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Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
August, 2013, Vol. 13, Issue 08
Massage Benefits Immune and Neuroendocrine Function
By Massage Therapy Foundation Contributor
Contributed by Beth Barberree, RMT, BA; Derek R. Austin, BS, MS, CMT; Sandra K. Anderson, BA, LMT, ABT
In April 2013, the Massage Therapy Foundation hosted the International Massage Therapy Research Conference in Boston.The author of this month's MTF article review, Dr. Mark Rapaport, was one of the keynote speakers and presented material further to this work, "A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic Pituitary–Adrenal and Immune Function in Normal Individual."1
This initial study was achieved through collaboration between Dr. Rapaport and team members Pamela Schettler, PhD, and Catherine Bresee, MS. They investigated the response of various biomarkers to a single dose Swedish massage therapy session versus a light touch control group. What they found is that a single session of Swedish massage therapy had measurable effects on both the immune system and hypothalamic–pituitary–adrenal (HPA) connection. Eventually, these may have implications for care of patients with inflammatory and autoimmune conditions. An understanding of the biological effects that massage therapy has on the body can help us, as massage therapists, make the best treatment choices for our clients who experience inflammation or live with autoimmune disorders.
Despite it being popular with Americans, little is known about the effect of massage therapy on human physiology.2 Of the work that has been done, recent reviews have shown there to be challenges with some of the methodology. There is some lack of confidence in the validity of many of the past claims about the effect of massage therapy on stress response and immune function, along with an inability to generalize results of those studies.
The authors set out to tackle this gap. Based on what they had found leading up to the project, they theorized that Swedish massage therapy would increase oxytocin levels, mediating a decrease in activity of various hormones involved with the HPA connection and improve immune function.
Licensed massage therapists performed both the massage and the control light touch interventions on 53 healthy men and women. The subjects were randomized into one of the two groups and neither the participants nor the therapists were aware of the hypothesis that was being explored in the study. Efforts were made to maintain consistency wherever possible in delivering the 45-minute sessions, with a standardized protocol outlined for both groups. The massage consisted of effleurage, petrissage, kneading, tapotement and friction applied with the thumb. Light touch was performed with the back of the hand only.
Blood and saliva samples were collected before and at varying times after the treatments. Plasma and salivary cortisol levels were analyzed, as were plasma adrenal corticotropin hormone (ACTH), oxytocin, vasopressin, lymphocyte markers and cytokine levels. (The free full text article contains full detail of the process of collection and analysis of the biological samples.) The participants also completed three psychological self-report statements before and following the intervention in effort to exclude shift in emotional state as a contributing factor to the results.
So, what did the researchers discover? When compared to light touch, Swedish massage therapy caused a decrease in vasopressin and a lesser decrease in cortisol levels. Contrary to their hypothesis however, these findings were not mediated by changes in oxytocin levels. The massage group also showed improvement in the biomarkers for immune function.
Interestingly, none of the results varied by age, gender or self-reported race for the two study groups. Another remarkable point is the unique, repeated assessment of neuroendocrine hormones that was utilized in the study. Samples were taken 1, 5, 10, 15, 30 and 60 minutes after the end of the intervention session. This information may be helpful in design of other studies when determining optimum times to draw samples. With consistency in collection and analysis of biomarkers, there is potential to use those methods in comparative studies and as outlined by the study authors, individuals of differing ages and those presenting with various pathologies.
While this is a well-designed study that lays the groundwork for future research in this area, there are still some limitations to drawing inferences from these results. A single session of massage therapy seems to have depressant effects on vasopressin and cortisol for as long as 60-minutes after the intervention. It would be interesting to see future research vary the interventions and collect samples at longer time frames after the interventions occur. In particular, a longitudinal study to find the optimal dose of massage therapy could be done using the protocol of repeated assessment of neuroendocrine hormones seen here.
It would seem that the research on massage therapy and the endocrine system could be on its way to full circle. At one point, there was excitement over studies reporting that massage therapy decreases cortisol, but recent systematic reviews looking at the basic science of those studies questioned the validity of the results. Now, Dr. Rapaport and his colleagues have data to support the notion that a single session Swedish massage therapy may have fairly pronounced acute effects on the immune system.
New evidence has begun to show that massage therapy has positive effects on management of stress hormones and immune function. This is occurring despite the need for more exploration of the potential mechanisms involved. So, even if you only treat a client once, be assured that science is backing up what you likely already know – that massage therapy can have a profound effect for our clients.
To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for massage therapy studies.
Click here for more information about Massage Therapy Foundation Contributor.
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