A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
2018 Gallup-Palmer Report: Key Findings
The fourth annual Gallup – Palmer College report is out; here are some of the key findings excerpted directly from the executive summary regarding Americans' experiences with chiropractic care relative to the management of neck and back pain:
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
September, 2011, Vol. 11, Issue 09
Massage for Symptoms of Multiple Sclerosis
A brief review of an article published in the Multiple Sclerosis Journal
By Massage Therapy Foundation Contributor
This month's Massage Therapy Foundation article review addresses a common issue, constipation, or difficulty having a bowel movement, among people with multiple sclerosis (MS).Constipation affects many people; however, this is commonly a chronic issue for people with multiple sclerosis. Constipation can involve discomfort, distress and can negatively affect the quality of life for people with MS. However, research suggests the use of abdominal (stomach) massage can improve bowel movements. McClurg and colleagues conducted a study to determine the feasibility of using abdominal massage to alleviate constipation in people with MS.
Of 41 volunteers, 30 patients with MS and constipation were recruited and met the requirements to be included in the study. Several outcome measures were used, including several self-report questionnaires, including the Constipation Scoring System (CSS), the Neurogenic Bowel Dysfunction Score (NBDS), and a bowel diary. Participants were randomly assigned to a massage group or a control group (no massage). Both groups received bowel management advice. In addition to advice, the massage group participants, or their caregivers, were taught abdominal massage techniques. Four primary techniques were provided – stroking, effleurage, kneading and vibration. Participants and their caregivers were provided with instruction, practice and opportunities to ask questions regarding the techniques. Each participant in the massage group was advised to perform on themselves or receive from their caretakers abdominal massage daily for the 4-week intervention period. An instructional DVD was provided to participants in the massage group. Outcomes were measured at baseline (Week 0), post treatment (Week 4), and at Week 8; and were administered by telephone by a third party data collector who was blinded to participants' group assignment (massage versus control).
Findings indicated participants in the massage and control groups reported a decrease in CSS score (Week 0 to Week 4), suggesting improved bowel function; however, the massage group improved significantly more than the control group. The massage group also reported improvement on the NBDS, but the control group reported worse scores (Week 0 to Week 8); these data indicated the massage group reports were significantly improved over those participants in the control group. The bowel diary also provided telling evidence, such that the frequency of bowel movements increased (improved) for both groups, but participants in the massage group reported significantly more bowel movements than those in the control group (Week 0 to Week 4). Further, participant reports suggest time spent defecating reduced for both groups from Week 0 to Week 4, in the massage group it was reduced from 10 minutes at baseline to 6 minutes per day; and in the control group from 12 minutes to 10 minutes, per day.
The authors reported several limitations in this study, namely the small sample size and the potential lack of sensitivity of the NBDS to detect changes in the study population. As with many similar studies, a convenient sampling strategy was used, in that patients self-selected to participate in the study and thus may have different characteristics than those individuals who do not self-select to participate in research. As with most massage research, it was not possible to blind the participants or clinicians. The duration of the intervention was short compared to other published research; authors suggest the effects may have continued to increase if the intervention had been for a longer duration. Furthermore, some participants felt applying self-massage was tiring, and they were unable to apply the same pressure as the therapist. It is noted that the inability to provide adequate pressure for a sustained period could reduce massage treatment effects.
What is the take home message of this publication? McClurg and colleagues' findings support the feasibility of a randomized control trial (RCT) of abdominal massage to manage symptoms of constipation in people with MS. These study findings provide support for using abdominal massage with clients and patients who report symptoms related to constipation. Notably, study participants reported finding the bowel diary useful; bowel diaries may be a useful tool for monitoring and managing constipation in tandem with other modalities such as massage. Furthermore, as massage becomes recognized as a viable treatment for diverse populations, the use of instructional DVDs continues to gain popularity. Instructional DVDs that provide informal caregivers with massage techniques opens up new opportunities to receive the benefits of massage for people who may not otherwise have the financial resources to access massage.
In closing, McClurg and colleagues provided data in an area where empirical data is needed and demonstrated the feasibility of using abdominal massage "as part of an integrated bowel management program." As more conclusive research findings are published, we will gain more insight into the effects of massage on constipation symptoms in patients with MS and other patient populations who struggle with bowel management.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
Click here for more information about Massage Therapy Foundation Contributor.
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