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Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
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.
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