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.
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.
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."
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.
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.
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.
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.
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.
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."
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?
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 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.
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.
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:
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.
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.
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.
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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.
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.
March, 2016, Vol. 16, Issue 03
Telling the Truth About Massage Therapy
By Tracy Walton, LMT, MS
Google "benefits of massage therapy," and you'll bring up 3.5 million web pages. Spend an afternoon checking out a bunch of them, and you'll find a few dozen benefits of massage therapy, along with a hundred or so conditions that massage is expected to help.
Among the many beneficial effects of massage, you might pick out a few focused on common cancer symptoms and side effects of treatment. In particular, you'll see references to the "Big Five" in cancer care: pain, nausea, fatigue, anxiety, and depression. These are compelling problems, familiar to oncology massage therapists and clients alike. Research has found growing support for effects on these symptoms and the strongest support is for easing pain and improving mood in people with cancer.
These claims are simple and fairly well documented. If we stopped there, with that last humble sentence about "growing support," we'd be on solid ground. But in the massage profession, we haven't stopped there, and some of our other claims are not so humble, and not solid at all. Go to some web sites, and you'll see long laundry lists of massage benefits. These don't apply to a specific population or problem. Instead, they are more generic. As we will see below, many of these generic claims are downright problematic.
All of us in massage therapy, not just those working with people with cancer, could do with a closer look at the generic list. I've whittled that list down to a short list of a few supposed massage benefits: claims of massage improving circulation, immunity, and endorphin levels. The likelihood of massage clearing out toxins or lowering cortisol levels.
You might have heard some of these claims repeated for years, starting with your first class in Swedish massage. They are mainstays in the massage therapy profession. Unfortunately, there are at least two problems with this short list.
Clients Don't Ask for These Benefits: Many of our claims about massage are focused on physiological effects, rather than clinical improvements. How many of your clients ask for an increase in circulation or endorphins? How many ask for detoxification or a smaller supply of cortisol coursing through their bloodstream? My guess is that, aside from an occasional request, most clients aren't focusing on these benefits. Our lists of benefits sound good, but they don't really address the primary reasons people come to us. People come to us in order to feel better.
Look back at the big five in cancer care vs. the generic lists of benefits and you'll find an important distinction: The Big Five focus on feeling better, improvements in pain, anxiety, and so on. In contrast, massage claims about endorphins and cortisol focus on complicated physiological explanations of how we might feel better. The former are clinical outcomes of massage therapy, the latter are mechanistic outcomes. Clinical outcomes are direct and relevant to the client. Mechanistic outcomes may not matter to a client at all. Many people take medications without questioning the way they work. In fact, many medications bring about positive clinical outcomes, while their mechanisms of action remain a mystery to consumers and medical providers alike.
This means that when our oncology clients (or really, any of our clients, regardless of health history) look for information about feeling better from massage, they are often met with a distracting list of mechanisms, focused mostly on cells or molecules in the blood going up, going down, or moving more swiftly through the body. These mechanistic claims might sound appealing, but they aren't usually related to the client's problem. And they come with other problems, too.
Our Claims Are Not Accurate: Many of the claims we've been making with such certainty are not at all certain. In most cases, we have no decent research to back what we are saying. For example, the claim about massage upping endorphins can be traced to only two tiny, primitive studies. Only one of those studies, fraught with design issues, reports an endorphin boost. Yet a Google search for "massage" and "endorphin" brings up tens of thousands of websites claiming massage will raise your endorphin levels.
Likewise, claims about improved circulation and immunity — mainstays of massage literature — have only a handful of studies behind them, with conflicting results. A body of research on cortisol has been analyzed and reported that massage does not lower cortisol. And there is no good evidence that I know of, anywhere in the English language, on the massage and toxin question at all.
The weakness in our claims about massage raises serious ethical issues for our profession. Health care providers have a recognized duty to tell the truth about their treatments. Even outside of health care, truth in advertising is a responsibility of anyone promoting a service or product.
When we offer massage therapy, people with cancer, health care providers and the public assume we are telling the truth about our services. In cancer care, patients may be especially vulnerable to false claims and oversold promises. They need to hear reasonable expectations about what massage will do for them. That's why the humble statement above, about "growing research support," for massage and cancer symptom relief is so important.
In particular, at least five of the generic claims we make about massage — effects on endorphins, circulation, immunity, cortisol, and detoxification — should be phased out of our literature, our websites, and our massage classrooms. Any time we tell someone, "massage does this," or "massage will help you with that," without good backing, we are making a false claim. Even with a few million websites repeating the same thing, we have a professional responsibility to question what we are told and what we tell our clients.
Telling the Truth, Discarding the Myths
To help MTs in this regard, the Massage Therapy Foundation has just released a free e-book, 5 Myths and Truths about Massage Therapy: Letting Go without Losing Heart (http://info.massagetherapyfoundation.org/5-myths-and-truths-about-massage-therapy).
In partnership with the Foundation, I wrote the e-book to help straighten out our stories about massage. I offer up a research summary of each claim about endorphins, immunity, cortisol, circulation, and detoxification. I also reference many of the small research studies behind each claim, such as the two tiny studies about endorphins, mentioned above. The results may be surprising, but will help all of us make fair, accurate, more defensible claims about our work.
Reporting the true benefits of massage therapy is just as important as discarding untrue claims. The Foundation offers free e-books on massage and pain research, pediatric massage, connecting with researchers, and even an e-book on connecting with physicians. These and other resources are referenced on the Foundation website www.massagetherapyfoundation.org/resources/general/. The e-books are just a sample of the many resources available at the Massage Therapy Foundation, which has funded research, education, and community service projects for 25 years.
In addition to the free e-book through the Foundation, I have listed 20+ highest-level massage research papers in a recent blog post, "One Massage Study Does Not Prove a Point, www.tracywalton.com/one-massage-study-does-not-prove-a-point/. Three of the papers listed are on massage and cancer. In that post, I also explain why a research review typically provides more useful and accurate information than the single massage studies we are told to promote.
All of our client populations deserve clear, accurate information about the benefits of massage therapy. Massage therapy is a wonderful intervention that is becoming more and more welcome in health care circles, and especially in cancer care. When we keep our claims true, humble and thoughtful, we strengthen the foundation of massage therapy for years to come.
Click here for more information about Tracy Walton, LMT, MS.
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