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Alternative Therapy Meets Traditional Medicine--East Meets West!
Whole-Health is an "Integrated Medical Practice". This means that
diagnosis and treatment for various conditions is undertaken using either
traditional medical modalities, "alternative" modalities, or a combination
of both. The theme of the practice is "East meets West" referring to the
two traditionally separate schools of thought. There is a time and a place
for everything! A patient experiencing crushing chest pain is certainly not
a candidate for herbal therapy, but somebody with upper respiratory symtpoms
may benefit more from natural immune-stimulating treatment than they would
from antibiotics. It is our physicians' job to determine what medical
issues you are dealing with and what the most appropriate treatment course
would be. You will be given various treatment options and informed
regarding their pros and cons- you are ultimately the boss of your own
body. We are here to help and educate, but you must ultimately be
comfortable with the treatment protocol. At Whole-Health we make every
attempt to modify behavior, diet, and lifestyle and use natural therapies
first before resorting to pharmaceuticals. Again, this is a philosophy, and
your individual circumstances will be reviewed and addressed on a
case-by-case basis.
Herbal Medicine
What is herbal medicine?
Herbal medicine, also called botanical medicine or phytomedicine, refers
to the use of any plant's seeds, berries, roots, leaves, bark, or flowers
for medicinal purposes. Long practiced outside of conventional medicine, herbalism is becoming more mainstream as up-to-date analysis and research
show their value in the treatment and prevention of disease.
What is the history of herbal medicine?
Plants had been used for medicinal purposes long before recorded history.
For example, ancient Chinese and Egyptian papyrus writings describe
medicinal plant uses. Indigenous cultures (e.g., African and Native
American) used herbs in their healing rituals, while others developed
traditional medical systems (e.g., Ayurveda and Traditional Chinese
Medicine) in which herbal therapies were used systematically. Scientists
found that people in different parts of the globe tended to use the same or
similar plants for the same purposes.
In the early 19th century, when methods of chemical analysis first became
available, scientists began extracting and modifying the active ingredients
from plants. Later, chemists began making their own version of plant
compounds, beginning the transition from raw herbs to synthetic
pharmaceuticals. Over time, the use of herbal medicines declined in favor of
pharmaceuticals.
Recently, the World Health Organization estimated that 80% of people
worldwide rely on herbal medicines for some aspect of their primary
healthcare. In the last twenty years in the United States, increasing public
dissatisfaction with the cost of prescription medications, combined with an
interest in returning to natural or organic remedies, has led to an increase
in the use of herbal medicines. In Germany, roughly 600 to 700 plant-based
medicines are available and are prescribed by approximately 70% of German physicians.
How do herbs work?
For most herbs, the specific ingredient that causes a therapeutic effect
is not known. Whole herbs contain many ingredients, and it is likely that
they work together to produce the desired medicinal effect. Many factors
affect how effective an herb will be. For example, the type of environment
(climate, bugs, soil quality) in which a plant grew will affect its
components, as will how and when it was harvested and processed.
How are herbs used?
For the reasons described in the previous section, herbalists prefer using
whole plants rather than extracting single components from them. Whole plant
extracts have many components. These components work together to produce
therapeutic effects and also to lessen the chances of side effects from any
one component. Several herbs are often used together to enhance
effectiveness and synergistic actions and to reduce toxicity. Herbalists
must take many things into account when prescribing herbs. For example, the
pecies and variety of the plant, the plant's habitat, how it was stored and
processed, and whether or not there are contaminants.
What happens during a visit to an herbalist?
When you visit an herbalist, the treatment goals are often more broad than
stopping a single complaint. Herbalists aim to correct imbalances, resolve
patterns of dysfunction, and treat the underlying cause of your complaint.
Specific symptoms may also be treated if necessary.
A session with an herbalist typically lasts one hour. You may be
physically examined and asked about your medical history and your general
well-being (that is, how well you sleep, what you eat, if you have a good
appetite, good digestion and elimination, how often you exercise, and what
you do to relax). The herbalist might recommend one or more herbs, dietary
changes, and lifestyle modifications. Because herbal medicines are slower
acting than pharmaceuticals, you might be asked to return for a follow-up in
two to four weeks.
What is herbal medicine good for?
Herbalists treat many conditions such as asthma, eczema, premenstrual
syndrome, rheumatoid arthritis, migraine, menopausal symptoms, chronic
fatigue, and irritable bowel syndrome, among others. Herbal preparations are
best taken under the guidance of a trained professional. Be sure to consult
with your doctor or an herbalist before self-treating. Some common herbs and
their uses are discussed below. Please see our monographs on individual
herbs for detailed descriptions of uses as well as risks, side effects, and
potential interactions.
Ginkgo (Ginkgo biloba), particularly a standardized extract known as EGb
761, appears to produce improvements in awareness, judgment, and social
function in people with Alzheimer's disease and dementia. In a year-long
study of 309 people with Alzheimer's disease, those taking EGb 761
consistently improved while those on placebo worsened.
Kava kava (Piper methysticum) has become popular as a treatment for
anxiety, but recent reports have traced liver damage to enough people who
have used kava that the U.S. FDA has issued a warning regarding its use
and other countries, such as Germany and Canada, have taken kava off of the market.
St. John's wort (Hypericum perforatum) is well known for its
antidepressant effects, and an analysis of 27 studies involving more than
2,000 people confirmed that the herb is an effective treatment for mild to
moderate depression.
Valerian (Valeriana officinalis) has had a long tradition as a
sleep-inducing agent, with the added benefit of producing no hangover
feeling the next day.
Echinacea preparations (from Echinacea purpurea and other Echinacea
species) may bolster immunity. In a study of 160 volunteers with flu-like
symptoms, echinacea extract reduced both the frequency and severity of cold
symptoms.
Is there anything I should watch out for?
Used correctly, many herbs are considered safer than conventional
medications, but because they are unregulated, herbal products are often
mislabeled and may contain undeclared additives and adulterants. Some herbs
are associated with allergic reactions or interact with conventional drugs.
Self-prescribing herbal products will increase your risk, so it is important
to consult your doctor and an herbalist before taking herbal medicines. Some
examples of adverse reactions from certain popular herbs are described
below.
St. John's wort causes sensitivity to the sun's ultraviolet rays, and may
cause an allergic reaction, stomach upset, fatigue, and restlessness.
Studies show that St. John's wort also interferes with the effectiveness of
many drugs, including warfarin (a blood thinner), protease inhibitors for
HIV, possibly birth control pills, and many other medications. In addition,
St. John's wort must not be taken with anti-depressant medication. The Food
and Drug Administration (FDA) has issued a public health advisory concerning
many of these interactions.
Kava kava and echinacea have both been linked to liver toxicity. Again,
kava has been taken off the market in several countries because of the liver toxicity.
Valerian may cause oversedation, and in some people it may even have the
unexpected effect of overstimulating instead of sedating.
Feverfew (Tanacetum parthenium) may cause agitation.
Bleeding time may be altered with the use of garlic, ginkgo, feverfew,
ginger (Zingiber officinale) and ginseng.
Who is using herbal medicine?
Nearly one-third of Americans use herbs and it is estimated that in 1998
alone $4 billion was spent on herbal products in this country.
Unfortunately, a recent study in the New England Journal of Medicine
indicated that nearly 70% of individuals taking herbal medicines (the
majority of which were well educated and had a higher-than-average income)
were reluctant to reveal their use of complementary and alternative medicine
to their doctors. Because herbal medicines contain a combination of
chemicals, each with a specific action, many are capable of eliciting
complex physiological responses?some of which may create unwanted or
unexpected results when combined with conventional drugs. Be sure to consult
our doctor before trying any herbal products.
How is herbal medicine sold in stores?
The herbs available in most stores come in several different forms: teas,
syrups, oils, liquid extracts, tinctures, and dry extracts (pills or
capsules). Teas are simply dried herbs left to soak for a few minutes in
boiling water. Syrups, made from concentrated extracts and added to
sweet-tasting preparations, are frequently used for sore throats and coughs.
Oils are extracted from plants and often used as rubs for massage, either
alone or as part of an ointment or cream. Tinctures and liquid extracts are
solvents (usually water, alcohol, or glycerol) that contain the active
ingredients of the herbs. Tinctures are typically a 1:5 or 1:10
concentration, meaning that one part of the herbal material is prepared with
five to ten parts (by weight) of the liquid. Liquid extracts are more
concentrated than tinctures and are typically a 1:1 concentration. A dry
extract form is the most concentrated form of an herbal product (typically
2:1 to 8:1) and is sold as a tablet, capsule, or lozenge.
Currently, no organization or government body regulates the manufacture or certifies the labeling of herbal preparations. This means you can't be sure
that the amount of the herb contained in the bottle, or even from dose to
dose, is the same as what is stated on the label. Some herbal preparations
are standardized, meaning that the preparation is guaranteed to contain a specific amount of the active ingredients of the herb. However, it is still
important to ask companies that are making standardized herbal products the
basis for their product's guarantee. If consumers insist on an answer to
this question, manufacturers of these herbal products may begin to implement
more quality control processes, like microscopic, chemical, and biological
analyses. Again, it is important to consult your doctor or an expert in
herbal medicine for the recommended doses of any herbal products you are
considering.
Acupuncture
What is acupuncture?
Acupuncture is a treatment based on Traditional Chinese Medicine (TCM), a
system of healing that dates back thousands of years. At the core of TCM is
the notion that a type of life force, or energy, known as qi (pronounced
"chee") flows through energy pathways (meridians) in the body. Each meridian
corresponds to one specific organ, or group of organs, that governs
particular bodily functions. The proper flow of qi is thought to create
health. Qi maintains the dynamic balance of yin and yang, which are
complementary opposites. According to TCM, everything in nature has both yin
and yang. An imbalance of qi (too much, too little, or blocked flow) results
in disease. In acupuncture, needles are inserted at points along the
meridians to restore balance to the qi. Acupuncture points, or the specific
locations where needles are inserted, are places where the energy pathway is
close to the surface of the skin.
What is the history of acupuncture?
The earliest recorded use of acupuncture dates from 200 BCE. Knowledge of
acupuncture spread from China along Arab trade routes towards the West. Up
until the early 1970s, however, most Americans had never heard of
acupuncture.
Acupuncture gained the attention of the American public after President
Nixon's trip to China in 1972. Traveling with Nixon was a New York Times
reporter, James Reston, who received acupuncture in China after undergoing
an emergency appendectomy. He was so impressed with the procedure's ability
to relieve his postoperative pain that he wrote about his experience upon
returning to the United States.
Acupuncture was formally recognized as part of mainstream medicine's range
of healing options in 1997, when the National Institutes of Health issued a
statement documenting its safety and efficacy for a range of health
conditions. Although slowly changing, many conventional physicians remain
unfamiliar with both the theory and practice of acupuncture.
How does acupuncture work?
The effects of acupuncture are complex and how it works is not entirely
clear. Research suggests that the needling process, and other modalities
used in acupuncture, may produce their complex effects on a wide variety of
ways in the brain and the body. For example, it is theorized that stimulated
nerve fibers transmit signals to the spinal cord and brain, thus activating
parts of what is called the central nervous system. The spinal cord and
brain then release certain hormones responsible for making us feel better
overall and, more specifically, feel less pain. In fact, a study using
images of the brain confirmed that acupuncture increases our pain threshold,
which may explain its ability to produce long-term pain relief. Also,
acupuncture may increase blood circulation and body temperature. It may also
affect white blood cell activity (responsible for our immune function),
reduce cholesterol and triglyceride levels, and regulate blood sugar levels.
In general, acupuncture appears to transmit its effects via electric,
neurologic, hormonal, lymphatic, and electromagnetic wave pathways.
What does an acupuncturist do?
In addition to asking questions, the acupuncturist may want to take your
pulse at several points along the wrist and look at your tongue to observe
its shape, color, and coating. He or she may also observe the color and
texture of your skin, your posture, and other physical characteristics that
offer clues to your health. The acupuncturist then asks you to lie down on a
padded examining table, and he or she inserts the needles, twirling or
gently jiggling each as it goes in. You may not feel the needles at all, or
you may feel a twitch or a quick twinge of pain that subsides as soon as the
needle is completely in. Once the needles are all in place, you rest for 15
to 60 minutes. During this time, you'll probably feel relaxed and sleepy and
may even doze off. At the end of the session, the acupuncturist quickly and
painlessly removes the needles.
For certain conditions, acupuncture is more effective when the needles are
heated using a technique known as "moxibustion." The acupuncturist lights a
small bunch of the dried herb moxa (mugwort) and holds it above the needles.
The herb, which burns slowly and gives off a little smoke and a pleasant,
incense-like smell, never directly touches the body. Another variation is
electrical acupuncture. This technique consists of hooking up electrical
wires to the needles and running a weak current through them, which may
cause no sensation at all or a mild tingling. Acupuncturists trained in
Chinese herbal preparations may also prescribe herbs along with acupuncture.
Are there different styles of acupuncture?
There are a number of different approaches to the practice of acupuncture;
some of those most commonly found in the United States today are as follows:
TCM-based acupuncture -- the most commonly practiced in the United States today. It focuses on a diagnosis based on eight principles of complementary
opposites (yin/yang, internal/external, excess/deficiency, hot/cold).
French energetic acupuncture -- mostly used by MD acupuncturists. Meridian
patterns are emphasized, in particular the yin-yang pairs of primary
meridians.
Korean hand acupuncture -- based on the principle that the hands and feet
have concentrations of qi, and that applying acupuncture needles to these
areas is effective for the entire body.
Auricular acupuncture -- based on the idea that the ear is a microcosm of
the body. This means that applying acupuncture needles to certain points on
the ear affects corresponding organs. This type of acupuncture is used widely in treating addiction disorders.
Myofascially-based acupuncture -- often practiced by physical therapists,
involves feeling the meridian lines in search of tender points, then
applying needles. Tender points indicate areas of abnormal energy flow.
Japanese styles of acupuncture -- sometimes referred to as "meridian
therapy," tend to put more emphasis on needling technique and feeling
meridians in diagnosis.
How many treatments do I need?
The number of acupuncture treatments you need depends on the complexity of
your illness, whether it's a chronic or recent condition, and your general
health. For example, you may need only one treatment for a recent wrist
sprain, whereas for a long-standing, chronic illness you may need treatments
once or twice a week for several months to get good results.
What is acupuncture good for?
Acupuncture is particularly effective for pain relief and for post-surgery
and chemotherapy-associated nausea and vomiting. In addition, both the World
Health Organization and the National Institutes of Health recognize that
acupuncture can be a helpful part of a treatment plan for many illnesses. A
partial list includes: addiction (such as alcoholism), asthma, bronchitis,
carpal tunnel syndrome, constipation, diarrhea, facial tics, fibromyalgia,
headaches, irregular periods, low back pain, menopausal symptoms, menstrual
cramps, osteoarthritis, sinusitis, spastic colon (often called irritable
bowel syndrome), stroke rehabilitation, tendinitis, tennis elbow, and
urinary problems such as incontinence. You can safely combine acupuncture
with prescription drugs and other conventional treatments, but it is
important for your -primary care physician to be aware of and to monitor how
your acupuncture treatment may be affecting your conventional therapies.
The American Academy of Medical Acupuncture also lists a wide range of
Conditions for which acupuncture can be used. In addition to those already
mentioned above, they recommend acupuncture for sports injuries, sprains,
strains, whiplash, neck pain, sciatica, nerve pain due to compression,
overuse syndromes similar to carpal tunnel syndrome, pain resulting from
spinal cord injuries, allergies, tinnitus (ringing in the ears), sore throat
(called pharyngitis), high blood pressure, gastroesophageal reflux (felt as
heartburn or indigestion), ulcers, chronic and recurrent bladder and kidney
infections, premenstrual syndrome (PMS), infertility, endometriosis, memory
problems, insomnia, multiple sclerosis, sensory disturbances, depression,
anxiety, and other psychological disorders.
Should anyone avoid acupuncture?
Some physicians and practitioners may avoid treatment during pregnancy. If
you have been seen by a particular practitioner prior to your pregnancy,
however, it is generally safe to continue receiving treatment from the
practitioner during your pregnancy.
Should I watch out for anything?
Be sure your acupuncturist uses only disposable needles. In addition, if
your acupuncturist is qualified to prescribe herbs and would like you to
take them as part of your treatment, first discuss this with your physician.
Herbs are potent substances that can be harmful if you suffer from certain
conditions; they can also interact with drugs you may be taking and cause
side effects.
Does my medical insurance cover acupuncture treatments?
An increasing number of insurance providers and HMOs now cover all or part
of the cost of acupuncture treatments, but these providers may have
restrictions on the types of illnesses they cover. Check with your insurance
company to see what your policy offers.
Osteopathy
What is osteopathy?
Osteopathy is based on the belief that most diseases are related to
problems in the musculoskeletal system and that structure and function of
the body are inseparable. The musculoskeletal system is comprised of the
nerves, muscles, and bones?all of which are interconnected and form the
body's structure.
What is the history of osteopathy?
Osteopathy was founded in 1874 by Andrew Taylor Still. Still was a
Missouri physician who had become frustrated with what he viewed to be the
ineffective and hazardous nature of remedies at that time. He believed that
the doctor's role in combating disease was to restore proper musculoskeletal
function to the body. Despite mainstream opposition, Still founded the
American School of Osteopathy in Missouri in 1892. The school taught manual
manipulation, nutrition, and lifestyle modifications rather than surgery and
drug therapies.
In 1896, Vermont became the first state to license DOs and the American
Osteopathic Association was formed in 1901 to regulate the profession. Even
with these important milestones, those in conventional medicine continued to
disapprove of osteopathy until 1962 when DOs had full practice rights in all
50 states. By 1973, the California Medical Association invited DOs to join
and become voting members.
Today, doctors of osteopathy (D.O.s) receive the same basic training as
medical doctors (M.D.s), and D.O.s also learn manipulation therapies
(hands-on adjustments of muscles, bones, and ligaments) and use these in
addition to more conventional medical treatments. Most D.O.s are primary
care practitioners, specializing in family medicine, internal medicine,
obstetrics/gynecology, or pediatrics. A few can be found in other medical
specialties as well.
According to the American Osteopathic Association, there are well over
40,000 osteopathic physicians practicing in the United States today (that's
5% of all physicians in the country), and 100 million people visit D.O.seach year.
How does osteopathy work?
Long nerves connect the spine to various organs in the body. Andrew Taylor
Still believed that every disease or illness began with structural problems
in the spine. According to Still, when problems arise in the spine the
nerves send abnormal signals to the body's organs. Still called these spinal
problems "osteopathic lesions" ("osteo" for bone and "pathic" for diseased),
and devised osteopathic manipulation techniques (OMTs) to treat them. Such
lesions are detected by the osteopathic doctor from abnormal texture of the
skin and other soft tissues of the body as well as from restricted range of
motion in the joints. OMTs range from light pressure on the soft tissues to
high-velocity thrusts on the joints. These treatments, he believed, would
return the nerves to their normal function and allow the blood to flow
freely throughout the circulatory system. With structure restored, the
body's own natural healing powers would then be able to restore the entire
body to full health.
What happens during a visit to the osteopath?
A visit to a D.O. is much like a visit to your family doctor. The D.O.
will ask you questions about your medical history, physical condition, and
lifestyle. However, because D.O.'s have particular expertise in
musculoskeletal systems (namely, bones, joints, and soft tissues like
ligaments and tendons), the physical exam of that bodily system will be more
extensive than one with your family doctor. During the physical, the D.O.
will assess your posture, spine, and balance; check your joints, muscles,
tendons, and ligaments; and may use his or her hands to manipulate your
back, legs, or arms. Variations in your skin temperature and sweat gland
activity will also be measured. If needed, the D.O. will order X-rays and
laboratory tests. When the results are in, the D.O. will make a diagnosis
and establish a treatment plan for you that may even include prescriptions
for medications.
For problems involving the bones, muscles, tendons, tissues, or spine,
many current day (but not all) D.O.s use OMTs. There are two categories of
OMT procedures: direct and indirect. In direct OMT, "problem" or "tight"
tissues are moved (by the D.O., the person being treated, or both) toward
the areas of tightness or restricted movement. In indirect OMT, the D.O.
pushes the "tight" tissues away from the area of restricted movement, in the
opposite direction of the muscle's resistance. He or she holds the tissues
in this position until the tight muscle relaxes.
What illnesses and conditions respond well to osteopathy?
OMTs can be applied to a variety of health problems, both musculoskeletal
and non-musculoskeletal. According to the US Department of Health and Human
Services, OMTs are most effective for back and neck pain. In fact, if you
have back pain, you may be able to reduce the amount of pain medication you
are taking if you receive OMT as part of your therapy. One study showed that
patients with pancreatitis were able to go home from the hospital sooner
when they had OMT.
In one small study, people with Parkinson's disease were able to walk
better after only one session of OMT. Another study looked at 38 patients
who had knee surgery. Those who had OMT were able to walk up stairs 20%
earlier than those who did not have OMT.
A study of 100 people with high blood pressure treated only with OMT
showed that OMT produced significant reductions in blood pressure.
Studies show that OMT eases breathing, drains the sinuses and relieves the
symptoms, duration, and recurrence of the common cold.
Osteopathy may also be an effective way to treat carpal tunnel syndrome.
More studies are needed to confirm this.
Examples of other conditions for which OMT may be helpful include:
-stress-related problems (such as tension headaches, muscle spasm)
-strains and sprains (especially of the neck and back)
-shoulder pain
-osteoarthritis
-headaches
-painful menstruation
-injuries (such as whiplash)
-scoliosis (side to side curvature of the spine)
-infantile colic
-insomnia
Are there conditions that should not be treated with osteopathy?
You should avoid osteopathic manipulation if you have a broken bone or
dislocation, bone cancer, a bone or joint infection, damaged ligaments,
rheumatoid arthritis of the neck, or osteoporosis. Osteopathic manipulation
is also not recommended for people who recently underwent joint surgery nor
for people taking an anticoagulant (blood thinning) medication.
Massage
What is massage?
Massage is a "hands-on" therapy in which muscles and other soft tissues of
the body are manipulated to improve health and well-being. Varieties of
massage range from gentle stroking and kneading of muscles and other soft
tissues to deeper manual techniques. Massage has been practiced as a healing
therapy for centuries in nearly every culture around the world. It helps
relieve muscle tension, reduce stress, and evoke feelings of calmness.
Although massage affects the body as a whole, it particularly influences the
activity of the musculoskeletal, circulatory, lymphatic, and nervous
systems.
What is the history of Massage?
The use of massage for healing purposes dates back 4,000 years in Chinese
medical literature and continues to be an important aspect of Traditional
Chinese Medicine (TCM) today. A contemporary form of massage known as
Swedish massage was introduced to the United States in the 1850s. By the end
of the 19th century, a significant number of American doctors were
practicing this manual technique and the nation's first massage therapy
clinics opened its doors to the public.
In the early 20th century, the rise of technology and prescription drugs
began to overshadow massage therapy. For the next several decades, massage
remained dormant and only a few therapists continued to practice the
"ancient" technique. During the 1970s, however, both the general public as
well as the medical profession began to take notice of alternative medicine
and mind-body therapies, which thrust massage therapy back into the
limelight. Today, there are more than 125,000 massage therapists practicing
in the United States and their numbers are growing rapidly to keep up with
the more than 80 million massage therapy appointments made every year.
Are there many types of massage?
There are nearly 100 different massage and body work techniques. Each
technique is uniquely designed to achieve a specific goal. The most common
types practiced in the United States include:
Aromatherapy massage: Essential oils from plants are massaged into the
skin in order to enhance the healing and relaxing effects of massage.
Essential oils are believed to have a powerful effect on mood by stimulating
two structures deep in the brain known to store emotions and memory. (See
the Aromatherapy monograph for more details)
Craniosacral massage: Gentle pressure is applied to the head and spine to
correct imbalances and restore the flow of cerebrospinal fluid in these
areas.
Lymphatic massage: Light, rhythmic strokes are used to improve the flow of
lymph (colorless fluid that helps fight infection and disease) throughout
the body. One of the most popular forms of lymphatic massage, Manual
Lymphatic Drainage (MLD), focuses on draining excess lymph. MLD is commonly
used after surgery (such as a mastectomy for breast cancer) to reduce
swelling.
Myofascial release: Gentle pressure and body positioning are used to relax
and stretch the muscles, fascia (connective tissue), and related structures.
Both physical therapists and massage therapists who are appropriately
trained use this technique.
On-site/chair massage: Popular in offices and other public places, on-site
massage therapists use a portable chair to deliver brief, upper body
massages to fully-clothed people.
Polarity therapy: A form of energy healing, polarity therapists stimulate
and balance the flow of energy within the body to enhance health and
well-being.
Reflexology: Specialized thumb and finger techniques are applied to the
hands and/or feet. Reflexologists believe that these areas contain "reflex
points" or direct connections to specific organs and structures throughout
the body.
Rolfing: Pressure is applied to the fascia (connective tissue) to stretch
it, lengthen it, and make it more flexible. This goal of this technique is
to realign the body so that it conserves energy, releases tension, and
functions better.
Shiatsu: Gentle finger and hand pressure are applied to specific points on
the body to relieve pain and enhance the flow of energy (known as qi)
through the body's energy pathways (called meridians). Shiatsu is widely
used in Traditional Chinese Medicine (TCM).
Sports massage: Often used on professional athletes and other active
individuals, sports massage can enhance performance and prevent and treat
sports-related injuries.
Swedish massage: A variety of strokes and pressure techniques are used to
enhance the flow of blood to the heart, remove waste products from the
tissues, stretch ligaments and tendons, and ease physical and emotional
tension.
Trigger point massage: Pressure is applied to "trigger points" (tender
areas where the muscles have been damaged) to alleviate muscle spasms and
pain.
How does massage work?
When a practitioner massages soft tissue, electrical signals are
transmitted both to the local area and throughout the body. These signals
help heal damaged muscle, stimulate circulation, clear waste products via
the lymphatic system, boost the activity of the immune system, reduce pain
and tension, and induce a calming effect. They may also enhance a general
sense of well-being by stimulating the release of endorphins (natural
pain-killers and mood elevators) and reducing levels of certain stress
hormones.
What happens during a massage therapy session?
At your first massage therapy session, the practitioner will ask you about
any symptoms you may have (like low back pain) and will also ask questions
about your medical history. The practitioner may also initiate a discussion
about what you expect to achieve from the massage session.
The therapist leaves the room while you undress and lay down on the
massage table. A sheet is used as a drape during the session and is moved
only to expose the part of the body being worked on at any given time.
Massage oil or lotion is often used to reduce friction between the
practitioner's hands and your skin. The room is kept warm and free of
distractions. The therapist may have soft music playing in the background
and frequently asks whether he or she is applying too much or too little
pressure.
The manner in which a practitioner massages your body depends on the
problem being treated. A massage session can last from 15 to 90 minutes and
may include a schedule of follow-up visits, depending on the severity of
your situation.
What is massage good for?
In general, massage is believed to support healing, boost energy, reduce
recovery time after an injury, ease pain, and enhance relaxation, mood, and
well-being. In addition to being of value for many musculoskeletal problems
such as low back pain, osteoarthritis, fibromyalgia, and sprains and
strains, massage may relieve depression in people with chronic fatigue
syndrome, ease chronic constipation (when the technique is performed in the
abdominal area), decrease swelling after a mastectomy (removal of the
breast), alleviate sleep disorders, and improve self-image. In the
workplace, massage has been shown to melt away stress and enhance mental
alertness.
Studies have found that massage relieves chronic back pain more
effectively than other treatments (including acupuncture and conventional
medical care for this condition with education via books and videos) and, in
many cases, costs less than other treatments for this common health problem.
In addition, mothers and newborns also appear to benefit from massage.
Mothers trained to massage their infants often feel less depressed and have
a better emotional bond with their babies. Newborns who receive massage from
their mothers also tend to cry less, and are more active, alert, and
sociable. Premature babies who receive massage therapy have been shown to
gain weight faster than preemies who do not receive this type of therapy.
Infants who receive massage regularly may also sleep better, be less gassy
or colicky, and have better body awareness as well as more regular
digestion.
Studies have also shown that massage may be an effective treatment for
young children and adolescents with a wide range of health problems
including the following:
Autism: Autistic children, who usually don't like being touched, show less
autistic behavior and are more social and attentive after receiving massage
therapy from their parents.
Atopic dermatitis/Eczema: Children with this scaly, itchy skin problem
seem to experience less redness, scaling, and other symptoms if receiving
massage between flares. Massage should not be used when this skin condition
is actively inflamed.
Attention deficit hyperactivity disorder (ADHD): Massage may improve mood
in children with ADHD and help them feel less fidgety and hyperactive.
Bulimia: Studies have shown that adolescents with this eating disorder
feel less depressed and anxious after receiving massage therapy.
Cystic fibrosis: Massage may reduce anxiety and improve respiration in
children with this lung condition.
Diabetes: Massage may help regulate blood sugar levels and reduce anxiety
and depression in children with diabetes.
HIV: In a small study, teenagers with the human immunodeficiency virus
(HIV) showed improved immune function and diminished feelings of depression
and anxiety after receiving two massages per week for 12 weeks.
Rheumatoid arthritis: Children with juvenile rheumatoid arthritis (JRA)
have been shown to experience less pain, morning stiffness, and anxiety as a
result of massage therapy.
Are there any risks associated with massage?
In general, massage is considered relatively safe. Pain or other rare
negative side effects are generally caused by an extremely vigorous massage
technique.
Women should be very cautious about receiving massages during pregnancy.
If you are pregnant, be sure to find a therapist specifically trained to
perform massages on pregnant women.
Even though massage is a useful technique to help regulate blood sugar
over time, if you have diabetes you should check your blood sugar after a
massage session because it may be too low just following a treatment. Plus,
if you have diabetes and you are receiving massage on a regular basis, you
should check your blood sugar frequently to evaluate for any changes over
time.
Should anyone avoid massage?
Massage should be avoided by people with congestive heart failure, kidney
failure, infection of the superficial veins (called phlebitis) or soft
tissue (called cellulitis) in the legs or elsewhere, blood clots in the
legs, bleeding disorders, and contagious skin conditions. If you have
cancer, you must check with your doctor before considering massage because
you should not receive such treatments under certain circumstances. For
example, sometimes massage can damage tissue that is fragile from
chemotherapy or radiation treatments. People with rheumatoid arthritis,
goiter (a thyroid disorder characterized by an enlarged thyroid), eczema and
other skin lesions should not receive massage therapy during flare-ups.
Experts also advise that people with osteoporosis, high fever, few platelets
or white blood cells, and mental impairment, as well as those recovering
from surgery, may be better off avoiding massage. Also, be sure to let your
massage therapist know any medications you are taking as the treatment may
influence absorption or activity of both oral and topical medications
Nutrition
What is clinical nutrition?
Clinical nutrition is the study of the relationship between food and the
well-being of the body. More specifically, it is the science of nutrients
and how they are digested, absorbed, transported, metabolized, stored, and
discharged by the body. Besides studying how food works in the body,
nutritionists are interested in how the environment affects the quality and
safety of foods, and how these factors influence health and disease.
What are nutrients?
Nutrients are substances that are involved in the creation of every
molecule in the body. The body needs more than 45 nutrients, and the ways
that nutrients are used are as varied as the molecules, cells, and tissues
they help to create. Carbohydrates, proteins, and fats (called
macronutrients) are broken down (metabolized) to give the body energy.
Vitamins and minerals (called micronutrients) are not themselves metabolized
for energy, but they are crucial in helping the macronutrients convert to
energy.
What is the history of clinical nutrition?
The study of human nutrition dates back to the 18th century, when the
French chemist Lavoisier discovered that there was a relationship between
our metabolism of food and the process of breathing. By the early 20th
century, scientists had found that diseases were associated with certain
diets (beri-beri, rickets, scurvy and pellagra). Later it was found that
these diets lacked specific nutrients (namely vitamin B1 [thiamine], vitamin
D, vitamin C, and vitamin B3 [niacin] respectively). By 1912, the Polish
chemist Casimir Funk had found a substance (vitamin B1) that actually
prevented beri-beri, and he named it "vitamine."
In the early 1940s, Recommended Dietary Allowances (RDAs) were established
by the National Research Council. The RDAs define the minimal nutrient
intakes necessary for the prevention of basic deficiency diseases like
beri-beri and rickets. Until recently, these guidelines were used to set
nutritional adequacy standards for the general population.
Researchers and scientists also continue to uncover the therapeutic role
of individual nutrients in the prevention and treatment of disease. For
example, antioxidants like beta-carotene, selenium, vitamin E, and vitamin
C, particularly from foods, appear to protect against the development of
heart disease, cancer, and other chronic degenerative diseases. Dietary
Reference Intakes (DRIs) have been developed to show how much of a nutrient
we need every day to maximize health and lower the risk of chronic disease
(in contrast to RDAs which state the minimal amount to avoid disease
secondary to deficiencies). The field of clinical nutrition has evolved into
a practice that is increasingly incorporated into mainstream medical
treatment.
What are nutritional supplements?
The term "nutritional supplement" refers to vitamins, minerals, and other
food components that are used to support good health and treat illness. For
example, plant compounds known as phytochemicals (found abundantly in
tomatoes and soybeans, for example) have powerful disease-battling
properties. While it's possible almost all of the time to successfully
incorporate nutrients into your diet alone, supplementation can help
maintain sufficient levels and produce specific desired effects. For
example, supplementation with zinc supplementation has been shown to reduce
the duration of the common cold and decrease the incidence of acute diarrhea
in children.
How do vitamins and minerals work?
Vitamins and minerals play an essential role in the body's normal
metabolism, growth, and development. They do this by helping the body to
perform various tasks. For example, while a vitamin is not a source of
energy in and of itself, it can provide the key the body needs to unlock
energy stored in food. Some vitamins and minerals work together--such as the
mineral zinc and vitamin A. Zinc enables the body to use vitamin A to
promote good vision. Deficiencies in vitamin A may lead to night blindness,
a condition in which the eyes have difficulty adjusting to darkness. Zinc
supplementation, therefore, may prevent this condition by keeping vitamin A
functioning normally. Supplementation alone, however, is not the answer to
long-term good health. Combining a healthful diet with a regular exercise
program and a positive mental attitude has been shown, time and again, to be
the best bet for a healthy lifestyle.
What constitutes a healthful diet?
The optimal diet for improving health has to be individualized to meet
your unique needs. The USDA food pyramid suggests that we use fat
"sparingly," and that our daily diet include two to three servings of dairy
products; two to three servings of meat, poultry, fish, eggs, beans, or
nuts; three to five servings of vegetables; two to four servings of fruit;
and six to eleven servings of bread, cereal, rice, or pasta. But the numbers
alone don't tell the whole story. Our food needs are influenced by many
factors, including age, gender, body size, pregnancy, and health. A clinical
nutritionist can help you determine what type of diet is best for you.
What happens during a visit to a clinical nutritionist?
During the initial part of the visit, the clinical nutritionist will ask
you questions about your medical history, family history, and personal
lifestyle. The medical history might include questions about your diet,
digestion, history of weight loss or gain, sleep and exercise patterns, and
relaxation habits. Some clinical nutritionists will ask you to bring to your
first meeting a 3-day food diary and list of any herbs, supplements, or
medicines that you take regularly. Laboratory tests might be used to find
any deficiencies and test organ function. This way, a nutritionist will get
a full picture of your nutritional lifestyle.
During the second part of the visit, the nutritionist will recommend ways
that you can fill the gaps and reduce the nutritional "overloads" in your
diet. For example, if appropriate, he or she may suggest that you schedule
your meals at different times or cut down on the amount of carbohydrates
that you eat. He or she will also offer advice on specific nutritional
supplements if necessary (see below). The nutritionist will then schedule
follow-up visits to monitor the progression of your health.
What is clinical nutrition good for?
Studies show that eating habits play a major role in the development of
certain chronic diseases (such as heart disease, obesity, cancer, and
diabetes). Dietary changes can help to both prevent and treat these
conditions. For example, lowering fat and cholesterol intake and adding
whole grains to the diet can atherosclerosis (plaque build up in the
arteries) which can lead to heart disease or stroke. Reducing caloric intake
can help lower weight. Cutting down on simple sugars (glucose, sucrose,
fructose, and lactose) can prevent diabetes, and high fiber diets
(especially soluble fiber) can help control diabetes.
Scientists have found many other connections to diet and disease. In a
study of 20,000 men, for example, one fish meal per week was linked to a 52%
reduction in the risk of sudden death from a heart attack. Fish is high in
omega-3 fatty acids, which are essential components of cells and can protect
the heart from, for example, fatal arrhythmias (abnormal heart rhythm).
In another study of more than 42,000 women, those who ate lots of fruits,
vegetables, whole grains, low-fat dairy, and only lean meats lived longer.
High intake of fruits, vegetables, and legumes is associated with a lower
risk of developing heart disease.
There are numerous, ongoing studies regarding clinical nutrition. Some
interesting results indicate that:
high dietary intake of folate (found in leafy greens, dry beans and peas,
fortified cereals and grain products, and some fruits and vegetables) may
lower risk of stroke and heart disease
eating small amounts of fish in pregnancy may protect against early
delivery and low birth weight infants
iron supplementation in iron depleted women improves aerobic training
ability
lutein and zeaxanthin (carotenoids) in the diet may reduce risk of
cataracts
lutein from dietary sources (such as kale and spinach) may protect against
colon cancer
flavonoids (found in broccoli, citrus fruits, apples, onions, and carrots)
may protect against certain types of lung cancer
vitamin E (in the diet from fruits and vegetables) may reduce the risk of
angina (chest pain) and heart attack in people with atherosclerosis
In hospitals, nutrition is used to improve the overall health of patients
with a wide range of conditions. Examples of these conditions are AIDS,
cancer, osteoporosis, lung disease, obesity, burns, metabolic disorders, and
kidney, liver, and pancreatic disorders. Patients who need surgery are also
supported with clinical nutrition.
