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.
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?
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."
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.
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?
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.
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.
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).
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 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.
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.
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.
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."
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.
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 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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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.
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.
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.
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.
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.
August, 2015, Vol. 15, Issue 08
Does Massage Therapy Lower Blood Pressure? A Literature Review
By Massage Therapy Foundation Contributor
Contributed by Derek R. Austin, PT, DPT, MS, BCTMB, CSCS, Renee Stenbjorn, BS, MPA, LMT, April Neufeld BS, LMP
If you did not already have enough reasons to get a stress-busting, mood-lifting, pain-relieving massage, this month's Massage Therapy Foundation research review details another great benefit of massage therapy.Promising research suggests that massage therapy can lower blood pressure. The study of the month explores the following questions: Is massage as effective as antihypertensive drugs to lower blood pressure? Does adding massage to antihypertensive drugs lower blood pressure further? The answer to these questions may be yes.
A rigorous analysis of research articles published on the topic of massage and hypertension was published in the Journal of Human Hypertension during 2014. Dr. Xing Jiang Xiong and his colleagues published the article with the title, "Massage therapy for essential hypertension: a systematic review." A systematic review aims to provide an exhaustive summary of current literature relevant to a research question. The question under study is how effective and safe is massage therapy for essential hypertension, meaning hypertension that has no known cause. The authors note that hypertension is the leading risk factor for mortality worldwide. Preliminary research has shown that complementary medicine approaches such as yoga, qigong, Tai Chi, acupuncture, and moxibustion may lower blood pressure. The researchers performed the first systematic review of randomized clinical trials to determine whether massage can combat hypertension.
The authors searched a large number of databases for randomized controlled trials published in English or Chinese. To be included, a study had to involve massage as an intervention for participants diagnosed with essential hypertension. The massage intervention had to be compared to a control group not receiving massage. Treatment duration of the analyzed studies ranged from a minimum of 10 days up to 1 year. Studies were excluded if the patients involved had a history of heart attack, kidney failure, liver failure, arrhythmia, or heart failure.
A total of 24 articles were selected and then analyzed for their risk of bias. The studies included a total of 1,962 patients with essential hypertension. Treatment groups included either massage alone or massage combined with antihypertensive drugs. Massage interventions were widely variable between studies, ranging from 1 hour per week to 45 minutes each day. Control groups received no intervention or antihypertensive drugs. Most studies were determined to be of generally poor methodological quality; for example, only 3 of the 24 studies included follow-up. The authors developed four categories of research, each compiled and analyzed using the process called meta-analysis. This statistical process comprises contrasting and combining results from different studies in the hope of identifying patterns among study results. Due to the statistical nature of this approach, only trials with quantitative data of blood pressure measurements could be included in the analysis.
The first group, of five studies, compared massage with no intervention. Only three of these studies provided blood pressure data in numerical terms. The researchers combined the results of these three trials and performed a meta-analysis to determine significance. The meta-analysis indicated no significant for massage in lowering blood pressure compared to no intervention.
The second group, of nine trials, compared massage to antihypertensive drugs, and six of these provided figures appropriate for meta-analysis. The meta-analysis showed that massage lowers systolic blood pressure better than antihypertensive drugs by an average of 3.5 mm Hg (p=0.0004). There was no significant effect on lowering diastolic blood pressure (p=0.14).
The third group, of eleven trials, compared antihypertensive drugs to massage combined with antihypertensive drugs, and six provided numerical values appropriate for meta-analysis. The meta-analysis indicated that massage plus antihypertensive drugs was superior compared to the antihypertensive drugs alone. Adding massage to antihypertensive drugs reduced systolic blood pressure by an average of 6.9 mm Hg (p=0.0001) and diastolic blood pressure by an average of 3.6 mm Hg (p=0.005). A meta-analysis of four of the other trials, which summarized the effect of massage based on grades of efficacy, also indicated that massage combined with antihypertensive drugs lowered blood pressure better than antihypertensive drugs alone (p=0.0002).
The final group, of five trials, reported adverse effects, and the authors' analysis showed that massage was potentially safer than antihypertensive drugs. While this conclusion is limited by the small number of trials reporting adverse events, massage may provide an effective alternative for those who suffer serious side effects from antihypertensive drugs.
The authors conclude that combining massage with antihypertensive drugs may be more effective than using just antihypertensive drugs to lower blood pressure. They also conclude that massage alone appears beneficial for reducing systolic blood pressure when compared with antihypertensive drugs.
One of the main strengths of this article is the thoroughness of its search for research articles and its inclusion of research articles published in either Chinese or English. Including Chinese language articles greatly expanded the number of articles included in the review, as massage is frequently studied in China. Other strengths include the rigorous assessment of methodological quality and the use of meta-analysis to combine published research data.
The authors report that the primary weakness of their review is the poor quality of the original studies. They note that many of the included trials did not report randomization procedures, concealment of allocated groups, whether individuals dropped out, pre-trial estimation of sample size. The most important weakness of the included studies was the lack of follow-up; it remains unclear whether massage would continue to have any effects on blood pressure beyond the end of the treatment period.
Due to the wide use and acceptance of massage therapy in general, massage could be an important adjunct therapy for treating hypertension in the primary care setting. Further research can help determine exactly how effective massage is in lowering blood pressure. A cost-efficacy analysis would also be useful, since essential hypertension is tremendously common, and yet many effective antihypertensive drugs are quite expensive. Future research will also help determine the most effective dose of massage and how massage interacts with different classes of antihypertensive drugs.
Not sure you understand the difference between a confidence interval, p-value, t-test, and ANOVA? MTF offers a course on the Basics of Research Literacy that teaches massage therapists and educators how to incorporate principles of research literacy into your practice and teaching. In this online, 8-hour, NCBTMB-approved workshop, you will be introduced to basic research vocabulary and concepts. Once you understand the terminology, you will learn how to use databases to look up research, evaluate the validity of published research articles, and apply research findings to improve massage outcomes. Your massage therapy practice can be improved by becoming more research literate.
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.
Click here for more information about Massage Therapy Foundation Contributor.
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