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Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Massage Effective for Cancer Pain Relief
Contributed by MK Brennan MS, RN, LMBT; Jolie Haun PhD, EdS, LMT; Beth Barberree BA, MT
Complementary therapies are commonly used by cancer patients for physical, emotional, and spiritual benefits. Among these therapies, massage is often provided for relief of cancer-related symptoms and treatment, most notably the pain. Sook-Hyun, et al, conducted a meta-analysis to review studies in nine electronic databases in English, Chinese, and Korean languages. Twelve high quality studies were retrieved and used for the analysis. The twelve identified studies were conducted between 1990 and 2013 in four countries, and included 559 subjects in total. Nine of the twelve studies found cancer pain was reduced after massage.
Findings of the meta-analysis indicated 40% to 90% of cancer patients report pain due to changes in their bodies from the cancer itself or as a result of treatments such as surgery, chemotherapy, or radiation. Conventional treatment is not always effective in relieving the pain satisfactorily and many patients also use massage and/or other complementary therapies to treat it.
Previous reviews of studies about massage for cancer pain have shown mixed results from not being significantly effective to suggesting that massage therapy can reduce cancer pain by 40.2%. For the purpose of this meta-analysis, randomized controlled trials (RCT) and nonrandomized controlled clinical trials (CCT) with a control group of those who received conventional care or no-massage and patients with all types of cancer were systematically reviewed. The review also included trials that used the Visual Analogue Scale (VAS), Brief Pain Inventor (BPI), Numeric Rating Scale (NRS) and present pain intensity (PPI) to reduce bias due to the use of different pain assessment scales. Evaluation of the methodological quality of the studies was based on the Physiotherapy Evidence Database (PEDro) scale and Cochrane risk of bias for quality of studies in meta-analysis. Studies awarded greater than or equal to six on the PEDro scale were considered a high-quality study.
Soon-Hyun, et al, reviewed the effects of massage therapy according to a number of items including pain relief, cause of cancer pain, type of cancer, massage type, methodological quality of the studies, blinding of studies, pain assessment scales, and time points of the studies. Results from these reviews show that massage therapy largely reduced pain in all types of cancer.
The authors recommended that future studies include the qualifications, affiliation, experience, and clinical expertise of the massage therapists, since these may influence treatment effects. They also recognized that there were some limitations in their study. They included RCT and CCT studies with possible selection bias however, results didn't change when the analysis was restricted to the assessment score in the PEDro scale. Another limitation is the possibility of both performance and response biases in some studies since the comparisons between massage and the control groups cannot be blinded. It was noted, however, that results did not change when either blinded or non-blinded studies were used in the analysis. Additionally, results did not change when the authors restricted the analysis to the time points measured at primary treatment or the following weeks. So, combining different measurement time points may be critiqued, but may not necessarily be a limitation.
Given that there are few long-term studies, the evidence is not sufficient to suggest that massage is an effective long-term treatment for cancer pain. Well designed, long-term studies are needed to draw firm conclusions about the effect of massage on cancer pain but this meta-analysis is a good resource for anyone wishing to pursue this research.
Meta-analysis studies make a significant contribution to advancing the science of a practice such as massage therapy. Analyzing multiple studies across diverse populations with a range of conditions in diverse geographic locations provide the power necessary to make strong inferences about the effects of an intervention such as massage therapy. As the adage goes, "there is power in numbers." Meta-analyses provide the numbers and power which often elude single study designs; this article provides more evidence to support the use of massage therapy with patients receiving treatment for cancer who experience related symptoms such as pain. Massage therapists in the field can share the results of this analysis with their patients who have cancer to provide support for the significant palliative effects of massage therapy.
As AMTA celebrates National Massage Therapy Week during the National Convention in Milwaukee, October 26-29, we invite you to visit our Poster session to learn more about recent studies in massage. Stay updated with more information at our website: www.massagetherapyfoundation.org.