resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
March, 2009, Vol. 09, Issue 03
Hospice Massage: Easing the Pain of a Life-Limiting Illness, Part 1
By Ann Catlin, LMT, NCTMB, OTR
A couple of years ago, I had the privilege of spending a few days at a residential hospice in Washington, D.C. called Joseph's House; I was there to conduct a workshop for the staff. While I was there to teach, in the process I learned so much about dying with dignity. You see, Joseph's House takes in and cares for homeless men and women with terminal illness. Witnessing the impact of touch on the lives of these men and women was profound and has stayed with me ever since. Anxiety was eased, relationships were deepened and spirits were lifted for those receiving the touch and those giving it. I recall gently massaging the legs and arms of a young man who, it was believed, was only days away from dying. As I watched him fully receive my touch with a look of peace, I felt blessed to be doing this humble work. Those who entered the doors of Joseph's House were given the gift of living well with dignity in their final days.
I believe that is the essence of hospice care to help the dying person live well and to support quality of life. A paramount concern in hospice care is alleviating pain. As massage practitioners, we have much to contribute to easing pain and suffering on many levels. The complex nature of pain is holistic, meaning it is related to the whole person: the body mind and spirit. By acknowledging only the physical component of pain, we are disregarding a significant part of the pain experience that may have as much impact on the quality of life as the physical discomfort. The dimensions of pain obviously include the physical, however the psychological, emotional, social and spiritual dimensions equally impact the quality of life as well.
Dimensions of Pain
The dimensions of pain include:1
Massage: Why it Works
The American Massage Therapy Association (AMTA) defines massage as "a manual soft tissue manipulation, and includes holding, causing movement, and/or applying pressure to the body." The intention of applying massage is, according to the AMTA to positively affect the health and well-being of the client.
A hands-on complementary approach for those in eldercare, hospice and palliative care enhances quality of life. Combining sensitive massage techniques, focused touch, one-on-one attention and specialized communication skills can be highly effective for those in later life stages. The concepts and techniques of this hands-on approach are effective as a non-pharmacological tool in alleviating discomfort associated with the dimensions of pain. What follows is an exploration of the effects of massage along with some of the rationale for why massage may be important tools in alleviating pain for individuals with life-limiting illness.
Physiological Effect: Physical sensation of pain is reduced. Massage has been shown to affect the nervous system through stimulation of sensory receptors. The gate control theory refers to the idea that pain impulses pass through a "gate" to reach the nerve fibers leading from the spinal cord to the thalamus in the brain. Pain impulses are transmitted by large and small diameter nerve fibers. Massage stimulates the large-diameter fibers, preventing the small diameter fibers from transmitting signals, suppressing the sensation of pain.2
Massage stimulates production of endorphins. Endorphins are opiate-like compounds produced by the body that relieve pain and produce feelings of euphoria.2 Massage decreases cortisol levels. Cortisol is a stress hormone that is produced by the adrenal glands during prolonged stress. When cortisol levels are lowered it enhances sleep quality and the immune system.2
Behavioral Effect: Physical tasks are performed with greater comfort (i.e. transfers, dressing, ambulating). When the burden of pain is eased the individual may increase his or her involvement in self-care and participate more actively in daily life and level of function is improved.
Emotional Effect: Positive feelings and mood is enhanced. Massage has a generalized effect on the autonomic nervous system, resulting in changes in mood and an induced relaxation response.2 Massage seems to increase serotonin levels. Serotonin is a neurochemical that regulates mood; feelings of calm; and subdues anxiety and irritability.3
Cognitive Effect: The cycle of pain and fear may be interrupted, resulting in more positive thought patterns. One hypothesis4 states that pain has three phases: the anticipation phase; the sensation phase; and the aftermath phase. The person suffering from chronic or intermittent pain may experience fear in the anticipation phase stemming from unpleasant past painful experiences. When the pain experience is eased with massage and one-on-one focused attention, those associations may lose their grip on the belief system of the person.
Social Effect: Touch and massage is a medium that enhances the relationship between the ill person and caregivers.
Bush5 reports that substantial evidence points to the fact that the experiences of touch are laden with psychosocial as well as physiologic implications. It is a viable means of improving both verbal and non-verbal communication. Human touch creates a way for the dying person to interact and connect with others, decreasing feelings of isolation and loneliness.
Spiritual Effect: Human touch enhances spiritual well-being. Nelson6 reports that when individual felt cared for by staff during and after receiving complementary approaches, the burden of disease (i.e. physical, emotional) seemed less and allowed them to feel like they had more of a desire to participate in life.
The unconditional gift of touch acknowledges the individual's worth regardless of the condition of the body or mind easing suffering on all levels. Hospice organizations are offering massage therapy as a complementary service more than ever before. We truly hold within our hands the means to make a meaningful difference in the quality of life at life's end.
Click here for previous articles by Ann Catlin, LMT, NCTMB, OTR.
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