resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Massage Combats PTSD
Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops in response to a traumatic event. The event often includes physical and/or psychological harm to an individual or a loved one. Triggers of PTSD include violent personal assaults, natural or man-made disasters, accidents, or military combat. Post-traumatic stress is the inability to dissociate the trauma from the past and live without fear of the future. Evidence demonstrates that massage therapy eases suffering caused by this disorder and assists in the recovery process.
Trauma and PTSD
After the September 11th terrorist attacks on the United States, the perspective of the world changed forever. Since, the Indian Ocean tsunami, the Chilean and Kasuri earthquakes, hurricane Katrina, countless wars and famine, PTSD has risen to unprecedented levels. According to the National Center for PTSD, 7.7 million in the United States have suffered from PTSD.
Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq, according to a major RAND study.1 Most of the 1.64 million will return home from war without problems and readjust successfully. However, 18.5 percent of all returning service members meet criteria for either PTSD or depression.1
Symptoms include: flashbacks and/or nightmares, avoidance/numbing, a feeling of estrangement from others, hyperarousal/hypervigilance, and a feeling of constantly being in danger. Other common symptoms include: sleep disturbance, physical pain, irritability, depression, suicidal thoughts, and no longer feeling at home in one's body.2
However common the disorder, stigma may hinder individuals from receiving treatment. In 2008, it was reported that only half of military service members who have returned from Iraq with PTSD or major depression have sought treatment.1 Stigma includes factors such as being concerned that one will be viewed or treated differently by peers or military leaders if they are receiving mental health treatment. Other barriers to receiving care include not being able to get time off work, lack of information about where to find help and not having adequate transportation to get to the location where care is available. Stigma and barriers seem to affect both genders, especially males, who are not as likely to pursue professional help as females.3
Sgt. Travis Runnels, Combat Veteran of the 1st Infantry Division, U.S. Army, (himself a sufferer of PTSD) said, “Team strength is emphasized within the units and nobody wants to feel like the loose link. Sometimes a cry for help is confused with being weak, instead of taken for the serious disorder it is. Understand that PTSD needs proper medical treatment and sometimes intervention.” Runnels found that massage and alternative medicine were a real compliment to his conventional treatment. However, for a long time he had a hard time with doctors touching him, let alone someone that he was not comfortable with. Ultimately, at the right time with the correct counseling resources, he was able to control his reactions and unwind enough to the point where he was able to receive massage. “Massage helped me to learn to relax, let my guard down, and begin to feel safe and comfortable within my body and mind,” said Runnels.
Traditional treatment includes pharmacology and psychotherapies, cognitive behavioral programs, exposure therapies, and eye movement desensitization and reprocessing (EMDR). Cognitive behavioral treatments include: psychoeducation, anxiety management, exposure and cognitive restructuring. According to the National Center of PTSD,4 specific cognitive behavioral therapies including prolonged exposure, cognitive processing therapy and EMDR are best used as initial treatments of PTSD. Group and family therapies along with alternative methods continue to be studied.4
Treatment is provided by TRICARE Prime, a health care plan for active duty military personnel, the Veterans Administration and the U.S. Department of Defense (DoD). Since 1998, the DoD has required soldiers to complete a pre-and post-deployment health assessment, and more recently has mandated a post-deployment health reassessment to be completed six months after the service member returns home.5
Based on the combined screening, clinicians identified 20.3 percent of active duty and 42.4 percent of reserve soldiers as requiring mental health treatment, according to a 2007 study.6 Mental health treatment by the Veterans Administration is helping those with PTSD; 49-59 percent of those who had PTSD symptoms identified after the first assessment, report improvements six months later.6 However, those who didn't initiate treatment at that time, tend to get worse. Several community health programs are also becoming more readily available, one being a DE-STRESS program (Delivery of Self-Training and Education for Stressful Situations), that utilizes an interactive Web site to complete an eight-week program designed to help manage and treat PTSD.5
A revolutionary change in the treatment of PTSD has begun with a holistic approach at the Fort Bliss Restoration and Resilience Center in Texas.7 The program, created by clinical psychologist John Fortunato, was launched in the summer of 2007 after a long struggle for funding. His six- to nine-month program includes a rigorous 35-hour treatment week that combines group and individual therapies that include alternative therapies such as: massage, reiki, qigong, tai qi, meditation, yoga, acupuncture, chiropractic, exercise, games, hot-stone therapy treatments and "rehearsal therapy", which includes telling your most painful memories over and over until they lose their power.
Fortunato uses acupuncture in the treatment of anxiety, panic and tension-induced pain. Reiki treatments are used to assist in treating hyperarousal symptoms. According to Fortunato, "In order to stay alive, their bodies have been hyperaroused for so long, that they come back and cannot turn it off. Their body doesn't even remember how to relax again, and because of that they don't sleep and are irritable. ... The massage has helped soldiers sleep."
And the holistic healing approach for soldiers is paying off: 12 of the 37 soldiers have returned to their units and only two have ended up having to take medical discharges from the army.
According to a 2005 study,8 positive changes have been shown in biochemistry following massage therapy including reduced cortisol and increased serotonin and dopamine. By decreasing the clients' cortisol levels with bodywork, a client can reduce the constant feelings of hyperarousal and danger. By increasing serotonin and dopamine in the brain, an ease of suffering and anxiety is felt.8
A study on sexual abuse victims suffering from PTSD conducted by Cynthia Price, concluded victims of PTSD showed a significant decrease in physiological and physical symptoms, after massage and body-oriented therapy (in addition to psychotherapy).9
Alternative medicine, massage and bodywork, along with traditional methods, can help victims of PTSD in the recovery process. With PTSD numbers on the rise, and more troops coming home every day, there are plenty of sufferers in need. In the hands of a well-intentioned therapist, massage for clients with PTSD acknowledges and helps to restore the most basic human needs of safety, trust, control, self-worth and intimacy. When these needs are satisfied in the context of a healthy therapeutic relationship, an individual may not only succeed but re-learn or discover for the first time how to thrive.2
For a comprehensive list of PTSD resources go to: http://ptsdcombat.blogspot.com/2007/01/need-transition-help-free-resources.html.