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.
September, 2012, Vol. 12, Issue 09
Research Shows Acupressure Reduces Chronic Neck Pain
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, MS, CMT, April Neufeld, BS, LMT, NCTMB, Sandra K. Anderson, BA, LMT, ABT
In this month's Massage Therapy Foundation Research Column, we are taking a critical look at the effects of acupressure.Widely accepted in Japan, many Americans are unaware of the many benefits of manual acupressure. It is a noninvasive technique in which, instead of needles, the practitioner's fingers press on traditional acupuncture points. Acupressure has been shown to be calming, relieve pain and induce relaxation.
Lead author Dr. Takako Matsubara, PT, an Associate Professor in the Department of Rehabilitation at Nihon Fukushi University, Japan, and his colleagues studied an area of interest to most massage therapists - chronic neck pain. Their research article, "Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain" was published in the journal Evidence-Based Complementary and Alternative Medicine.
Matsubara and colleagues randomly allocated 33 female subjects (n=33) to three groups. Group one subjects received acupressure at three tender points consistent with local acupuncture points (LP) "Jianjing" (GB 21), "Jianwaishu" (SI 14), and "Jianzhongshu" (SI 15). These local acupuncture points align with tender points in the trapezius muscle with acupressure (see Figure 1). Group two subjects received acupressure at three distal acupuncture points (DP); in this study, distal meant points distal to the location of the neck pain. These points were "Hegu" (LI 4), "Shousanli" (LI 10), and "Quchi" (LI 11). These distal acupuncture points are traditionally associated with neck-shoulder-arm disorders in Chinese/Japanese traditional medicine (see Figure 2). A third group, termed the control, received no acupressure at all.
Subjects were assessed about pain intensity using a verbal rating scale (VRS); the intensity of neck pain or stiffness was evaluated on a numerical scale from 0 to 3 (0: no pain, 1: mild pain, 2: moderate pain, and 3: severe pain). Subjects were also assessed about pain-related disability using the Neck Disability Index (NDI), pain-related anxiety using State-Trait Anxiety Inventory-I (STAI-I), and about muscle hardness (MH) on bilateral trapezius muscles. Pain-associated stress was assessed using salivary alpha-amylase (sAA) activity and heart rate variability (HRV) to determine parasympathetic and sympathetic activity. Low electrical frequency fluctuations in heart are indicators of sympathetic and parasympathetic activity, and high electrical frequency fluctuations are indicators of parasympathetic activity.
Parasympathetic and sympathetic activity in the test subjects was measured because several previous reports showed that the effects of acupuncture and acupressure are due to influencing the autonomic nervous system. The acupressure treatment lasted about ten minutes per session. Three sets of acupressure were applied with thumb pressure in a rotary fashion at 20-25 cycles per minutes for 30 seconds on each of the three assigned local or distal points on the right side of the subject's body; the same procedure was followed on the left side. The same investigator applied acupressure in all cases.
There were no significant differences among the three groups pre-treatment. There were no measured changes in pain, stiffness or autonomic activity in the control group throughout the study. However, in the LP and DP groups, the VRS, STAI-I, and MH significantly decreased immediately following treatment, indicating a decrease in pain and stiffness. The next day, the NDI was significantly lower compared with pre-treatment in the LP and DP groups. The subjects' heart rates significantly decreased and high frequency component of HRV significantly increased, indicating a parasympathetic autonomic response, only in the LP group.
This study is notable for its use of both local and distal acupressure therapy. Both appear to be effective in relieving chronic neck pain in only a single ten minute session, with significant next-day effects on the NDI, a validated measure of pain-related disability. Interestingly, reduction in pain in the LP and DP groups as assessed by the VRS were not significantly different from the control group at the one day follow-up.
This study by Matsubara et al., is limited by the lack of longer term follow-up beyond one day, the small sample size of 11 participants per group, and the inherent inability to blind the practitioner and participants from knowing which treatment was administered or received. As a primary measurement of pain intensity, the authors could have used a 10-cm visual analog scale (VAS), which may have been more sensitive to differences between groups at the one-day follow-up. Also, the addition of a "sham acupressure" group would have helped rule out the possibility of placebo effects or effects stemming from touch, not acupressure per se. Finally, the sample used in this study only included women; men might respond differently to acupressure applied to the points used in this study.
In conclusion, acupressure to both local and distal acupuncture points significantly reduces chronic neck pain in this randomized, controlled trial. The researchers point out that most clinicians combine local and distal acupuncture points in clinical practice, and they suggest that further research should assess combinatorial effects. This Open Access journal article is freely available in PubMedCentral at www.ncbi.nlm.nih.gov/pmc/articles/PMC2952311/.
Author's Note: For additional research about accupressure, please see Robinson et al.'s 2011 Open Access review entitled, "The Evidence for Shiatsu: a systematic review of Shiatsu and acupressure" published in BMC Complementary & Alternative Medicine and available at www.biomedcentral.com.proxy.library.vcu.edu/1472-6882/11/88.
Editor's note: For more information about massage therapy research, visit the Massage Therapy Foundation at www.massagetherapyfoundation.org.
Click here for more information about Massage Therapy Foundation Contributor.
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