Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
June, 2015, Vol. 15, Issue 06
Massage Therapy Can Reduce Inflammation at the Circulatory Level
By Massage Therapy Foundation Contributor
Contributed by MK Brennan, MS, RN, LMBT; Derek Austin, PT, DPT, MS, BCTMB, CSCS and April V Neufeld, BS, LMP
Massage therapy is commonly used following physical exertion to manage soreness and promote healing.Physical exercise often results in microscopic muscle injury with its associated soreness, decreased range of motion, pain, and inflammation, particularly with high force or repetitive muscle contractions. This month’s research review by the Massage Therapy Foundation explores the findings of a randomized, blinded study examining the effects of Swedish massage on exertion-induced muscle injury. Dr. Nina Franklin and her team at the University of Illinois at Chicago published their research in the Archives of Physical Medicine and Rehabilitation in 2014.
Massage therapy may be an effective treatment for exercise-induced injury and is often recommended. Recent research studies have shown that massage may contribute to a reduction of post-exercise inflammation. Following exercise, especially eccentric exercise, there can be an acute increase in inflammatory cytokines in muscle. This cytokine reaction can lead to a systemic inflammatory response in which neutrophils may be activated and result in impaired endothelial function as they adhere to vascular endothelial cells. For that reason, the authors sought to investigate the effect of massage therapy on endothelial dysfunction.
The study included 36 sedentary adults aged 18 to 40 who were divided into three groups: the exertion-induced muscle injury and massage group, the control group of exertion-induced muscle injury without massage, and a control group of massage without exertion-induced muscle injury. Only sedentary adults were included in the study, as defined by "<150 minutes of moderate physical activity per week [and] no history of resistance or aerobic training within the past six months prior to enrollment." Subjects were excluded if they had a history of cardiovascular disease, suspected collagen vascular disease, or cancer and no use of vasoactive medications. Physical and physiological characteristics such as weight and blood pressure were similar among all groups.
Study subjects were initially screened prior to the study and assessed five times before and after the intervention. Total cholesterol, high-density lipoproteins, low-density lipoproteins, and glucose were all measured in the initial screening following a 12-hour fast. The researchers also assessed heart rate, blood pressure, height, weight, and waist circumference as well as dietary intake and nutritional content.
Following the initial assessment, subjects were then tested for their baseline endothelial function. This was done by testing the brachial artery flow-mediated dilation (FMD) using ultrasound technology and a blood pressure cuff. Brachial artery diameter was measured after the cuff was inflated 50mmHG above the person’s systolic blood pressure reading and again after release of the cuff. Dilation was determined with 30-second images taken during the first, second, and third minutes after the cuff was released. Each subject’s FMD was assessed at baseline and then again at 90 minutes, 24 hours, 48 hours, and 72 hours after the intervention. Sublingual nitroglycerin was given to the subjects to induce endothelium-independent dilation of blood vessels after each FMD measurement.
Perceived muscle soreness was also assessed. Using a ranking scale of 1 (normal) to 10 (very sore), the subjects were asked to rate their perceived muscle soreness by palpation of their relaxed quadriceps muscles by an exercise professional.
The subjects randomized to one of the exertion-induced muscle injury groups performed a single bout of bilateral eccentric exercise on a leg press machine. The subjects worked up to their 1 repetition maximum, or the maximum amount of weight that they could press one time, over the course of several familiarization sets. Then, in order to induce muscle injury, subjects performed 6 to 8 sets of 10 repetitions at approximately 70 percent to 80 percent of the maximum. To emphasize eccentric muscle contraction, the researchers instructed the subjects to lower the weight under control for 5 seconds per repetition.
The massage therapy treatment used in this study was a 30-minute protocol of Swedish techniques to the muscle groups of the bilateral lower extremities. Effleurage and petrissage were used according to a well-defined massage protocol. The treatments were provided within 30 minutes after exercise for those assigned to the exercise/massage group or after rest for those assigned to the massage only group. All of the sessions were provided by the same massage therapist.
Results indicate that massage has systemic effects. The subjects who received massage on the lower extremities had significantly higher FMD measurements in the upper extremity both after exertion and after rest. One thought is that this is due to the effect on circulation through massage. The authors write, "Increased local blood flow with massage may hasten the inflammatory response by reducing the time course of neutrophil infiltration and activation, thereby protecting against neutrophil-mediated tissue damage." Reducing inflammation with massage may improve endothelial function and thus may benefit many recipients of massage therapy, since this result was also true for those who received massage after rest.
In addition to circulatory responses, modulation of the autonomic nervous system may contribute to the results observed from massage therapy. Eliciting the parasympathetic nervous system with massage can result in a decreased heart rate and blood pressure. These effects may have an impact on the brachial artery FMD, even though no changes in heart rate and blood pressure were noted in this study. The lack of any blood pressure or heart rate response following massage was viewed by the authors as one of the limitations of their study.
Further limitations include the lack of a true control group, meaning a group with neither massage therapy nor exertion-induced muscle injury. Additionally, specific differences among different sexes, races, or ethnicities were not considered as possible influences on endothelial function. One further limitation is the potential impact body mass index (BMI) may have on the effect of massage, though the authors did note that subjects in each group had similar BMI measurements. Finally, endothelium independent dilation to the nitroglycerin was not able to be tested before the exertion-induced muscle injury and/or massage due to the vasodilatory effect of the medication on blood pressure.
The implications of this study are far-reaching since massage is being used more and more for health promotion and in hospital settings. Demonstrating that massage has a positive impact on brachial artery endothelium-dependent FMD may help support the use of massage as a way to reduce exertion-induced muscle injury and hypoperfusion in some individuals with heart disease or other at-risk populations in exercise training regimens. The conclusions of this study regarding massage’s effect on endothelial function may also be beneficial for those with other physiological stressors that have vascular responses such as hypertension, wound healing, and hypoxemia.
To help massage practitioners become more comfortable with scientific research, the Massage Therapy Foundation offers courses on research literacy. Online courses include Basics of Research Literacy (8 CE hours) and Finding and Evaluating Research (3 CE hours). The AMTA 2015 National Convention in Pittsburgh, Pa. this August also offers a research track developed in partnership with the Massage Therapy Foundation. This year the research track will consist of five high caliber researchers, including Dr. Nina Cherie Franklin. Any of these options offer an excellent way to bolster your skills in reading and evaluating massage research.
Click here for more information about Massage Therapy Foundation Contributor.
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