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Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Massage Therapy Reduces Suffering for Patients With Advanced Illness
Contributed by Jolie Haun PhD EdS LMT; MK Brennan MS, RN, LMBT; Renee Stenbjorn MPA, LMT
Patients suffering with advanced cancer or other life-limiting illnesses often experience chronic pain, anxiety, and decreased quality of life. Medications for symptom relief are often inadequate and can result in numerous side effects. Previous studies evaluating massage have reported decreases in pain in individuals with advanced illness, such as cancer, but these studies have been limited by small sample size, lack of a control group, or randomization. This month's Massage Therapy Foundation research review focuses on recent study findings on the integration of massage therapy into a palliative care service. In this published research, Mitchinson and colleagues report on the outcomes of massage for patients with advanced illnesses.
The Study Design
Patients receiving palliative care for advanced illnesses, such as cancer, received massage at a Veterans Affairs Medical Center in Ann Arbor, Michigan. Massage therapists collected data pre and post massage to examine outcomes associated with pain, anxiety, dyspnea, relaxation, and inner peace. A retrospective chart review was conducted to collect all the data related to the patient and the massage sessions. The statistical method, analysis of covariance was used to examine changes over time.
Massage treatments were provided by a nationally certified massage therapist. Massage sessions averaged 20 minutes for inpatients and 22 minutes for outpatients and primarily consisted of effleurage with limited trigger point therapy for those patients who could tolerate the therapy. The pressure was light to moderate depending on the patient's health condition. Wounds were avoided. Patients with bony metastases often received massage to uninvolved areas. Patients who were actively dying usually received foot massage.
Of the 153 patients who received massage, 115 were able to provide data for analysis. Patients unable to do so included those who fell asleep, were delirious or confused, were very near the end of life, or who refused to answer. In total, 52% of the patients received massages in an inpatient setting; 37% received massages as outpatients and others received massages in both the inpatient and outpatient settings. In addition to their life-threatening diagnosis, 70% of patients had preexisting chronic pain. Of this sample, 69% had a primary diagnosis of cancer; the other patients were referred for non-cancer diagnoses. As is common among Veteran populations, this sample was primarily older white males.
For the sample, all short-term changes in symptoms showed improvement and all were statistically significant. Pain intensity decreased by 1.65 (0-10 scale, P < .001), anxiety decreased by 1.52 (0-10 scale, P < .001), patients' sense of relaxation increased by 2.92 (0-10 scale, P < .001), and inner peace improved by 1.80 (0-10 scale, P < .001). Unique to this study, the authors also provided individual cases to demonstrate the suffering associated with advanced illness and the impact of massage therapy (excerpts from cases).
A 55-year-old veteran with bipolar illness, a personality disorder, chronic back pain, low social support, and a history of heroin and alcohol abuse was admitted with a new diagnosis of advanced non–small-cell lung carcinoma metastatic to liver and spine. Psychiatry was consulted to help address agitation, irritability, and pacing behavior. He primarily complained of neck and shoulder pain. After the first massage, his pain intensity dropped from 10 of 10 to 8 of 10. He was initially reluctant to admit how much massage had helped relieve his pain because he feared no longer receiving opioids. Initially, he rated his sense of relaxation and inner peace as 0 of 10 prior to massage and 3 of 10 afterward. When asked about his anxiety after the second massage he commented, "I feel better than I have in a long time; that was beautiful." Later during his illness, he commented that the massages were very helpful and said, "I'm in heaven. No offense to God, but this is the only time I'm in heaven."
An 81-year-old World War II veteran with end-stage congestive heart failure and chronic back pain was followed in the clinic. He received 8 massages over an 18-month period. At his first visit, he was complaining about not being able to get his "happy breath." Prior to the massage, he rated his anxiety a 6 out of 10 and his shortness of breath 8 out of 10. He enjoyed the massage and reported a decrease in his anxiety (0 of 10) and shortness of breath (6 of 10). He commented that he felt "a little happier" because he could breathe more easily. On another occasion, he described the massage as "a little better than a piece of warm apple pie and a cup of coffee" and admitted, "I'd be lying if I said I didn't like it."
These case histories provide compelling evidence for the relief of massage experienced by patients suffering with advanced illness.
Implications for the Field of Massage
Mitchinson and colleagues conclude that "massage is a useful tool for improving symptom management and reducing suffering in palliative care patients." The most impressive aspects of this study are the sample size, the implementation of the massage program in palliative care, and the qualitative case histories exemplifying the participants' experiences with massage.
The authors' noted in their discussion that the massage program has been well accepted by professionals within the medical facility and there have been no reports of adverse events related to massage. They reported the biggest challenge was prioritizing patients by need, not having time to keep up with the requests for massage, allocating time between inpatients and outpatients, and getting access to inpatients with competing demands for the patients' time.
The authors also reported study limitations; this study used an observational method with no control group, and the sample had limited diversity. Future studies will benefit from collecting data from a diverse sample including a range of ages and ethnicities from both genders. Finally, data were self-reported and collected by the therapist, so it is possible there was reporting bias to please the therapist. Future research would benefit from data collection from someone other than the therapist; and of greater value would be to complement self-report data with objective data such as biomarkers, to support a rigorous data collection process. The use of qualitative case histories, as used in this study, provide rich data from the perspective of the participants and clearly illustrates their personal experience with massage therapy. Though the authors did not mention it as a limitation, the massage therapy protocol provided in the article was vague and would thus be difficult to replicate. The practical nature of implementing palliative care programs within a medical setting may warrant the use of a wide range of individualized massage protocols.
Practitioners, particularly those working in medical facilities now have information to support the recommendation of massage therapy within palliative care programs. As for the field of massage, this study supports the ever-expanding scope of populations and conditions for which massage therapy can be delivered as an effective treatment to alleviate pain and suffering.
Are you interested in learning more about the uses of massage therapy to alleviate pain and promote quality of life for patients with advanced illness? To learn more about the effects of massage therapy, to learn more about the effects of massage therapy, you can review the Massage Therapy Foundation review article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.