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Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
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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