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News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
September, 2013, Vol. 13, Issue 09
Massage Can Relieve Workplace Pain and Stress
By Massage Therapy Foundation Contributor
Contributed by Jolie Haun, PhD, EdS, MK Brennan, MS, RN, LMBT and April V. Neufeld, BS, LMT
When we think of massage, we often think of spa and clinical care settings. In this month's research review, sponsored by the Massage Therapy Foundation, we take a closer look at an article by Back and colleagues who examined the impact of massage therapy as an intervention for healthcare providers in the workplace.
Back and colleagues report that healthcare is the second largest industry in Canada with a high incidence of occupational injury and illness. Particularly, long-term care staff suffers from high levels of musculoskeletal injuries, resulting in high rates of back-related worker's compensation claims. Despite decades of research, these work-related musculoskeletal injuries remain an unsolved problem. Yet, studies with on-site massage therapy programs in healthcare demonstrate that these programs have a positive impact. While past interventions focused on physical factors in the reduction of musculoskeletal injuries, Back and colleagues explored the effects of a massage-based wellness intervention that focused on psychological well-being and physical health.
The pilot program evaluated the efficacy of on-site massage therapy on outcomes including job satisfaction and workplace stress, as measured by work culture, job demands, social interaction, control at work, as well as pain and discomfort levels, as measured by pain severity, pain interference, pain relief and massage therapy perceptions.
Six matched questionnaires were distributed: three pre-intervention (Q1, Q2, and Q3) and three post-intervention (Q4, Q5, and Q6) during an approximate six month period. Using the questionnaires, organizational culture, job demand and social interactions were evaluated. Additionally, two of the questionnaires, Q3 and Q6, also included a pain inventory. One hundred and seven employees participated in the Q1 survey, which determined staff preference for each wellness program. Massage therapy was the most preferred relaxation modality and was subsequently offered to 145 healthcare workers immediately after Q3.
Participants were allowed to sign up for one 20-minute massage therapy session each week. The time taken for the massage was a paid break in addition to the employee's regular break times. Massage therapy sessions were offered for four weeks at the facility by one of four Registered Massage Therapists. Participants received up to four sessions of massage therapy over a four-week period. Participants did not necessarily receive treatment from the same therapist in all their sessions. The massage therapy was performed with participants fully clothed, sitting prone on a massage chair. Therapists used tapotement, effleurage, petrissage, passive stretching, grade 1 or 2 joint mobilization and traction, as well as active and passive range of motion. Treatment was limited to the neck, shoulders, upper back, lower back and arms; techniques reflected those for the purposes of general relaxation.
Findings indicate that the average number of participants receiving massage therapy sessions increased each week (except in between weeks two and three): 17.4% (week one), 25.7% (week two), 19.4% (week three) and 37.5% (week four). Work culture showed a significant decrease from Q3 to Q6, while massage therapy had no significant impact on job demands, social interaction or control at work. Data showed trends toward improvement of quality of life associated with the massage intervention, but this decreased after the intervention period, as indicated by responses in Q4. There was no significant change in staff feeling a lack of recognition in the workplace, although lack of recognition scores increased from Q3 to Q6. Findings indicate the number of massages received by a participant did not influence their perception of psychosocial constructs.
Pain severity significantly decreased between Q3 and Q4. However, pain severity showed an increasing trend from Q4 to Q6. Neither pain interference nor pain relief showed any significant change. Positive perception of massage therapy significantly increased from Q4 to Q6 with 80% of respondents perceiving that massage therapy was effective in Q6 compared to 79% in Q5 and 59% in Q4.
Initial results indicate benefits in terms of pain severity, with a possible improvement in job satisfaction and morale. Massage had a significant effect on pain severity, with the greatest benefit on individuals with preexisting musculoskeletal symptoms. A long-term effect was not demonstrated. Back and colleagues reported that six weeks after the intervention ceased, pain symptom reports became worse and decreased job satisfaction and lower morale was observed. The authors suggest the possibility that massage sessions increased participants' body and pain awareness; for example, contrast between days of massage treatment and non-treatment may have become more noticeable.
Study limitations include the lack of a control group, however Back and colleagues provide a reasonable justification for their choice to using quasi-experimental time-series methodology, including difficulty in finding similar participants and the possibility of communication between staff (treatment vs. control group members). However, one might have suggested the use of a cross over design, where groups participate in both treatment and control groups (also known as A-B design). Further, though 145 employees were offered massage, there were 98 participants; nonparametric statistics were used to evaluate pain outcomes on sub-sample sizes between 12 to 25 participants, which limit the power and generalization of findings to other populations. This should be considered when evaluating findings, such that larger sample sizes may have produced different results. The implementation of twenty-minute generic chair massage with clothing on is not a study limitation, however it should be considered when evaluating the outcomes of this study. It was noted that funding limited the time allotted for the treatments, and that such a factor could impact results. Authors also noted the same potential limitation associated with implementing non-specific relaxation massage techniques.
The findings of this research provide exciting implications for the field of massage therapy. First, this pilot research supports the efficacy of alternative workplace programs employing the use of massage therapy to benefit healthcare workers. Targeting individuals, such as those with preexisting musculoskeletal signs and symptoms are most likely to benefit from a massage therapy workplace program. Combining a massage therapy program with other health and safety programs is strongly recommended by Back and colleagues. Second, though much of the literature has previously focused on patient massage, implications of this work suggest that massage therapists may have a role in the healthcare environment to provide services to healthcare providers who provide patient care. With musculoskeletal injuries, lost days of work and morale issues, massage therapy may be just the wellness intervention needed to support this large workforce.
If you would like to know more about the effects of massage therapy or the use of massage therapy based wellness program in the workplace, review the Massage Therapy Foundation article archives, where you can read accepted MTF Research Grant abstracts, or search Pub Med for massage therapy studies.
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