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.
September, 2015, Vol. 15, Issue 09
Massage Brings Pain Relief in Acute Care Setting
By Massage Therapy Foundation Contributor
Contributed by Renee Stenbjorn, BS, MPA, LMT; Jolie Haun, PhD, EdS, LMT; MK Brennan MS, RN, ACM, LMBT
Hospitalizations are often necessary for those who are ill, having a baby, or requiring lifesaving procedures.While the patient care received is intended to enhance health and ensure survival of critical events, it can come at a cost. Some of the challenging aspects of hospitalization include pain, stress, anxiety, sleeplessness and social isolation. Adams and colleagues, the authors of "The Effects of Massage Therapy on Pain Management in the Acute Care Setting" published in the International Journal of Therapeutic Massage Bodywork, address these issues and detail five previous studies on the topic of massage benefits for patients. Among these studies, established benefits include a decrease in pain and the need for medication, lowered stress levels, improved sleep, as well as decreased anxiety and depression.
Adams et al., describe their study as an attempt to answer the question, "does the use of massage therapy in an inpatient setting improve patient perception of pain management?" Their study focused on the perception of pain management, in addition to the analysis of pain levels and medication usage. Their interest lied in the patient's quality of experience and psychological healing, the "personal experience of the transcendence of suffering." They proposed that such healing is very personal, with different meaning for different people. To study these inner aspects of healing, they used a mixed methods approach, meaning they blended aspects of qualitative and quantitative measures in hopes of uncovering valuable insights into the effectiveness of the intervention.
Most medical research focuses on quantitative methods of analysis. This process means that all aspects of care are reduced to numerical values for the benefit of statistical analysis. The patient's experience is quantified on a visual analog pain scale or by the number of pain medications and/or dosages. While such numerical values allow researchers to make easy comparisons between patient behaviors, it does not address an understanding of the patient's inner world. Qualitative methods are considered more difficult to compare and are less commonly used in trials on pain and medication use. However, there is a trend to reconsider such data as it is valuable for understanding the psychological impact of interventions. In this case, the question is, "did massage have an impact on the sense of healing for the patient?"
Adams et al., recruited 65 inpatients to participate in their study in a nonprofit community hospital serving a large rural area of northern Arizona. All participants had physician's orders for massage therapy, were able to give consent and provide data. The massage sessions were provided by massage therapists employed by the hospital who had specialized training and experience with medically fragile patients. Each massage was 15 to 45 minutes long and the modalities used included Swedish massage, acupressure and craniosacral therapy. Massage was most commonly applied to the head, neck, shoulders, back and feet. Lightly scented or unscented lotion was offered to the patients, as well as relaxing music.
The quantitative data collected included Visual Analog Scales for pain using a scale of 0 to 10, as well as the effect of the massage on pain, sleep and relaxation through surveys provided to the patients. The survey and VAS information were collected before and after the massages. Additionally, the number of massages each patient received and the number of days of the hospital stay was recorded. The qualitative data came from comments found in the nursing charts as well as open ended questions on a post-hospitalization survey that asked patients to comment on their massage experience.
Fifty-three patients completed the research study. Pain levels significantly decreased from an average of 5.18 before the massage, to 2.33 after massage suggesting that the massage was associated with the patients' decrease in reported pain levels. For most patients, the decease in pain was experienced for one to four hours after massage. Some participants reported feeling the decrease for up to eight hours, while seven participants reported feeling the effects for 24 hours. Sixty-seven percent of the participants reported they planned to continue to use massage as part of their healing process. Participants perceived that massage decreased their overall pain levels and need for pain medications, and improved emotional well-being, sense of relaxation, and contributed to a faster recovery. No participants reported feeling massage had a negative effect on their recovery.
Grounded theory was used to analyze the qualitative data. The authors describe this theory as a method for allowing data themes to emerge and then identify categories, and look for interrelationships between those categories. Forty-five participants returned their post hospitalization surveys. Several themes emerged, including benefits for pain management, improvement in sleep and relaxation, emotional well-being and healing. The primary theme among the qualitative data was "massage therapy promotes recovery." One example of qualitative feedback from a specific patient was this quote: "After three days in the hospital I was suffering a migraine, nausea, and a lot of body pain. After the massage my headache was lessened and my body pain was greatly reduced." Additionally, notes from nursing reports included comments, such as "patient reports relaxation and pain relief after massage, slept for three hours." Fifty-two percent of patients reported needing less pain medication after the massage; 98% of patients reported increased feelings of relaxation following their massage. Comments about the positive effect of pain relief on sleep were very common.
There have been many studies evaluating the effects of massage for hospitalized patients; all showing great benefits such as those highlighted in this study. Previous studies primarily focused on one type of patient in one location in the hospital, such as oncology patients. This study deliberately took a wider view of hospitalized patients with the aim of showing the benefits of massage extend to all wards of the hospital. Consistent with previous research, this study showed a significant decrease in pain levels after receiving massage.
Though this study provides compelling evidence for the use of massage to reduce pain and improve the experience of recovery in the acute care setting, some limitations of this study should be noted. First, there was also no control group in this study due to issues of funding. Second, the sample size limits power of findings. Third, this study included patients who were stable enough to fill out paperwork and give feedback; the authors suggest that patients who were less medically stable might not benefit so greatly from massage. Future research should include a larger sample, with a control group. The authors also suggest subsequent studies should be conducted to collect physiological data such as heart rate, blood pressure and oxygen levels which was not done in this study.
These findings support the use of massage therapy for patients to promote pain relief and relaxation, and aid the healing process in the acute care setting. This research contributes compelling evidence that supports a growing body of knowledge and massage therapy outcomes research. To learn more about the use of massage in the clinical care setting, you can visit the Massage Therapy Foundation article archives, read accepted MTF Research Grants or search PubMed for massage therapy studies.
Save the date for the 2016 International Massage Therapy Research Conference. The conference will be held May 12-15 at the Renaissance Seattle Hotel in Seattle, Washington. Stay tuned for registration information and a call for presenters. Check out the Massage Therapy Foundation website for updates.
Click here for more information about Massage Therapy Foundation Contributor.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.