Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
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WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Does Dairy Cause Dampness?
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Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
The Certified Practitioner
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Doc, Are You a Social Media Holdout? Your Future Is Now
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Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
A Bold Strategy to Take Chiropractic to New Heights
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Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Hidden Hip in LBP: Critical Screening Tests
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Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
Art of the Associateship: It's OK to Trust, But Verify
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Trending: CBD / Hemp Oil
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Help Shape the New Neck Pain Best Practices Guideline
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NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
April, 2012, Vol. 12, Issue 04
Thai Massage Reduces Pain
By Massage Therapy Foundation Contributor
Have your clients reported having pain between their shoulder blades? Have your clients ever asked about the effects associated with Thai massage? Do you provide Thai massage as a modality in your practice? If you answered yes to any of these questions, we at the Massage Therapy Foundation (MTF) are reporting on a new study that may be of interest to you.The study we're reporting provides evidence that Thai massage reduces pain, muscle tension, and anxiety in patients who had myofascial trigger points in the scapular region.
This study from Thailand investigates the effects of traditional Thai massage on scapulocostal syndrome (SCS), a musculoskeletal pain syndrome in the posterior shoulder area. Buttagat and colleagues compared the effectiveness of Thai massage to physical therapy treatments using ultrasound and heat packs in treating pain localized to the medial superior border of the scapula. Previous studies by the same research team showed that traditional Thai massage promotes relaxation and reduces stress in patients with back pain associated with trigger points.
In this pilot study, the authors recruited patients aged 18-50 years old who had "spontaneous scapular pain which had lasted longer than 12 weeks, and had at least one trigger point in the scapular region." An independent assessor, who was blind to which treatment the patient would receive and had no knowledge or effect on the outcome of the study, examined each patient for associated myofascial trigger points in the serratus posterior superior, rhomboid and levator scapula muscles on the affected side. Trigger points were defined as "the presence of tender points within palpable taut bands of muscle in areas that the patient identified as painful." A total of 20 patients were included in the study because they lacked any other known cause of their pain, nor had any contraindication for Thai massage — e.g. fracture or contagious skin disease.
The 20 participants were randomly assigned into two groups of 10 – a traditional Thai massage group (TTM) or the PT modalities group (PT). The TTM patients "received a 30-min session of TTM for nine sessions over a period of three weeks around the scapula region while lying on their side [in a position of] transverse adduction of their arm, plus protraction of the scapula." The same certified Thai massage therapist performed all nine treatments for each of the ten participants. The PT patients "received a 30-minute session of a hot pack and ultrasound therapy [for 10 min] for nine sessions over a period of three weeks in the same environment as the TTM group."
One common critique of any study investigating pain, especially those involving bodywork therapy, is that pain is inherently subjective. Buttagat and colleagues considered this objection and collected data using five different physiological and psychological outcome measures to assess the participants' experience of pain. Pain and tension were assessed using a horizontal visual analogue scale (VAS). The scale ranged from 0 to 10, with 0 indicating no pain or muscle tension, and 10 indicating the most pain or muscle tension ever experienced. The patients marked the line indicating their levels of pain intensity and muscle tension. Pressure pain threshold (PPT) was assessed using a pressure algometry technique involving participants giving a verbal signal when they began to feel pain or any discomfort (at which point the compression was stopped). State Anxiety Inventory (STAI), Thai version, was measured using a 20 item inventory of how the participant felt at the moment. Characteristic items included "I feel calm" and "I am regretful," and were answered in scale of severity (not at all, a little, somewhat, etc.). Patient satisfaction was determined through a questionnaire consisting of a 5-point scale (not satisfied at all, not satisfied, satisfied, very satisfied, and most satisfied).
All outcome measures were compared at three points – after the first treatment session (immediate effects on day one), one day after the last treatment session (short-term effects at three weeks), and two weeks after the last treatment session (long-term effects at five weeks). Patients were similar at baseline; the TTM group reported pain intensity of 5.2 and muscle tension of 5.5; slightly more compared to the PT group's pain of 4.4 and tension of 4.5.
The pain intensity, muscle tension, and state anxiety all showed significant improvements with treatment among patients in both groups at all time points. However, there was no change in PPT for the PT group. When comparing each outcome measure individually, the researchers found a significant improvement in the TTM group compared to the PT group, except for the STAI (immediate and long term effect). Just as important, patients were much more satisfied with the TTM therapy – all TTM patients indicated they were "most satisfied" or "very satisfied," compared to the majority of PT patients who reported that they were only "satisfied."
The PPT for the PT modalities group did not change at any point: there was no immediate response, nor was there response after nine sessions. For TTM, however, the pressure needed to elicit pain doubled after nine sessions. Compared to baseline, this was a highly significant change that was also significantly more than the PPT of the PT group at three weeks and at five weeks. Objectively, TTM reduced the pressure sensitivity of these chronically painful areas in only nine half-hour sessions.
While the study size was small, involving only ten people per group, it is highly likely that the effects shown here will be duplicated. Often, a large sample size is necessary to reveal small differences between groups. The differences between TTM and PT modalities were highly significant even with only the twenty participants. The major limitation of this design was that it is impossible to blind the therapists and the patients to the treatments, as is the case in the majority of massage studies. The authors concede that further study should include a "resting condition" or relaxation group where the patients would simply lie on their side for nine sessions of 30-minutes.
Buttagat and colleagues write, "We may therefore conclude that the treatment by TTM among patients with SCS was superior to the PT." However, the two PT modalities used here – heat pack and ultrasound for ten minutes – would likely not be the only treatments that these patients would receive in out-patient physical therapy practice.
If you use Thai massage, you can refer to resources such as this article to support Thai massage as an evidence-based practice. If you want to use Thai massage in your practice, the specific treatment protocols used in this study are included in the research article. However, these protocols are part of traditional Thai massage, which requires knowledge, skill and training for best results to result from this modality. Pursuing continuing education in Thai massage could be worthwhile in order to offer added pain relief benefits to your clients.
Source: Buttagat V, Eungpinichpong W, Chatchawan U, Arayawichanon P. Therapeutic effects of traditional Thai massage on pain, muscle tension and anxiety in patients with scapulocostal syndrome: a randomized single-blinded pilot study. J Bodyw Mov Ther. 2012;16:1:57-63.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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