resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
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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