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, 2015, Vol. 15, Issue 07
Have Chronic Headaches? Get a Massage
By Massage Therapy Foundation Contributor
Contributed by Jolie Haun PhD, EdS, LMT; Beth Barberree BA, RMT; Derek Austin, PT, DPT, MS, BCTMB, CSCS
Chronic headaches can be debilitating. Though it seems intuitive that massage therapy may be an effective treatment for chronic headaches, little research has been conducted to validate the use of massage therapy for managing chronic headaches.In this month's research review provided by the Massage Therapy Foundation, we take a closer look at one research team's attempt to examine massage therapy as a nonpharmacological approach to treating chronic headaches. Quinn and colleagues conducted a pilot study with individuals to "determine whether a regimented massage therapy program could have beneficial effects on the frequency, intensity, and duration of pain associated with chronic tension headache."
Though the cause of chronic headaches is unclear, evidence cited by Quinn and colleagues suggests that these headaches may originate from sustained contraction of head and neck muscles, resulting in local nutrient deficiencies due to ischemia. Ischemia can generate trigger points within muscles, which can remain contracted for an extended period of time and collectively result in a tension headache. Because the activation of myofascial trigger points has been implicated as a cause of headaches, the authors focused on the role of trigger points in treatment of chronic headaches with the hypothesis that reducing trigger point pain may result in decreased headache pain. Quinn and colleagues suggest massage treatments that aim to increase blood flow to tissue may reduce the activity of a trigger point. Thus, it is possible that headaches that have this origin may be reduced with massage therapy.
Ten chronic tension headache sufferers participated in an 8-week study beginning with baseline headache measures recorded for the first 4 weeks that allowed each participant to serve as his or her own control. In the remaining 4 weeks, the participants received 30-minute massage therapy sessions twice a week. Each participant was asked to complete a nightly logbook in which they recorded their number of headaches, intensity of most severe headache, and duration of longest headache for each day. Headache intensity was measured using a visual analog scale (0–100mm; 0 = no pain; 100 = most pain).
The treatments were directed toward neck and shoulder muscles, specifically the "upper trapezius, sternocleidomastoid, suboccipital, splenius capitis, levator scapulae, and temporalis." The massage protocol consisted of six distinct phases within the 30-minute time frame: preparatory tissue warm-up; myofascial release; axial cervical traction; trigger point therapy procedure; facilitated stretching techniques; and session closure. The full article provides complete detail of each of these phases of the treatment protocol.
Due to incomplete data, data was analyzed for four of the original ten participants. Within-subject analyses (i.e. participants are their own control) indicated headache frequency was significantly reduced within the first week of the massage protocol, which held for the remainder of the study. Though not statistically significant, duration of headaches decreased during the massage treatment period (p = .058). Headache intensity was unaffected by massage treatments.
Anecdotally, on four occasions when a participant began the massage session with a headache, the headache was alleviated by the end of the 30-minute treatment. This suggests that massage administered during a headache episode might result in immediate beneficial effects and that patients should be instructed in appropriate self-massage techniques.
Overall, Quinn and colleagues suggest, "The muscle-specific massage therapy technique used in this study has the potential to be a functional, nonpharmacological intervention for reducing the incidence of chronic tension headache." Notably, they suggest the protocol was successful in reducing pain associated with chronic tension headache, but they cannot state the massage portion directed at relieving trigger point activity was the causative agent rather than the stretching or relaxation techniques.
Implications for Research and Practice
The most impressive aspect of this study is the highly standardized massage treatment protocol. The authors recognize that the protocol complicates the question of which component of the treatment was most effective. While this research does not clarify what is the most effective massage technique for headaches, the overall protocol was shown to be effective at treating chronic headache symptoms. The authors suggest that treatment protocols validated for their efficacy can be later examined to determine which aspects of massage have a clinically significant therapeutic contribution.
Though this pilot study is unique in its examination of chronic headaches with a highly standardized protocol, its usefulness is greatly limited by its extremely small sample size. With only four subjects used for analysis, there is almost no power – proof of validity – in the findings. Though this may sound discouraging at first, it is important to realize that small studies such as this one provide foundational knowledge to determine if a large scale study is warranted. In the case of this pilot study, data indicate that the use of massage therapy as a nonpharmacological treatment for chronic headaches is worthy of further exploration.
Practitioners now have a data to support the recommendation of massage therapy for the treatment of clients with chronic headache pain. Furthermore, maybe the greatest contribution of this publication is the detailed protocol. Massage and bodywork practitioners may find the detailed protocol used in this study useful for delivering a standardized treatment in their own practice. This study, and others like it, continue to support the ever-expanding scope of conditions for which massage therapy can be delivered as an effective nonpharmacological adjunctive treatment to alleviate pain and suffering.
Are you interested in learning more about the uses of massage therapy to alleviate pain and promote wellness? To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation review article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
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