long way in improving function and alleviating physical discomfort. But I'd like to go back to those hidden symptoms I described earlier, the frustration, isolation and feelings of low self-worth. Let's look beyond bodywork to the power of compassionate human touch to heal in ways we are only beginning to fully understand. The man I described who felt shunned by his peers looks forward to our sessions which take place in his home. Following the massage, he reports decreased pain and appears physically comfortable and is able to move his arms a little smoother. But what shines through the physical benefit is a shift in his demeanor. The other day he told me how much our sessions mean to him. "You treat me like I still matter." I believe his statement had nothing to do with bodywork but rather by reaching past the disease to serve the human being inside of the body impacted by PD.
Acceptance and compassionate presence comes through caring human touch. I'll close with a quote from one of the sources for this article, "While complementary treatment modalities are used widely by patients with PD, only use of various massage techniques seems to improve subjective well-being and quality of life," from Rehabilitation Interventions in Parkinson Disease by Alex Moroz, MD, et.al.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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