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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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?
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.
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.
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 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.
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.
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.
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).
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.
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.
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?
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
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."
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."
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
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.
June, 2012, Vol. 12, Issue 06
Recent Research Provides Evidence of How Massage Therapy Heals
By Massage Therapy Foundation Contributor
Contributed by Jolie Haun and Derek Austin
Why does massage make sore muscles feel better? How does massage promote healing? What are the biological mechanisms of massage therapy? These are questions that clients, patients, practitioners and researchers ask all around the world and have been considered since the days of Hippocrates.Massage is a therapeutic modality commonly used to reduce muscular pain and promote rehabilitation. However exactly how massage affects cellular function remains unknown. Yet, still today, as massage therapy continues to remain a popular healing method and a clinically therapeutic modality, science seeks to understand the biological mechanisms by which massage therapy creates therapeutic effects.
The Massage Therapy Foundation is always on the hunt for new research to provide evidence about the bio-mechanisms of massage – inspiring the review of a study by Crane and colleagues published in Science Translational Medicine.
Musculoskeletal problems impact daily function and quality of life, so it is important to validate treatments such as massage therapy, to demonstrate the bio-mechanisms of massage therapy in promoting recovery, while reducing inflammation and muscular pain. The increase in physician and chiropractic referrals for massage for musculoskeletal injuries indicates a shift in practice toward the use of massage therapy as a complementary modality to conventional care. As massage gains popularity as an adjunctive therapy, it must be validated as a clinically effective treatment that can be medically billed for and reimbursed in the healthcare setting. Validation of the biological mechanisms of massage is the fundamental basis for advancing the science and practice of massage therapy.
Crane and colleagues seek to contribute to the field of science through innovative research which used methods that provide data, at a bio-molecular level, that describes the effects massage therapy has on muscular-skeletal tissue. The aim of this study was to investigate the pain relieving effects of massage therapy with a sample of 11 men. Each participant was asked to exercise to the point of exhaustion to create exercise-induced muscle damage to their thighs. Immediately following the exercise, participants recovered for 10 minutes. Massage oil was lightly applied by a registered massage therapist to both quadriceps while the participant lay in the supine position. To assess the effects of massage, the research team administered either massage treatment or no treatment to the quadriceps of each participant; such that, one leg was randomized to receive the massage treatment for 10 minutes. The treatment included the use of three types of soft tissue manipulations: (1) two minutes of effleurage, using moderate pressure at the beginning and end of the treatment; (2) three minutes of petrissage; and (3) three minutes of slow muscle stripping. After massage, the subjects rested for 10 minutes. Unique to this study, muscle biopsies were acquired from the participants’ quadriceps (vastus lateralis) at three time-points: before treatment (also known as baseline), right after massage treatment, and after a 2.5-hour recovery period.
Findings indicated massage therapy reduced inflammation through production of inflammatory cytokines; and promoted mitochondrial biogenesis, promoting enhanced recovery. However, findings did not support the popular notion that massage therapy clears lactic acid from muscle tissue; nor did glycogen levels change. In scientific terms, Crane and colleagues suggest the massage treatment.
Activated the mechanotransduction signaling pathways focal adhesion kinase (FAK) and extracellular signal–regulated kinase 1/2 (ERK1/2), potentiated mitochondrial biogenesis signaling [nuclear peroxisome proliferator–activated receptor g coactivator 1a (PGC-1a)], and mitigated the rise in nuclear factor kB (NFkB) (p65) nuclear accumulation…despite having no effect on muscle metabolites (glycogen, lactate), massage attenuated the production of the inflammatory cytokines tumor necrosis factor–a (TNF-a) and interleukin-6 (IL-6) and reduced heat shock protein 27 (HSP27) phosphorylation, thereby mitigating cellular stress resulting from myofiber injury.
These study findings provide evidence that manipulative therapies may be justifiable in medical practice. According to Crane and colleagues, the effects of massage are akin to the same mechanism as conventional drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs). Findings such as these, are the basis for providing patients and clients the option of massage therapy opposed to conventional drug-based therapies (e.g. NSAIDS).
Though these study findings provide much promise for advancing the science and practice of massage therapy, some study limitations that should be noted. The study sample size was small, involving only 11 males. A larger sample size using females and males would provide more power and rigor to data findings. Another limitation of this design is that it was impossible to blind the therapists and the patients to the treatments, however the research team was blinded to which leg received treatment; this was known only to the massage therapists. Though these study limitations cannot be denied, the strengths of this study outweigh limitations. The use of biopsied tissue data is a rare case in massage therapy research, but has proven critical in gaining insights to the biological mechanisms of this muscular-skeletal based adjunctive therapy. It is recommended that future research investigate additional post-translational signaling pathways influenced by massage therapy.
Crane and colleagues have provided much needed data about the biological mechanisms of how massage therapy promotes healing. If you practice massage to treat sore, tired muscles you can refer patients and clients to resources such as this article to support massage therapy as an evidence-based practice. The next time someone asks how massage therapy works, you can highlight these findings which suggest massage therapy effects inflammation and enhanced mitochondrial biogenesis; and dispel beliefs about milking muscles of lactic acid.
If you are interested in learning more about the evidence supporting the use of massage therapy in clinical practice with different populations, you can review the Massage Therapy Foundation article archives, read accepted abstracts or search Pub Med for massage therapy studies.
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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