Supplement Safety: Is It Time to Give Big Pharma a Chance?
Why in the world would I, a chiropractor, consider Big Pharma when I make a vitamin / supplement recommendation to a patient? There are several supplement manufacturers at every chiropractic conference, even at some of our schools.
A Little More Chiropractic, A Lot Less Pain
Why should I visit a doctor of chiropractic when I'm not experiencing pain or other symptoms? That's the question many patients still ask themselves, despite the growing body of research supporting the value of chiropractic maintenance care.
The Carcinogen Most Patients Consume
A known carcinogen is being naively consumed by many, if not most of your patients, who have little to no understanding of how dangerous it really is. Depending on the age of the patient, this carcinogen is a leading, if not the leading, risk factor for death and disability.
Renying-Cunkuo Pulse: The Essential Pulse Method of the Ling Shu
The Ling Shu is a Han Dynasty classic book on the practice of Chinese medicine. It presents five main channel systems: Muscle Channels, Chapter 13; Luo Collaterals, Chapter 10 and others; The Main Channels, Chapter 10 and many more; Separate Channels (Divergent Channels) Chapter 11; and the Eight Extraordinary Channels, referenced in chapters throughout the book (there is very little theory).
A Moment of Silence for Dr. Leon Chaitow (1937-2018)
After months of declining health, Dr. Leon Chaitow – clinician, author and teacher – passed away on Sept. 20, 2018 at the age of 80.
How to Address the Question, "Do You Accept Insurance?"
Do you ever dread getting asked the question, do you accept insurance—when you only accept cash, or when you are out-of-network? As part of my daily practice, mentoring acupuncturists to grow their practices faster and more effectively, I talk to a lot of practitioners.
Pregnancy Health: Looking at the Lower Extremities
When patients tell us they are pregnant, many times we focus on the obvious pregnancy signs and symptoms related to their current trimester of pregnancy, and the biomechanical impact on the spine and pelvis.
Procuring a Place for the Future
As the acceptance of acupuncture continues to grow in the U.S. it is important that the profession be licensed in every state, and nationally board certified.
A New NCCIH Director ... One That Backs Acupuncture
The third time is a charm—the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH), announced it's newest director, Dr. Helene Langevin.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 1)
In the absence of acute trauma, a usual strength-building session includes concentric, eccentric and isometric exercises. Popular exercise programs typically include concentric movements as the major muscle contraction and should constitute approximately 70-75 percent of the workout time.
Paradise Lost: AWB Relief in Hawaii
In November, 2014, Acupuncturists Without Borders (AWB) was hosting a training seminar on Oahu. A couple of us from the big island (aka "Hawaii" County) contacted AWB because the big island was in the middle of a crisis.
Manual Muscle Testing for Cervical Radiculopathy (Pt. 2)
Dr. John Bandy developed a protocol that associated specific muscles with myotomal nerve root levels. The deltoid is associated with the C6 nerve root; the triceps with the C7 nerve root; and the finger abductors with the C8 nerve root.
World Acupuncture Day: A Meeting in Paris
World Acupuncture Day is an event organized by the World Acupuncture Day Organization (WADO) in response to the eighth anniversary that UNESCO has included acupuncture and moxibustion on it's Representative List of the Intangible Cultural Heritage of Humanity.
Creatine: Muscle Fuel No Longer Just for Athletes!
Erase that image of the 20-year-old, muscle-bound bodybuilder using creatine. Replace it with the image of a lean, strong, fit 80-year-old hiking up a mountain. Creatine, a staple of athletes for more than 50 years, is now being used by athletes and non-athletes alike to help slow normal age-related muscle loss, improve exercise recovery, increase strength, and live a more active lifestyle.
Travel-to-Treat Coverage Finally Becoming a Reality?
Long-awaited legislation poised to hit the president's desk extends liability insurance coverage from one state to another for DCs and other state-licensed health care professionals who care for athletes / athletic teams that cross state lines.
NBCE Exams: Better, Shorter, More Opportunities
The NBCE's Written Exams department, led by Bruce Shotts, DC, developed a solution to computer-based testing on college campuses. Their work has resulted in 11 exam opportunities per year. CBT exams are on schedule to begin January 2019 as follows:
The Husband/Wife Imbalance
The Husband/Wife Imbalance, like Aggressive Energy, is an energetic block that will result in death, unless cleared, as its presence indicates that nature has given up the fight against the internal or external pathogenic factors that have assaulted the body/mind/spirit of the patient.
Case Study: Osteoporosis and the Role of Orthotic Support
The following is the second of three case studies by Dr. Wong on conservative management of lower-extremity complaints. Article #1 (September issue) explored chiropractic management of patellofemoral arthralgia.
Bait & Switch: Are You Guilty?
One of my three sons recently shared a story with me regarding an experience with a chiropractor, which stimulated me to write this ethics article. According to my son, he called a chiropractor's office and asked if his insurance was accepted at the office.
Cyberthreat Checklist: 10 Key Steps to Defend Your Practice
Living in an Internet-connected society brings many conveniences and benefits. The power of the Internet to connect us with customers, store data and find information has opened the door for many small-business owners to grow and flourish.
Vertebral Subluxation: Give Credit Where Credit Is Due
Vertebral subluxation: have any other words caused as much turmoil and controversy in the chiropractic profession? As a chiropractic term, vertebral subluxation did not make its debut until six or seven years after the profession's founding.
Chiropractic Integration a Big Success, Suggests Research
Whether chiropractors should integrate with other health care professionals in medical / multidisciplinary settings remains a contentious issue, depending on whom you ask, but there's no denying two realities.
An Effective Herb for Stress
We all know stress has become a significant factor in the increasing number of reported mental health disabilities and a contributor to various physical health conditions, such as ulcers, high blood pressure, heart disease, and so on.
On Point: Acupuncture Theory & Discussion
Welcome to my new column for Acupuncture Today, which will focus exclusively on the theoretical discussion and clinical application of acupuncture theory and acupuncture points. One of the most common questions I encounter from novice to experienced practitioners is "how do I choose the correct acupuncture point?". I hope this column can help answer some of these questions.
The NCCIH Seeks Participants for Acupuncture RCT
The National Center for Complementary and Integrative Health (NCCIH) is seeking participants for a new Funding Opportunity Announcement (FOA)—a Randomized Control Trial (RCT), which will evaluate the impact of, and strategies to best implement acupuncture treatment of older adults (65 years and older) with chronic low back pain (CLBP).
Checking Your Posture: A Wholistic View From Head to Toe
As you begin reading this article, what position is your body in? Are you sitting down, standing up, lying down, or walking down the street perhaps? Whatever position you are in, stop and observe your posture.
Avoid These New-Patient Turnoffs (Before It's Too Late)
I can't believe this doctor is making me watch this video in a room by myself, your new patient thinks to herself as she texts her best friend.
The Road to TCM, A Talk With Bob Doane
Bob Doane, a veteran acupuncturist, talks about his journey to TCM, the evolution of this medicine, and what he foresees in the future.
Cynicism, Burnout and the Search for the Ideal Patient (Pt. 1)
There is a video on the Internet that has gathered 6 million views as I write this article (so likely millions more by the time you read it). The video is of a doctor in an ER mocking a patient who is extremely weak and distressed.
Placebos, Presence and the Zero Point
We spend a huge amount of time learning the techniques and methods of acupuncture and Chi-nese medicine, and are given professional licenses based on our ability to remember and accu-rately apply them.
A Moment of Silence for Dr. Leon Chaitow (1937 – 2018)
After months of declining health, Dr. Leon Chaitow – clinician, prolific author and teacher – passed away on Sept. 20, 2018 at the age of 80.
News in Brief
The Next Generation of Chiropractic Researchers: Historic NIH Grant; Cleveland University – Kansas City VP Joins CCE Site Accreditation Team; NUHS Opens Second Veterans Clinic; R.I. Chiro. Society Celebrates 100 years.
May, 2011, Vol. 11, Issue 05
Research Provides Evidence of Physiological Mechanism For Stress Reduction Resulting From Touch Massage
By Massage Therapy Foundation Contributor
As massage therapy gains popularity as one of the most commonly, used modalities among those offered in complementary and alternative medicine, more research is addressing the physiological effects and mechanisms of massage.This month's Massage Therapy Foundation research synopsis reviews an intriguing study out of Umea University, in Sweden, that evaluated the physiological effects of touch massage and was published in the journal, Autonomic Neuroscience: Basic and Clinical.
Like other massage modalities, touch massage is provided to decrease stress, anxiety and pain. Often massage therapists observe decreases in blood pressure, heart rate, and respiration. These observations suggest massage modalities influence the autonomic nervous system and alter an individual's stress response. The autonomic nervous system is comprised of sympathetic and parasympathetic activity. It controls involuntary bodily functions, such as breathing and the heartbeat. Simply put these two synergistic components act as internal stress (sympathetic) and relaxation (parasympathetic) response systems, which work to maintain autonomic balance. The autonomic nervous system and stress response mechanisms have received considerable attention for explaining a physiological mechanism of massage. Lindgren and colleagues tackled the arduous task of evaluating the physiological effects of touch massage on stress responses in 22 healthy volunteers using a battery of bio-markers to identify autonomic nervous system responses.
Lindgren and colleagues used a crossover design method to conduct this study. In a crossover design, each participant is in both groups (treatment and control). At two separate occasions, each individual either receives the treatment of touch massage or rests in the supine position as a control. Using this method, participants can function as their own comparison with and without the treatment. Though crossover design has many advantages, like requiring smaller sample sizes, the disadvantage of crossover design methods is the carryover effect, where the treatment has lingering effects. If there were a strong carryover effect, we would expect to see the participants who receive treatment first having a different baseline when they return for the control session. However, there were no significant differences between massage first and rest first in the baseline measures taken immediately before the second session, so carryover effects should not influence these results.
Participants received touch massage on their hands and feet, which "consisted of stroking movements on the ventral and dorsal side of hands and feet along with circular movements on each finger and toe. Touch massage was performed for 80 min in the following order: 20 min each on the left hand, the right hand, the right foot, and the left foot." Participants in the control group rested in the same setting. Outcomes measures included heart rate and heart rate variability (the variation in time between heart beats), cortisol stress hormone levels from saliva, blood glucose, and serum insulin. Data were collected before, during, and after touch massage or rest session.
The main finding in this study for Lindgren and colleagues was, "After 5 minutes of touch massage there was a significant decrease in heart rate lasting for 65 min, indicating reduced stress response." Though findings suggested significant changes across several measures, "the only significant differences between the groups were the decreases in heart rate after 45 minutes and in the HF component [high frequency domain of heart rate variability] after 5 minutes." Group differences between treatment and control groups are typically the focus of studies such as this one, because these differences measure the effect resulting from the treatment. Though there were no significant differences between groups in levels of cortisol, glucose, and insulin, "Saliva cortisol and insulin levels decreased significantly after intervention, while the serum glucose level remained stable. A similar pattern, although less prominent was observed in the control group." The findings from this study suggest, "Touch massage reduces the heart rate by decreasing sympathetic nervous activity and evoking a compensatory decreased parasympathetic nervous activity in order to maintain autonomic balance." These findings suggest that after receiving touch massage the participants experienced a biological relaxation response - producing the experience of stress reduction.
As with all research, this study identified limitations to interpreting the findings of this study. First, "calm music" was played during the sessions, which could have had an effect; however, music was used in both groups, therefore touch massage served as the single outcome. Second, as with most massage studies the interpersonal interaction between the therapist and recipient could have affected the treatment. We cannot eliminate the effects of this interaction especially since there was no "sham massage" or "therapeutic touch" group included as a level in between treatment and control. One other potential limitation of the study is that the authors reported that five participants' heart rate and heart rate variability data were excluded due to arrhythmias. Given the already small sample size of less than two dozen individuals, decreasing the sample size by almost 25% for these data points could impact the ability to interpret and generalize these data findings. Further, it is possible that the trend observed of a greater decrease in cortisol following touch massage than following quiet rest and insulin level in this study could prove to be significant with larger sample sizes in future studies. Larger randomized clinical trials will provide evidence for generalizable findings to inform consumers about the effects and physiological mechanisms of touch massage.
This study provides evidence that supports one of the most popular theories for explaining the relaxing effects of massage therapy. Specifically, Lindgren and colleagues found that touch massage significantly reduces cortisol, although not significantly more so than quiet rest, and that massage significantly lowers heart rate. The findings of this study warrant future research to evaluate these physiological mechanisms in larger controlled clinical trials and with more diverse populations. But what does this mean for providers and touch massage recipients? Whether in a non-clinical or clinical setting touch massage can reduce stress for clients and patients. Though this is not likely new information to many providers, as observations of stress reduction are commonplace in the massage setting, Lindgren and colleagues have provided evidence to substantiate these observations, which support incorporating touch massage in individuals' wellness and healthcare plans to facilitate stress reduction and promote personal health.
Source: Lindgren L, Rundgren S, Winsö O, Lehtipalo S, Wiklund U, Karlsson M, Stenlund H, Jacobsson C, Brulin C. Physiological responses to touch massage in healthy volunteers. Autonomic Neuroscience: Basic and Clinical. 2010; 158: 105-110.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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