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.
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.
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?
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
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
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.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
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.
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.
#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 Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
News in Brief
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.
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.
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?
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
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.
Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
"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.
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.
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.
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.
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.
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.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
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
May, 2012, Vol. 12, Issue 05
Benefits of Using Massage Therapy to Treat TMJ
A brief review of an article published in the International Journal of Therapeutic Massage & Bodywork.
By Massage Therapy Foundation Contributor
Contributed by Sandra K. Anderson, BA LMT ABT and Jolie Haun, PhD LMT
Have you ever wondered what inspires research in massage therapy and bodywork? Often, it starts from the work of practitioners who write case reports illustrating their experiences with clients and patients.A case report is a detailed description of a practitioner's work with a client who has a condition which is addressed by a specific therapy or intervention. It also includes a review of published literature about research on issues similar to the client's. Both the practitioner's work with the client and the research literature can form the foundation for further scientific investigation.
This month, we at the Massage Therapy Foundation (MTF) are presenting a case report published in the International Journal of Therapeutic Massage & Bodywork in 2011. "Changes in Temporomandibular Joint Dysfunction Following Massage Therapy: A Case Report" was written by Melissa Joan Pierson, MT, and won a Silver Place Award in the Massage Therapy Foundation's Student Case Report Contest in 2010.
Most massage therapists have likely had clients with temporomandibular joint (TMJ) dysfunction as 65% to 85% of Americans experience symptoms during their lives. Symptoms include pain and muscle spasms in the head, mandible, neck and shoulder muscles; headaches; earaches; clicking noises or deviations when the mandible moves; limited ability to open the mouth; and dizziness. Causes of TMJ dysfunction include whiplash, bruxism, malocclusion, anxiety, stress, trigger points and postural dysfunction.
Treatments for TMJ disorder include splint therapy, analgesics, surgery, stress management, acupuncture, trigger point therapy, hydrotherapy and massage therapy. Data from focus groups and surveys of people with TMJ disorder suggest people experience frustration with conventional treatment, but are often satisfied with complementary and alternative medicine (CAM) treatments, especially massage therapy. However, literature regarding the effectiveness of massage therapy on TMJ disorder is limited and shows varying degrees of success, warranting more research on the topic. Pierson's case report is important because it shows the benefit of a treatment plan with detailed measurements of the outcomes associated with TMJ disorder.
Pierson's client was a 26 year-old female student who had TMJ disorder seven to ten years prior to the massage treatment series. There was no reported known cause of TMJ for this client. Her symptoms were pain, decreased range of motion, clicking and crepitus. She was a busy, stressed student who had sought treatment from a dentist and a TMJ specialist. Eating soft foods, stretching and following guidance on reducing stress decreased the majority of her symptoms, but when her stress levels increased, her symptoms returned. The client's goals from massage therapy were decreases in pain, muscle tension, stress and restrictions in the neck and facial muscles.
The treatment plan consisted of an initial assessment followed by ten treatments, with re-assessments midway through the series and afterward. Each assessment included a postural assessment using a plumb line and range of motion (ROM) and orthopedic assessments of the neck and TMJ. Pierson also conducted pre-treatment interviews which included questions about location of discomfort, duration, frequency, intensity and quality of pain, and aggravating and relieving factors.
The sessions lasted 45 to 50 minutes, and included intra-oral massage (with gloved hands) consisting of compression on the medial and lateral pterygoids to release trigger points and muscle tension and gentle stripping. Myofascial release was then performed on the neck muscles and pectoralis major to correct the client's rounded shoulder posture and release pressure on her jaw followed by stretching. The sternocleidomastoid was picked up and twisted to release trigger points and tension. Kneading, stripping and trigger point release through ischemic compression were also used on neck muscles. These techniques were done to relieve pain, increase blood flow to the muscles and elevate endorphin levels to further reduce the client's pain and stress. Shiatsu was performed on the client's scalp to restore and maintain the body's energy balance, prevent the buildup of stress and decrease pain.
Because studies have shown that 60% to 90% of patients with TMJ disorder have an improvement in symptoms after using only self-management techniques, self-care was essential to the client's treatment plan. The client performed daily exercises involving retraction to decrease forward head posture. To keep the jaw muscles from clenching, the client compressed and stretched masseter and temporalis musces, and performed self myofascial massage over pectoralis major. She also applied heat and ice alternately to painful areas. Starting three weeks prior to the treatment series, the client kept a daily journal recording her stress, pain and muscle tension levels; the amount and quality of her sleep; self-performed home care, daily activities and diet.
Overall, the treatment series was successful, yielding an increase in the client's ability to open her mouth maximally and range of motion in her neck and a decrease in muscle hypertonicity, pain and stress. Pierson states these results could be due to several factors - the client's compliance with home care, using evidence-based techniques and frequent sessions with no long breaks in between.
For greater accuracy in measurements, Pierson acknowledged that other tools could have been used. For example, a goniometer could have been used to measure the range of motion of the mandible. Instead of relying on the client's comments, valid and reliable measures could have been used to assess the client's mood, stress, concentration and patience. Also, during postural observation and resisted ROM assessment, more quantifiable measurements could have been used instead of the terms "mild, moderate, or severe."
This case report is valuable for several reasons. Because it details the techniques Pierson used on the client, massage therapists can use the information for their own clients with TMJ disorder. This case report warrants further study to investigate the benefits of massage therapy for TMJ disorder. And just as important, this case report may provide inspiration for other massage therapists to conduct and author case reports about their experiences using treatments with their clients.
The Massage Therapy Foundation has annual student and practitioner case report contests that are intended to enhance professional development and research skills of practitioners and students. For information about how you can submit a case report, please visit www.massagetherapyfoundation.org/grants-contests/case-report-contests/. Who knows? Maybe your case report could be the foundation of ground breaking research in the massage and bodywork field. To view the complete article in IJTMB, visit www.ijtmb.org/index.php/ijtmb/article/view/110/201.
For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.
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