resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
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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