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?
July, 2012, Vol. 12, Issue 07
Massage Therapy Reduces Hand Pain
By Massage Therapy Foundation Contributor
Contributed by April Neufeld, BS, LMT; Sandra K. Anderson, BA, LMT, ABT; Karen T. Boulanger, PhD, CMT
Research on the effects of massage therapy for various conditions is increasing. The Massage Therapy Foundation is invested in reviewing research on how massage therapy affects these conditions, especially those that are musculoskeletal.As noted in the June article, "Recent Research Provides Evidence of How Massage Therapy Heals" by Jolie Haun, "musculoskeletal problems impact daily function and quality of life, so it is important to validate..." massage therapy treatments. Complementary Therapies in Clinical Practice has published a study conducted at the University of Miami School of Medicine in which Tiffany Field and colleagues examined how massage therapy affects hand pain.
The researchers recruited 46 participants from the medical school who complained of hand pain regardless of the cause, such as arthritis or carpal tunnel syndrome. Most noted that their hand pain was related to computer use. The participants averaged 50 years of age, were of middle socioeconomic status, and were Hispanic, Caucasian and African-American. They were randomly assigned to the massage therapy group or the control group.
The massage therapy group received 15 minutes of hand massage from a massage therapist once a week for four weeks. The hand massage procedure included four techniques: stroking, milking, friction and skin rolling. They were also taught home massage, although this procedure was not described. Both massage and control participants completed assessments before and after their first and last sessions. Assessments included pain (0-10 Visual Analog Scale), grip strength, the State Anxiety Inventory, depression (the Profile of Mood States) and the Sleep Disturbances Scale. The control group received no massage but was given the hand massage instructions after the final assessment.
After four weeks of treatment, Field and colleagues reported that the massage group had decreased pain, increased grip strength, decreased anxiety and decreased depression. The researchers concluded, "These findings are consistent with data on massage therapy with pain syndromes and especially with results from our carpal tunnel syndrome study in which pain was also decreased and grip strength increased by massage therapy. The psychological changes following hand massage in the present study, including the reduction in depressed mood and anxiety are indications of relaxation effects."
This is excellent news for massage therapy practitioners because it helps us understand that patients may feel significant benefits even after treatments as short as 15 minutes in length. Nonetheless, this paper had its limitations, mostly focused on the lack of detail provided. Field and colleagues reported, "Moderate pressure appears to be critical for these effects," and "Other studies on hand massage also suggest the importance of pressure." However, there are no indications in this study as to if and how pressure was measured. Methods for measuring pressure should have been included or reasons should have been given for not measuring the moderate pressure outlined in the procedures description.
The researchers listed the use of four different techniques: stroking, milking, friction and skin rolling. But in order for a practitioner to duplicate the results in clinical practice, the details of the massage procedure should have included: how many times each technique is repeated, amount of pressure used, duration of each technique and order of technique application. However, Field and colleagues did make a point to describe the hand position of the practitioner and the position of the subject's arm for each technique; this detail is missing from many research studies on massage therapy. Another example of poor procedural description involves the control group. What did the participants in control group do for the 15 minutes between the before and after assessments? We need to be able to evaluate exactly to what massage therapy is being compared.
A third example of needed detail involves the explanation of the procedure of home hand massage that was taught to the participants. The study only states, "They [the participants] were also taught the hand massage." Specificity regarding the method of instruction, including detailed descriptions of the self-massage and recommended duration, are needed to evaluate the internal validity of the study. Additionally, the authors stated, "The participants were asked to keep a record of their massaging themselves daily and were called on a weekly basis to check on their ability to schedule daily sessions." However, whether the self-massage was performed correctly and consistently was not reported. A future study comparing the effects of massage vs. massage plus home self-massage, would help us to understand any added benefit of having our clients perform self-care.
We agree with the research implication that, "Further research is needed to explore [the] potential mechanisms [of massage therapy]." Studies like these do help support the work that individual massage therapists perform daily with their clients. Practitioners who want more information on the mechanisms of massage therapy and successful treatment methods can go to the list of commonly used PubMed search terms on the Massage Therapy Foundation website.
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