Richard G. Petty, MD

Non-pharmacological and Lifestyle Approaches to Attention-Deficit/Hyperactivity Disorder: 8. Massage and Manipulation

There is a small but persuasive literature on the value of massage and manipulation in people with attention-deficit hyperactivity disorder (ADHD).

The first study involved 28 adolescents with ADHD who were given either massage therapy or relaxation therapy for 10 consecutive school days. The massage therapy group, but not the relaxation therapy group, rated themselves as happier and observers rated them as fidgeting less following the sessions. After the 2-week period, their teachers reported more time on task and assigned them lower hyperactivity scores based on classroom behavior.

The second study was a randomized controlled trial involving 30 students aged 7-18 years. The results indicated that therapeutic massage given for 20 minutes twice a week produced significant improvements in both classroom behavior and mood.

There are a large number of studies that have shown that massage therapy can be helpful in managing anxiety in many different situations (1. 2.)

And it may also have some beneficial effects on the immune system.

There has been a great deal of interest in the notion that chiropractic manipulation may have an impact on the symptoms of ADHD.

A small study of seven children diagnosed with ADHD showed some improvements in ratings of hyperactivity.

There are some interesting case reports:
In the first a young girl who had been diagnosed with ADHD whose symptoms had failed to respond to an astonishing array of medications, but who improved once a cervical kyphosis was treated.

The second concerned a nine-year-old with Tourette’s and ADHD who showed a remarkable improvement after a course of chiropractic treatment.

The third concerned an 8-year-old with multiple learning and behavioral disorders associated with ADHD that improved after a course of chiropractic treatment. This case was rather different form the others in that the symptoms began after a fall, and it seems likely that the problems were at least in part due to pain and discomfort, and the child’s improvement may have been related to an improvement in both. The case highlights the importance of remembering that problems with mood, sleep and attention may be secondary to other medical or psychological maladies.

A recent review article on chiropractic care in people with learning disabilities and dyslexia does touch on ADHD and rightly concludes that the evidence so far is interesting but far from conclusive.

There is clearly a great deal of scope for further research into massage and manipulative therapies and ADHD.

I shall keep you posted if any more studies come out.

I am indebted to Dennis da Ponte from Life University in Atlanta for helping track down some of the papers that I referred to in this article.

Acupuncture Without Needles

There are, in the United States, over 7 million people who are partially or completely disabled by back pain and another 40-50 million people who suffer from chronic recurrent headaches. Frustrated with my inability to help all my patients with conventional treatments, I have been using acupuncture since 1981. But about ten years ago I started using more acupressure, particularly since I could teach a lot of people to continue treating themselves.

Last month we saw evidence from a study using magnetoencephelography (MEG) scanning equipment that acupuncture reduces the activity of regions of the limbic system of the brain. MEG is a relatively new technology that measures the very faint magnetic fields that emanate from the head because of brain activity, instead of measuring electrical activity itself, which is a fairly blunt instrument. This reduced activity only occurred with deep needling, and when the patient experienced what is known as de qi. In Chinese medicine it is normally considered that the needle has not been correctly positioned until the patient and the practitioner both get the sensation of de qi. By contrast, superficial needling just caused activation of sensory areas of the cortex. Many doctors trained in needling techniques ignore the de qi experience, which is, I think, a mistake. When you are able to elicit it, the efficacy of acupuncture increases enormously.

Keep in mind what I have said before: just because acupuncture is associated with neurological changes, does not mean that they are responsible for the effects of acupuncture.

In this week’s British Medical Journal is an article from Taiwan, showing the effectiveness of acupressure in 129 patients with chronic low back pain. Like every study ever done, it is possible to pick some holes in this one, but overall it appears to be sound.

Now I am interested to see a press release about a form of needle-less therapy. I have written before about Thought Field Therapy (TFT), and the subject of the press release is a development of it called Emotional Freedom Technique, or EFT. While TFT uses tapping at specific points, together with humming, counting and eye movements, EFT is much simpler. It combines gentle fingertip tapping on key acupuncture points with focused thought. It is claimed to effectively reduce – and often permanently eliminating – chronic pain. According to its practitioners, EFT is more than 80-percent effective in treating headaches, back pain, cancer pain, arthritis, and pain from other conditions.

There is the rub: I could find no published research when I did a Medline search. That being said, I have reported elsewhere that I went to California to debunk TFT and became a convert after being treated by its inventor, Roger Callahan. There is a small amount of research on TFT that appears to confirm its effectiveness in some conditions, and I have certainly found it to be very helpful for many people.

Whether the claims of EFT will be born out remains to be seen. I have seen the techniques work, and I have to give credit where it is due. In exchange for your email address Gary Craig, who developed EFT, allows you to download a EFT manual from his website. You may also purchase DVDs from his site to learn more about this treatment modality. As always, I do not suggest using EFT or any other method in place of tried and tested treatments, but it may be a good adjunctive treatment for mild conditions.

In future message and in my newsletter I shall share some of the precise techniques that I have found useful, as well as ones that did not work out for me.

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