resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
March, 2016, Vol. 16, Issue 03
Telling the Truth About Massage Therapy
By Tracy Walton, LMT, MS
Google "benefits of massage therapy," and you'll bring up 3.5 million web pages. Spend an afternoon checking out a bunch of them, and you'll find a few dozen benefits of massage therapy, along with a hundred or so conditions that massage is expected to help.
Among the many beneficial effects of massage, you might pick out a few focused on common cancer symptoms and side effects of treatment. In particular, you'll see references to the "Big Five" in cancer care: pain, nausea, fatigue, anxiety, and depression. These are compelling problems, familiar to oncology massage therapists and clients alike. Research has found growing support for effects on these symptoms and the strongest support is for easing pain and improving mood in people with cancer.
These claims are simple and fairly well documented. If we stopped there, with that last humble sentence about "growing support," we'd be on solid ground. But in the massage profession, we haven't stopped there, and some of our other claims are not so humble, and not solid at all. Go to some web sites, and you'll see long laundry lists of massage benefits. These don't apply to a specific population or problem. Instead, they are more generic. As we will see below, many of these generic claims are downright problematic.
All of us in massage therapy, not just those working with people with cancer, could do with a closer look at the generic list. I've whittled that list down to a short list of a few supposed massage benefits: claims of massage improving circulation, immunity, and endorphin levels. The likelihood of massage clearing out toxins or lowering cortisol levels.
You might have heard some of these claims repeated for years, starting with your first class in Swedish massage. They are mainstays in the massage therapy profession. Unfortunately, there are at least two problems with this short list.
Clients Don't Ask for These Benefits: Many of our claims about massage are focused on physiological effects, rather than clinical improvements. How many of your clients ask for an increase in circulation or endorphins? How many ask for detoxification or a smaller supply of cortisol coursing through their bloodstream? My guess is that, aside from an occasional request, most clients aren't focusing on these benefits. Our lists of benefits sound good, but they don't really address the primary reasons people come to us. People come to us in order to feel better.
Look back at the big five in cancer care vs. the generic lists of benefits and you'll find an important distinction: The Big Five focus on feeling better, improvements in pain, anxiety, and so on. In contrast, massage claims about endorphins and cortisol focus on complicated physiological explanations of how we might feel better. The former are clinical outcomes of massage therapy, the latter are mechanistic outcomes. Clinical outcomes are direct and relevant to the client. Mechanistic outcomes may not matter to a client at all. Many people take medications without questioning the way they work. In fact, many medications bring about positive clinical outcomes, while their mechanisms of action remain a mystery to consumers and medical providers alike.
This means that when our oncology clients (or really, any of our clients, regardless of health history) look for information about feeling better from massage, they are often met with a distracting list of mechanisms, focused mostly on cells or molecules in the blood going up, going down, or moving more swiftly through the body. These mechanistic claims might sound appealing, but they aren't usually related to the client's problem. And they come with other problems, too.
Our Claims Are Not Accurate: Many of the claims we've been making with such certainty are not at all certain. In most cases, we have no decent research to back what we are saying. For example, the claim about massage upping endorphins can be traced to only two tiny, primitive studies. Only one of those studies, fraught with design issues, reports an endorphin boost. Yet a Google search for "massage" and "endorphin" brings up tens of thousands of websites claiming massage will raise your endorphin levels.
Likewise, claims about improved circulation and immunity — mainstays of massage literature — have only a handful of studies behind them, with conflicting results. A body of research on cortisol has been analyzed and reported that massage does not lower cortisol. And there is no good evidence that I know of, anywhere in the English language, on the massage and toxin question at all.
The weakness in our claims about massage raises serious ethical issues for our profession. Health care providers have a recognized duty to tell the truth about their treatments. Even outside of health care, truth in advertising is a responsibility of anyone promoting a service or product.
When we offer massage therapy, people with cancer, health care providers and the public assume we are telling the truth about our services. In cancer care, patients may be especially vulnerable to false claims and oversold promises. They need to hear reasonable expectations about what massage will do for them. That's why the humble statement above, about "growing research support," for massage and cancer symptom relief is so important.
In particular, at least five of the generic claims we make about massage — effects on endorphins, circulation, immunity, cortisol, and detoxification — should be phased out of our literature, our websites, and our massage classrooms. Any time we tell someone, "massage does this," or "massage will help you with that," without good backing, we are making a false claim. Even with a few million websites repeating the same thing, we have a professional responsibility to question what we are told and what we tell our clients.
Telling the Truth, Discarding the Myths
To help MTs in this regard, the Massage Therapy Foundation has just released a free e-book, 5 Myths and Truths about Massage Therapy: Letting Go without Losing Heart (http://info.massagetherapyfoundation.org/5-myths-and-truths-about-massage-therapy).
In partnership with the Foundation, I wrote the e-book to help straighten out our stories about massage. I offer up a research summary of each claim about endorphins, immunity, cortisol, circulation, and detoxification. I also reference many of the small research studies behind each claim, such as the two tiny studies about endorphins, mentioned above. The results may be surprising, but will help all of us make fair, accurate, more defensible claims about our work.
Reporting the true benefits of massage therapy is just as important as discarding untrue claims. The Foundation offers free e-books on massage and pain research, pediatric massage, connecting with researchers, and even an e-book on connecting with physicians. These and other resources are referenced on the Foundation website www.massagetherapyfoundation.org/resources/general/. The e-books are just a sample of the many resources available at the Massage Therapy Foundation, which has funded research, education, and community service projects for 25 years.
In addition to the free e-book through the Foundation, I have listed 20+ highest-level massage research papers in a recent blog post, "One Massage Study Does Not Prove a Point, www.tracywalton.com/one-massage-study-does-not-prove-a-point/. Three of the papers listed are on massage and cancer. In that post, I also explain why a research review typically provides more useful and accurate information than the single massage studies we are told to promote.
All of our client populations deserve clear, accurate information about the benefits of massage therapy. Massage therapy is a wonderful intervention that is becoming more and more welcome in health care circles, and especially in cancer care. When we keep our claims true, humble and thoughtful, we strengthen the foundation of massage therapy for years to come.
Click here for more information about Tracy Walton, LMT, MS.
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