resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
New Leadership Era at the WFC
The World Federation of Chiropractic recently announced not only a new president, as is customary every two years, but also an incoming secretary-general, marking the first time since the WFC's inception in 1988 that someone other than David Chapman-Smith, Esq., will serve in that capacity.
Don't Trust What a Patient Says
When a patient presents to the office for care, they typically have a specific complaint in mind – lower back pain, whiplash, sinus congestion, sciatica, etc.
Employers Need Chiropractic First and Sooner
From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP).
Low Melatonin Linked to Risk of Advanced Prostate Cancer
Epidemiological and experimental studies suggest the hormone melatonin, which plays a role in regulating the sleep-wake cycle, may play a role in the development of prostate cancer, as lower melatonin levels have been associated with an increased risk of prostate (and breast) cancer.
News in Brief
D'Youville Vet Program Gets High Praise; A Moment of Silence for Dr. Paul Reginald ("Reg") Hug.
Shared Mechanisms Between Computer-Assisted Mechanical Adjusting and Contemporary Acupuncture?
Can contemporary acupuncture provide clues to the mechanisms responsible for pain relief provided by computer-assisted mechanical adjusting instruments, and clarify whether certain mechanical frequency combinations are superior to others for modulation of acute peripheral pain?
Working With The Yuan-Source Level: Resonance and the Extraordinary Vessels
How do we stay fresh with our medicine? As healers, how do we balance our medical selves with creative artistry? Chinese Medicine is not a fixed dogmatic entity, but a living system, reliant on a mysterious force called "resonance."
The Boston Benevolent Chiropractic Clinic: Standing Up for the Needy
Our chiropractic assistant, Bridget, greeted an arriving patient at the Emmanuel Church in downtown Boston. She said, "Hi, Michael, good to see you. It's been awhile. Have a seat and Dr. Ken will see you soon."
Halt Allergies With Moxibustion Therapy
An allergy is an immune system disorder in which the body is hypersensitive to normally harmless substances in the environment.
Don't Trust What Your Patients Say
When a patient presents to the office for care, they typically have a specific complaint – lower back pain, whiplash, sinus congestion, sciatica, etc. They are often not interested or engaged in what they consider "unrelated" personal health history.
Vibrational Medicine: Frequency Micro-Current and Color Acupuncture
Vibrational medicine involves the application of various forms of energy frequencies to the body for pain relief, healing and rejuvenation. Vibrational medicine will become a major growing trend in our medical systems for the following reasons:
We Get Letters & E-Mail
Imagine What More Could Be Achieved With Your Support; A Lesson in Hygiene: What Do You Do in Your Office? Open Letter to the Profession.
Wellness: A New Buzzword at the Aging in America Conference
Aging in America is "the nation's largest gathering of a diverse, multidisciplinary community of professionals in healthcare, social service, government, business and philanthropy with expertise in providing services and products for older adults."
Changes in Herbal Medicines from Ancient Times to the Present
The classical literature of Chinese medicine remains highly relevant in the modern era, as many of the basic theories and herbal combinations emphasized in clinical practice were first established in texts that are nearly 2000 years old.
The Importance of Knowing Mainstream Lingo
There is a secret lingo within mainstream medicine of which the vast majority of acupuncturists and Chinese medical professionals are unaware.
Deciphering the New CMS-1500 Claim Form
Q: I am confused about how and when to use the new 1500 form, particularly block 14 and block 15. What is required and how do I properly fill out these fields? And do I actually have to use this new form or may I continue using the old version?
Medial Knee Pain: 11 Potential Causes (and Corrections)
We have all seen patients with medial knee pain that either has no traumatic origin or lasts well beyond when it should be resolved. How can we help these patients? Here is an overview of clinical scenarios and how we can provide conservative care.
"Doctor ... Always Do the Right Thing"
So says "Da Mayor" in the iconic Spike Lee movie. As a fresh grad questioning in-network versus out-of-network, it struck me that some doctors have explicitly skirted the issue, while others have argued adamantly for the latter and "sticking it to the man."
News In Brief
Pacific College of Oriental Medicine obtains grant funding from NIH; Yo San University of Traditional Chinese Medicine Announces New President; Kentucky Gets Licensed; PCOM Receives Approval from WASC to Offer FPD.
Medical Qigong for the Heart: Part I
According to the Center for Disease Control and Prevention, heart disease is the leading cause of death in the United States, affecting people of all ages and backgrounds. Coronary heart disease, in just the United States alone, costs close to 109 billion dollars a year.
Home Sweet Medical Home
While the Affordable Care Act (ACA) has received its fair share of praise and criticism since its adoption, few question the value of its emphasis on collaborative, patient-centered health care.
The Search for the Origin of the Wiggle Technique
When Bob had adjusted me previously, most of the time I knew what he was doing. But this time, he had me lie on the treatment table in the usual side-posture position, and he "wiggled" my sacroiliac with the fingers of both hands, while stabilizing my pelvis with his forearm.
Replenishing and Restoring Jing
I learned an important principle from my great Taoist Master Sun Hak. He taught me that all people "leak" Jing, and that we can mitigate or stop this leaking, and as a result strengthen our life force, develop enhanced adaptability and lengthen our life.
February, 2014, Vol. 14, Issue 02
What Does an MRI Tell the Therapist? A Closer Look at Cervical Pain
By Debbie Roberts, LMT
There are more than six million car accidents every year in the United States alone. Worldwide, an estimated 1.2 million people were killed and fifty million injured from a car accident. There is a very big chance you will treat a whiplash injury over the course of your career.It is important not to treat these potentially serious trauma cases blindly. Even if you work in a chiropractic office ask to see their MRI report. The MRI and his prognosis for the case will give you a more precise treatment strategy. This will also help you determine how severe the injury is. You can divide a whiplash prognosis into three categories. Minor whiplash injuries usually resolve within one to two weeks. Moderate whiplash injuries with muscle spasm or ligament strains may take up to four to eight weeks to resolve. Severe whiplash injuries, or those that involve nerve damage or ligament or disc injury to the spine, may result in chronic or permanent disability. These injuries may require more drastic measures to resolve.
How many times has a patient said to you, "I feel like I am crazy?" Massage therapy is sometimes so much more than the physical portion of manual therapy. Massage therapy can be the gap of empathy, education and evaluation between the patient and their physician. Where does the process start? It starts with how well you assess and evaluate the situation. Evaluation takes a level of judgment, necessary to make sense of the clinical findings in order to correlate a relationship between the symptoms and the signs of dysfunction. This kind of thinking takes you away from treating symptom-based massage therapy into cause and affect therapy. Having real tangible evidence helps the therapist decide which techniques are necessary to help the client regain their previous level of health or even a better state of health.
Where is the easiest place to start? Start with the facts and not speculation. If the client has had a MRI, ask them to bring it to their first appointment. If you have never read a MRI report it can look and sound daunting, but it will actually help you make a more sound therapy session. The information this report can lend to you as a therapist is insight into what is really going on with the client. There may be certain range of motion movements you will not want to do with this client knowing their history. Also, now you will have a better idea on what you can expect from your treatment plan.
There are well over 100 types of massage and massage modalities to choose from these days so it is even more important to have a system on which to base the appropriate technique or tool from the tool box. I bring this up to help our community of massage therapists understand that although some techniques such as stretching, elongating fascia and helping with mobilization are good at times, certain directions of movements may not be appropriate after reading the clients MRI report. Holding ourselves accountable for knowing standard orthopedic joint range of motion measurements are critical in making sound stratagem for massage therapy. Just because you learned that a stretch in lateral side bending will lengthen the trapezius muscle, will that technique or modality be appropriate for this cervical patient? And without looking at their MRI report, you are trapped at speculating instead of correlating the facts.
It is not hard to read a MRI report of findings. You simply go to the end of the report and find the word IMPRESSION. This is where the basic conclusion of what the testing results showed. Taking the time to ask for the report and reading the report demonstrates to the patient you have knowledge and understanding as well as empathy. It also demonstrates you really want to know what to do and what not to do during their treatment session. Massage therapists have an opportunity to educate the client by showing charts of the muscles, joints and nerves involved that were indicated in the report. The patient doesn't understand why their muscles are still going into spasms one month, two months, even a year later, but you do. Giving the needed educational and emotional support when someone is in pain can immediately reduce their anxiety which in turn reduces their pain levels and an opportunity for healing can begin. When you take the time yourself to understand what a MRI report is saying, your treatment plan can be much more precise.
Here is the exercise for this article. I am going to give you the subjective information and the results of one of my cervical patients MRI report. Read the report all the way through. Jot down what you understand and then what you don't understand. Google it! Based on the subjective, how would you treat? Now, based on the facts how would you treat? Which technique or modality would you be comfortable using. Is there range of motion movements you would avoid? What muscles would you do manual muscle testing on?
Case Study Subjective
In total tears, over lunch my girlfriend relays she has been in neck and headache pain now for the past six months and can't workout. She had chiropractic care which included adjustments, ultrasound, hot/cold and electric stimulation which offered some relief.
Past Medical History
She had an accident one year prior to this car accident. She fell off of a ladder that tore her ACL, MCL, the medial meniscus and fractured her tibial plateau. She was found on the ground in a pool of blood.
Here is a beginning list of the muscles innervated at the different spinal roots. C5/6 innervate the Deltoid, Teres minor, Biceps, Brachioradialis, Subclavius, C4,5,6 Infraspinatus, Supraspinatus, C6/7 innervate Coracobrachialis, Pronator teres, Flexor Carpi Ulnaris, Triceps, C7 innervate the Latissimus dorsi. Let's look at a few terms that were in the report.
Spinal stenosis is an abnormal narrowing of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. There can be either sensory or muscular weakness. Cervical spinal stenosis is dangerous because it involves compression of the spinal cord.
A bulging disk extends outside the space it should normally occupy. The bulge typically affects a large portion of the disk, so it may look a little like a hamburger that's too big for its bun. The part of the disk that's bulging is typically the tough outer layer of cartilage. Usually bulging is considered part of the normal aging process of the disk and is common to see on MRIs of people in almost every age group.
A herniated disk, on the other hand, results when a crack in the tough outer layer of cartilage allows some of the softer inner cartilage to protrude out of the disk. The protrusion of inner cartilage in a herniated disk usually happens in one distinct area of the disk and not along a large component of the disk, which is more typical of a bulging disk. Herniated disks are also called ruptured disks or slipped disks. A herniated disc is more likely to cause pain.
Relief In The Findings
Because she didn't understand the report of findings, she was not making the necessary adjustments to her lifestyle to help with relief of long term pain and dysfunction. Her neck seems like a train wreck and is the third type of whiplash discussed previously. We treated her with ice and heat, performed soft tissue work to tolerance. No deep tissue was used. She was treated in supine, prone and side lying. Other treatments included some craniosacral therapy, light traction, and no range of motion movements instead the use of isometrics in all directions and again to tolerance. I managed to take her pain level from a 10 down to a 3 with soft tissue work, home contrast therapy, lying down as often as possible during the day while she was working. Also, she made modifications to her workout routine. The focus was not to let the pain cycle get started.
Understanding the MRI helped her make the necessary lifestyle corrections to allow the chiropractic and massage therapy to be successful. Although both kinds of care lowered her pain levels, it still remained a constant nagging dull ache with limitations to her standard of living. On the advisement of her lawyer she sought care from an orthopedist. The orthopedist recommended a series of facet injections to help break her pain cycle and he felt strongly that it would eliminate her pain. The injections were successful and this allowed her to resume closer to her previous way of living and working out. To make sure she doesn't get into that pain cycle again she presently maintains herself on as needed bases of both massage therapy and Chiropractic care.
Because the disc does not always protrude in the same direction in relation to the nerve root there is no way to know for sure which motions or positions will aggravate a nerve root compression. A safe rule of thumb is that if any motion or position or technique further aggravates the client's symptoms, it should be immediately stopped.
Click here for more information about Debbie Roberts, LMT.
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