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Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
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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