Differentiating Qi Under the Needle
In the marketplace, we hear of dry needling being talked about more and more. As professional practitioners of Chinese medicine and acupuncture, it is important that we do not lose sight of our passion, purpose and belief in what we are doing, both for the sake of preserving the full practice of acupuncture and Chinese medicine, and for the sake of our patients.
Give the Overtraining Injury Epidemic Your Full Attention
Athletes are known for their competitiveness, their drive. That's why it's no surprise to learn that research published in the Journal of Sports Medicine has found a large majority – as many as 60 percent – of athletes regularly "overreach" or "overtrain" by working their bodies either too often or too hard.
Extraordinary Chinese Medicine
The very fact that we exist as complex, multidimensional beings at this manifest level, and get to experience—through our senses—others, the world around us, as well as our own selves, is a miracle.
News in Brief
Dr. James Badge, former president of the National Board of Chiropractic Examiners who, among other accomplishments, played a key role in the development of the board's Practice Analysis of Chiropractic (a report issued every five years and based on a survey of the profession), passed away on Nov. 7, 2018.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 3)
Keep the neck in retraction by pulling the chin back toward the spine. Some rehab instructors used to refer to this as "packing the neck." I really emphasize decompressing the head away.
Acupuncture: More Effective in an Integrated Health Care System?
Acupuncture has traditionally been used in the primary care setting as a supplemental stream of care for patients. Patients can seek out or be referred to outside acupuncture providers based on their patients need.
Repave the Road to Financial Ease With Cash Profit Centers
Remember the adage, "Don't put all your eggs in one basket?" Well, that's what you do when you count 100 percent on insurance reimbursement to sustain your practice.
The NCCIH is Seeking Acupuncture Researchers for a Chronic Pain RCT
The National Center for Complementary and Integrative Health (NCCIH) in partnership with the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Medicare & Medicaid Services (CMS) is seeking acupuncturists for a new Funding Opportunity Announcement (FOA)—a Randomized Control Trial (RCT).
Updates to ICD10, Specifically for Myalgia (Muscle Pain)
Are there updates to ICD10? I attempted to enter M79.1 for myalgia (muscle pain) and it was rejected by my clearing house as being invalid. What is the new code for myalgia?
Diverting the Crisis Stages of Life: Yang Wei Mai and the Necessity of Change
One of the biggest struggles in which we help our patients is the process of change. I often hear two common questions, "I'm unhappy. How can I change?" and "My life is changing, how do I deal with it?"
How to Handle the "F" Word
Have you ever been fired? It's terrible, nasty business, especially if you're on the receiving end. Most people are doing their best, and when they're terminated, they can become furious. If it's handled incorrectly, some people may even try to sue you for doing what's best for your practice.
Calming the Disturbed Meridians: A Way to Treat "Phantom" Pain
Margot J. was advised by her oncologist to talk to a psychiatrist about her post-mastectomy phantom pain. Instead, her friends sent her to me. Interesting situation—she'd recently experienced a double mastectomy and still felt intense pain in the spaces once occupied by her breasts.
Quick SI Assessment: 8 Tests
The lower back is a generator for a number of types of pain. As you know, it involves several different articulations: the lumbar spine with vertebral bodies, discs and facets; the sacroiliac joints; and the lumbosacral junction.
Using Tuina in the Acupuncture Clinic
The beneficial effects of touch are apparent to anyone who has stubbed their toe on an errant piece of living room furniture – after the initial angrily shouted expletive, we grab the offending digit in our hands because we know that it will help the pain.
BCBS of Tennessee Takes a Stance for Acupuncture
BlueCross BlueShield (BCBS) of Tennessee, the state's largest insurance provider, is starting the year off with some significant changes—they have dropped Oxycontin from their list of covered prescriptions and added acupuncture coverage.
Digital Dilemma: Issues With Post-Processing Collimation
With digital radiography, we are now able to electronically collimate images after acquisition. This may seem convenient, but there are also downsides to this technique.
The Back Squat: More Than a Training Exercise
The squat movement pattern is not only essential for ADLs; it is considered a foundational exercise for strength, resiliency and sport performance.
West Hartford Group Charts a Possible Course for Chiropractic's Future
The West Hartford Group, incorporated in 2006, is "a think tank dedicated to the acquisition of social, cultural and professional authority for the chiropractic profession, where the doctor of chiropractic (i.e., chiropractic physician in some jurisdictions) serves within the mainstream health care delivery system as a patient-centered, evidence-based, non-surgical, primary spine care health care professional." The WHG Board of Directors recently approved the following resolution it suggests as "one possible future for the chiropractic profession."
Time to End the Medicare Madness
Medicare's coverage of only a single chiropractic service (manual manipulation of the spine to correct a subluxation) may change soon if H.R. 7157, the Chiropractic Patients' Freedom of Choice Act of 2018, is approved:
The Four Needle Technique: A Follow-Up to the Husband/Wife Imbalance
In my previous article on the Husband/Wife Imbalance (Nov 2018), I made mention that successful clearing of this lethal block may require treatment stronger than the first two protocols explained.
Quantum Physics Research and the Ancient Roots of Acupuncture
Acupuncturists and quantum physicists have a lot in common. They are both working in fields that are rooted in an inter-connected universe. According to traditional Taoist cosmology everything in the universe is connected to everything else – nothing is separate.
The #1 Essential Element of Every Patient's Care Plan
The #1 Essential Element of Every Patient's Care Plan
The Truth About Malpractice Claims Against DCs (Pt. 2)
I save (print and scan in file) all emails and texts to and from patients regarding any recommendations of care, follow through of therapies, and especially urgent or emergency care recommendations.
Turn Back the Clock With Nutrition
The anti-aging market is booming because, well, who doesn't want to look young, healthy and vibrant for as long as possible? And while there are many anti-aging products and systems marketed to the public, few people realize the most effective way to slow down the visible passage of time is to give the body the nutrients it needs to be truly healthy.
Make Room for New Kids on the Bus
Kids who were never "fortunate" enough to ride the bus to school actually may have missed out on many lessons related to the social challenges they would face later in life. One of the most classic might be called "The New Kid on the Crowded Bus."
2019 Practice Trends: How Does Your Practice Compare?
In order to better understand trends within the chiropractic profession, we periodically survey DCs throughout the U.S. and share the findings of our Expanding Chiropractic Practice Survey for your review and reflection.
Learn to Speak the Language of Personal Injury
For many providers, personal-injury cases and working within the med-legal arena can often be a confusing and frustrating endeavor. After all, for the majority, personal injury is a niche.
How H.R. 302 (Travel to Treat) Became Law: Behind the Scenes
Sports chiropractic has created opportunities to put our profession on a pedestal. However, as chiropractors have stood on the pedestal with the success of their athletes, they have risked everything and put their licenses on the line when knowingly or unwittingly crossing state lines where travel to treat is not allowed. H.R. 302, signed into law in October 2018, mitigates some of that risk.
August, 2012, Vol. 12, Issue 08
How Much Massage Therapy is Enough?
By Massage Therapy Foundation Contributor
Contributed by Karen T. Boulanger, PhD, CMT; Jolie Haun, PhD, LMT; Derek R. Austin, MS, CMT
This month's research summary brought to you by the Massage Therapy Foundation features a study completed by Adam Perlman and colleagues entitled, "Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial." There are three things that we really like about this published research.First, it calls attention to a condition that most massage therapists address frequently. Second, it is the first study that looked at dose to inform how much massage is needed to achieve good outcomes for this condition. And third, it resulted in a massage protocol that was respectful of the individualized nature of practice.
Like many degenerative joint diseases, osteoarthritis (OA) of the knee is painful and limits function. Typical drug therapies are not always helpful and have unpleasant side effects. Six years ago, Dr. Perlman and his team reported the results of a pilot study that offered massage therapy as a feasible, safe and potentially effective treatment for the 27 million Americans that suffer from this condition. The purpose of the current study was to define the "optimal dose" of massage therapy for OA. Once determined, the optimal dose can be used in a more sophisticated study to expand on the current findings.
Participants in the study included 125 adults at least 35 years old with radiographically confirmed OA of the knee and pain rated between 4 and 9 on a 10-point visual analog scale. Along with a wait list control group (usual care), participants were randomized to one of four regimens in which time and frequency (dose) of massage varied:
Swedish massage was provided by licensed massage therapists who provided input to develop 30- and 60-minute full body massage protocols specifically for OA of the knee. Although the protocol specified the percentage of time allotted for each body region, the order of the application was flexible to accommodate practitioner and patient preferences. Outcomes were assessed at baseline and at 8, 16 and 24 weeks. Measurements included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), which assesses pain, function and joint stiffness; a visual analog scale (VAS) for pain; range of motion (ROM); and the amount of time needed to walk 50 feet.
After eight weeks of massage, there were significant changes in WOMAC global scores between the usual care group and the groups that received 60 minutes of massage, but there were no significant differences between the massage groups. There were also significant differences in the WOMAC pain and function subscales and VAS scores between usual care and the 60-minute doses. However, there were no significant between-group differences in the WOMAC stiffness subscale and time to walk 50 feet. ROM improved significantly only in the group that received the highest dose of massage (Group 4).
A dose-response curve was constructed using the WOMAC global scores after eight weeks. It demonstrated that as minutes of massage increased, improvement also increased, plateauing at the 480-minute dose. The optimal dose of massage to improve symptoms of OA of the knee was revealed to be 60 minutes once a week. This result is consistent with the results of their previous pilot study. Although massage ended after eight weeks, significant improvements in WOMAC global scores were observed in all massage groups after 16 and 24 weeks compared to baseline. This improvement was not observed in the usual care group. In addition, there were significant improvements in the WOMAC pain and function subscales in the groups receiving the three highest doses of massage after 16 and 24 weeks compared to baseline.
The National Center for Complementary and Alternative Medicine (NCCAM) has awarded Perlman and colleagues additional funds to continue their exploration of the efficacy of massage for osteoarthritis of the knee. Between-group differences after 16 and 24 weeks may be uncovered with larger sample sizes in their next study. Comparisons of massage to light touch, biological mechanisms (biomarkers) and cost effectiveness will also be explored in their next multi-site trial. The results of this study, particularly the optimal dose of massage, 60 minutes once weekly, are relevant to improving treatment for OA of the knee. Massage therapists can use these findings to support the effectiveness of massage to treat OA of the knee, and for making treatment recommendations based on time and frequency.
These findings also support the notion that the time and frequency of massage treatments is of significance, suggesting more studies are needed to inform the dose of massage for other conditions. Because this study was funded by NCCAM, the full text article is available at no cost to the public. This free full text includes the actual massage protocols used for the treatment of OA. If you are curious to see what other projects NCCAM is funding, you can visit http://nccam.nih.gov/research/extramural/awards and type "massage" in the "term search" box.
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