Complementary therapies and patient coaching for assistive devices

Complementary therapies

Complementary therapies are used together with conventional medicine. For instance, massage and chiropractic care are considered complementary therapies. Sometimes people will use the term alternative, but that means the therapy is being used instead of conventional medicine. Most patients using complementary therapies will also see their healthcare provider. The deciding factor is whether the patient still uses conventional medicine alongside the therapy: complementary means alongside, alternative means instead of.

Massage therapy

Massage therapy ranges from light stroking to deep rubbing. With massage therapy, pressure is applied to a person’s skin and muscles. Studies have shown that massage reduces stress, pain, and muscle tension. Massage is performed by massage therapists, who are specially trained in the procedures. There are several types of massage:

• Deep massage: Used to help with muscle damage from injuries. Slower, more forceful massage is done to the muscles and connective tissues (e.g., tendons and ligaments).
• Swedish massage: Used to relax a person. Involves a gentle massage of long strokes and deep circular movements that can energize the individual.
• Sports massage: Used on athletes to help prevent or treat injuries. The technique is similar to Swedish massage.
• Trigger point massage: Used to help with muscle damage from injury or overuse. Involves a focused massage on tight muscles.

Chiropractic care

Chiropractic care focuses on the relationship between the spine and the function of the body. The goal is to correct alignment problems and thereby alleviate pain, improve function, and support the body’s natural ability to heal itself. Spinal manipulation has been shown to be beneficial for low back pain, headaches, neck pain, whiplash-associated disorders, and upper and lower extremity joint conditions.

Chiropractic doctors have at least 4 years of additional training beyond a bachelor’s degree. The training includes both classroom and direct patient care. The doctors must pass the National Board of Chiropractic Examiners (NBCE) exam to become licensed. State law regulates their practice, and many state boards require continuing education to maintain the license.

Acupressure and acupuncture

Both acupressure and acupuncture have been practiced for thousands of years. Acupressure involves applying firm pressure to specific points on the body, using only the hands or fingers and no needles. Acupuncture involves inserting fine needles into those same acupuncture points (specific sites on the body). The needles may be removed quickly or left in for longer periods of time. Acupressure and acupuncture are used to treat a wide range of symptoms, including pain, nausea, neuropathy, anxiety, depression, and sleep disturbance.

Patient coaching

When patients are using assistive devices, falls can occur. The medical assistant should teach patients how to prevent falls when using assistive devices. Furnishing this kind of home-safety information is itself an important part of patient-centered care for a patient dealing with pain or limited mobility. These instructions should include the following:

• Wear shoes with rubber or nonskid soles.
• Remove items in the walkway that can cause falls (e.g., throw or loose rugs, cords, and clutter). Small indoor animals may also cause falls if they are near the person’s feet.
• Make sure that floors are clean and dry.
• When attempting to sit, back up until the seat touches the back of the legs. With a free hand, grab the seat or armrest and lower yourself into the chair or onto the toilet.
• To stand, scoot forward in the chair and use the free hand to push up from the seat to stand up. Make sure to get your balance before moving.
• Consider adding handrails inside the tub and by the toilet.

Legal and ethical issues

A medical assistant does not perform massage, chiropractic manipulation, or acupuncture/acupressure - these are delivered by therapists and doctors with their own specialized training and licensure. If your role expands to assisting with a patient’s broader musculoskeletal care plan, that expanded role is delegated by the provider and governed by state law and your facility’s policies. Always check with your local and state medical assistant organizations before taking on any tasks beyond your standard scope of practice, and you remain responsible for performing any delegated task correctly.

Professional behaviors

Pain and limited mobility resulting from muscular disorders can affect a person’s behavior. A patient may be short tempered or have limited patience. The medical assistant must remember to talk calmly and remain composed, even if the patient is not. Treating a patient with respect and listening to the person’s concerns helps the patient to feel respected.