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.
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
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
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.
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.
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.
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.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
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.
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.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
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.
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.
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.
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.
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.
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:
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.
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 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.
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.
#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.
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?
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.
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.
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).
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.
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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