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?
June, 2013, Vol. 13, Issue 06
Massage Helps Hospital Patients Manage Pain
By Massage Therapy Foundation Contributor
Contributed By Sandra K. Anderson, BA LMT ABT; MK Brennan, MS RN LMBT; Jolie Haun, PhD EdS LMT
The Massage Therapy Foundation is always looking for new research that is helpful for massage therapists.This month we are reporting on "The Effects of Massage Therapy on Pain Management in the Acute Care Setting," published in the March 2010 issue of the International Journal of Therapeutic Massage and Bodywork.
The authors of this publication, Adams and colleagues, suggest pain management within the acute care setting is a focus of empirical study by researchers, healthcare facilities and accreditation organizations throughout the United States. Previous studies have shown that high levels of stress and anxiety increase pain, and delay hospital patients' recovery by limiting movement and self-care activities, while also reducing quality of sleep. In the hospital setting, stress is due to factors such as excessive noise, social isolation and pain from procedures. In fact, in the acute care setting, clinical procedures are often the only time patients receive touch.
Literature indicates massage therapy is the complementary and integrative medicine (CIM) treatment most often prescribed by physicians that is beneficial without adverse effects. Because massage therapy may be effective in reducing pain through the gate control theory, as well as the relaxation response, it may also play a role in psychological healing along with physical healing. Adams and colleagues conducted this study in the acute healthcare setting to examine the impact of massage therapy on pain and well-being. To account for both psychological and physical effects, the authors included quantitative and qualitative methods.
The study recruited 65 inpatients in various hospital units, admitted between October 1, 2006 and March 31, 2007, at a hospital in a large rural area in the southwest United States. Study inclusion requirements included a physician order for massage, as well as the ability of the patient or a family member to provide consent. Additionally, feedback about the massage and return of a qualitative survey after hospital discharge were collected.
Three licensed massage therapists employed by the hospital provided massage. Each was trained in working with hospitalized or medically frail patients. The massage sessions were 15 to 45 minute sessions given to patients at bedside. The session length varied depending on the patient's energy level and availability. Techniques used included effleurage, petrissage, acupressure, craniosacral therapy, cross-fiber friction and pressure point therapy. The head, neck, shoulders, back and feet were areas most commonly massaged depending on the patient's needs, with patients either supine or in side-lying position. Contraindication for massage sites included areas of injury, surgery or intravenous lines.
Patients indicated their levels of pain before and after receiving massage using a visual analog scale (VAS). The VAS consists of a horizontal line with "0" at 1 end and "10" at the other, with 0 indicating no pain and 10 indicating severe pain. At the completion of the patient's last session, a survey was given asking about length of hospital stay, number of massages received and the impact of the massage on overall pain levels, emotional well-being, ability to move, ability to participate in therapies, relaxation, ability to sleep and recovery. Additionally, participants were asked if they thought massage therapy had an effect on their need for pain medication, how long the effects of the massage had lasted and whether they planned to continue using massage therapy as part of their healing process. An open-ended inquiry at the end of the survey encouraged participants to comment freely about massage. These results, along with demographic data, number of massage sessions and nursing comments were also analyzed.
Of the initial 65 participants, 53 completed the research project. Most participants received one massage, many received two to three massages, and a few received more than three massages. Sessions lasted between 15 and 45 minutes with most being about 30 minutes. The pre-massage pain levels had a mean score of 5.18 on the VAS and the post-massage mean score was 2.33, indicating that the pain level decreased by more than half. The effects of the massage lasted one to four hours for most participants. Some felt they lasted four to eight hours and a few felt they lasted anywhere from eight to over 24 hours. No negative effects from the massage were reported by the participants. The results of the survey included significant reduction in overall pain and need for pain medication as well as an increase in emotional well-being, relaxation and ability to sleep. Over two-thirds of the participants said they planned to continue using massage therapy as part of their healing process.
The results of the study are promising. According to the article, "The fact that patients throughout the various hospital units, with a wide variety of pre-massage pain levels, experienced relaxation through massage therapy indicates the true potential for massage to support healing for hospitalized patients." Additionally, massage therapy relieved the sense of isolation the patients felt. Because so many participants reported increased emotional well-being, the authors suggest it is possible it could be due to the need for compassionate human touch.
Study limitations included only participation by those adults with health status that allowed them to receive massage and to complete the study paperwork. Patients whose energy or pain levels prevented them from participating may have provided information indicating other results. Another limitation is that physiological indicators of pain such as heart rate, blood pressure and oxygen levels were not collected. Finally, a minimal sample size was used with no control group; mainly due to the additional cost this would have incurred.
As researchers in the field continue to pursue understanding the role of massage in pain management, massage therapists can leverage these research findings to promote the need for skilled touch in hospitals to help patients heal. Adams and colleagues suggest, "The further integration of CIM therapies such as massage into the hospital offers the possibility to improve the experience for patients who face physical, psychological, and social challenges in an unfamiliar environment."
As health care systems continue to transform, it is possible that massage therapy will be more widely recognized as essential for patients in the acute care setting. Moving forward massage therapists can reference this work and other research on pain management in the healthcare setting to support the use of massage in the clinical care environment. To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant summaries, or search PubMed for massage therapy studies.
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