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Massage Therapy vs. Simple Touch to Improve Pain and Mood in Patients with Advanced Cancer: A Randomized Trial
Kutner, Jean S.
Smith, Marlaine C.
Corbin, Lisa
Hemphill, Linnea
Benton, Kathryn
Mellis, B. Karen
Beaty, Brenda
Felton, Sue
Yamashita, Traci E.
Bryant, Lucinda L.
Fairclough, Diane L.
Annals of internal medicine
Small studies of variable quality suggest that massage therapy may relieve pain and other symptoms.
Evaluate efficacy of massage for decreasing pain and symptom distress and improving quality of life among persons with advanced cancer.
Multi-site randomized clinical trial.
Population-based Palliative Care Research Network (PoPCRN).
380 adults with advanced cancer experiencing moderate-severe pain; 90% were enrolled in hospice.
Six 30-minute massage or simple touch sessions over two weeks.
Primary outcomes were immediate (Memorial Pain Assessment Card, MPAC, 0 – 10 scale) and sustained (Brief Pain Inventory, BPI, 0 – 10 scales) change in pain. Secondary outcomes were immediate change in mood (MPAC 0 – 10 scale) and 60-second heart and respiratory rates and sustained change in quality of life (McGill Quality of Life Questionnaire, MQOL, 0 – 10 scale), symptom distress (Memorial Symptom Assessment Scale, MSAS, 0 – 4 scale), and analgesic medication use (parenteral morphine equivalents (milligrams/24 hours). Immediate outcomes were obtained just prior to and following each treatment session. Sustained outcomes were obtained at baseline and weekly for 3 weeks.
298 were included in the immediate outcome analysis and 348 in the sustained outcome analysis. 82 did not receive any allocated study treatments (37 massage, 45 control). Both groups demonstrated immediate improvement in pain (massage -1.87 points (CI, -2.07, -1.67), control -0.97 points (CI, -1.18, -0.76)) and mood (massage 1.58 points (CI, 1.40, 1.76), control 0.97 points (CI, 0.78, 1.16)). Massage was superior for both pain and mood (mean difference 0.90 and 0.61 points, respectively, P<0.001). There were no between group mean differences over time in pain (BPI Mean 0.07 (CI, -0.23, 0.37), BPI Worst -0.14 (CI, -0.59, 0.31)), quality of life (MQOL Overall 0.08 (CI, -0.37, 0.53)), symptom distress (MSAS Global Distress Index -0.002 (CI, -0.12, 0.12)), or analgesic medication use (parenteral morphine equivalents -0.10 (CI, -0.25, 0.05).
The immediate outcome measures were obtained by unblinded study therapists, possibly leading to reporting bias and the overestimation of beneficial effect. The generalizability to all advanced cancer patients is uncertain. The differential beneficial effect of massage therapy over simple touch is not conclusive in the absence of a "usual care" control arm.
Massage may have immediately beneficial effects on pain and mood among patients with advanced cancer. Given the lack of sustained effects and the observed improvements in both study arms, the potential benefits of attention and simple touch should also be considered in this population.
Related Articles
Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain
Irnich, Dominik
Behrens, Nicolas
Molzen, Holger
König, Achim
Gleditsch, Jochen
Krauss, Martin
Natalis, Malte
Senn, Edward
Beyer, Antje
Schöps, Peter
BMJ : British Medical Journal
To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain.
Prospective, randomised, placebo controlled trial.
Three outpatient departments in Germany.
177 patients aged 18-85 years with chronic neck pain.
Patients were randomly allocated to five treatments over three weeks with acupuncture (56), massage (60), or "sham" laser acupuncture (61).
Main outcome measures
Primary outcome measure: maximum pain related to motion (visual analogue scale) irrespective of direction of movement one week after treatment. Secondary outcome measures: range of motion (3D ultrasound real time motion analyser), pain related to movement in six directions (visual analogue scale), pressure pain threshold (pressure algometer), changes of spontaneous pain, motion related pain, global complaints (seven point scale), and quality of life (SF-36). Assessments were performed before, during, and one week and three months after treatment. Patients' beliefs in treatment were assessed.
One week after five treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not compared with sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years (n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures. There were no differences in patients' beliefs in treatment.
Acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments.
What is already known on this topicAcupuncture is a widespread complementary treatmentEvidence from trials have given conflicting results on its use in the treatment of neck pain because of methodological shortcomings and because effects were compared either with alternative treatments or with different sham procedures imitating acupuncture, but not bothWhat this study addsCompared with sham laser acupuncture and massage, needle acupuncture has beneficial effects on mobility and pain related to motion in patients with chronic neck painAcupuncture was clearly more effective than massage, but differences were not always significant compared with sham laser acupunctureAcupuncture was the best treatment for patients with the myofascial syndrome and those who had had pain for longer than five years
Related Articles
Changes in Clinical Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study
Moraska, Albert
Chandler, Clint
The Journal of Manual & Manipulative Therapy
Complementary and alternative medicine approaches to treatment for tension-type headache are increasingly popular among patients, but evidence supporting its efficacy is limited. The objective of this study was to assess short term changes on primary and secondary headache pain measures in patients with tension-type headache (TTH) receiving a structured massage therapy program with a focus on myofascial trigger point therapy. Participants were enrolled in an open label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week phases) and follow-up. Twice weekly, 45-minute massage sessions commenced following the baseline phase. A daily headache diary was maintained throughout the study in which participants recorded headache incidence, intensity, and duration. The Headache Disability Index was administered upon study entry and at 3-week intervals thereafter. 18 subjects were enrolled with 16 completing all headache diary, evaluation, and massage assignments. Study participants reported a median of 7.5 years with TTH. Headache frequency decreased from 4.7±0.7 episodes per week during baseline to 3.7±0.9 during treatment period 2 (P<0.001); reduction was also noted during the follow-up phase (3.2±1.0). Secondary measures of headache also decreased across the study phases with headache intensity decreasing by 30% (P<0.01) and headache duration from 4.0±1.3 to 2.8±0.5 hours (P<0.05). A corresponding improvement in Headache Disability Index was found with massage (P<0.001). This pilot study provides preliminary evidence for reduction in headache pain and disability with massage therapy that targets myofascial trigger points, suggesting the need for more rigorously controlled studies.
Complementary and Alternative Medicine; Headache Disability Index; Manual Therapy; Myofasical Pain; Myofascial Trigger Points
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Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial
Preyde, M
CMAJ: Canadian Medical Association Journal
BACKGROUND: The effectiveness of massage therapy for low-back pain has not been documented. This randomized controlled trial compared comprehensive massage therapy (soft-tissue manipulation, remedial exercise and posture education), 2 components of massage therapy and placebo in the treatment of subacute (between 1 week and 8 months) low-back pain. METHODS: Subjects with subacute low-back pain were randomly assigned to 1 of 4 groups: comprehensive massage therapy (n = 25), soft-tissue manipulation only (n = 25), remedial exercise with posture education only (n = 22) or a placebo of sham laser therapy (n = 26). Each subject received 6 treatments within approximately 1 month. Outcome measures obtained at baseline, after treatment and at 1-month follow-up consisted of the Roland Disability Questionnaire (RDQ), the McGill Pain Questionnaire (PPI and PRI), the State Anxiety Index and the Modified Schober test (lumbar range of motion). RESULTS: Of the 107 subjects who passed screening, 98 (92%) completed post-treatment tests and 91 (85%) completed follow-up tests. Statistically significant differences were noted after treatment and at follow-up. The comprehensive massage therapy group had improved function (mean RDQ score 1.54 v. 2.86-6.5, p < 0.001), less intense pain (mean PPI score 0.42 v. 1.18-1.75, p < 0.001) and a decrease in the quality of pain (mean PRI score 2.29 v. 4.55-7.71, p = 0.006) compared with the other 3 groups. Clinical significance was evident for the comprehensive massage therapy group and the soft-tissue manipulation group on the measure of function. At 1-month follow-up 63% of subjects in the comprehensive massage therapy group reported no pain as compared with 27% of the soft-tissue manipulation group, 14% of the remedial exercise group and 0% of the sham laser therapy group. INTERPRETATION: Patients with subacute low-back pain were shown to benefit from massage therapy, as regulated by the College of Massage Therapists of Ontario and delivered by experienced massage therapists.
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Touch and Massage for Medically Fragile Infants
Livingston, Karen
Beider, Shay
Kant, Alexis J.
Gallardo, Constance C.
Joseph, Michael H.
Gold, Jeffrey I.
Evidence-based Complementary and Alternative Medicine : eCAM
Research investigating the efficacy of infant massage has largely focused on premature and low birth weight infants. The majority of investigations have neglected highly acute patients in academic neonatal intensive care units (NICUs). The current study was developed with two aims: (Phase 1) to develop, implement and demonstrate the feasibility and safety of a parent-trained compassionate touch/massage program for infants with complex medical conditions and (Phase 2) to conduct a longitudinal randomized control trial (RCT) of hand containment/massage versus standard of care in a level III academic Center for Newborn and Infant Critical Care (CNICC). Certified infant massage instructors (CIMIs) taught parents to massage their hospitalized infants. Massage therapy and instruction were performed for seven consecutive days and health outcomes were collected for up to 1 month following treatment. Caregivers, nurses and certified infant massage therapists indicated moderate to high levels of satisfaction and feasibility with the implementation of hand containment/massage in a level III academic center CNICC. In addition, infant behavioral and physiological measures were within safe limits during the massage sessions. All caregivers participating in the massage group reported high levels of satisfaction 7 days into the intervention and at the 1-month follow-up with regards to their relationship with their infant, the massage program's impact on that relationship and the massage program. Due to unequal and small sample sizes, between group analyses (control versus massage) were not conducted. Descriptive infant characteristics of health outcomes are described. Preliminary data from this study indicates feasibility and safety of infant massage and satisfaction among the caregivers, CIMIs and the nurses in the CNICC. An important contribution from this study was the demonstration of the infants' safety based on physiological stability and no change in agitation/pain scores of the infants receiving massage. Massage in a tertiary urban academic NICU continues to be an area of needed study. Future studies examining infant health outcomes, such as weight gain, decreased length of hospitalization and caregiver–infant bonding, would provide greater insight into the impact of massage for medically fragile infants.
medically fragile; infant massage; neonatal intensive care; caregiver depression; pediatric psychology; CAM; integrative medicine
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Effectiveness of Chinese massage therapy (Tui Na) for chronic low back pain: study protocol for a randomized controlled trial
Yang, Mingxiao
Feng, Yue
Pei, Hong
Deng, Shufang
Wang, Minyu
Xiao, Xianjun
Zheng, Hui
Lai, Zhenhong
Chen, Jiao
Li, Xiang
He, Xiaoguo
Liang, Fanrong
Low back pain is a common, disabling musculoskeletal disorder in both developing and developed countries. Although often recommended, the potential efficacy of massage therapy in general, and Chinese massage (tuina) in particular, for relief of chronic low back pain (CLBP) has not been fully established due to inadequate sample sizes, low methodological quality, and subclinical dosing regimens of trials to date. Thus, the purpose of this randomized controlled trial (RCT) is to evaluate the comparative effectiveness of tuina massage therapy versus conventional analgesics for CLBP.
The present study is a single center, two-arm, open-label RCT. A total of 150 eligible CLBP patients will be randomly assigned to either a tuina treatment group or a conventional drug control group in a 1:1 ratio. Patients in the tuina group receive a 20 minutes, 4-step treatment protocol which includes both structural and relaxation massage, administered in 20 sessions over a period of 4 weeks. Patients in the conventional drug control group are instructed to take a specific daily dose of ibuprofen. The primary outcome measure is the change from baseline back pain and function, measured by Roland-Morris Disability Questionnaire, at two months. Secondary outcome measures include the visual analogue scale, Japanese orthopedic association score (JOAS), and McGill pain questionnaire.
The design and methodological rigor of this trial will allow for collection of valuable data to evaluate the efficacy of a specific tuina protocol for treating CLBP. This trial will therefore contribute to providing a solid foundation for clinical treatment of CLBP, as well as future research in massage therapy.
Trial registration
This trial was registered with ClinicalTrials.gov of the National Institute of Health on 22 October 2013 (http://NCT01973010).
Chronic low back pain; Effectiveness; Randomized controlled trial; Tuina; Chinese massage therapy
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Randomized Trial of Therapeutic Massage for Chronic Neck Pain
Sherman, Karen J.
Cherkin, Daniel C.
Hawkes, Rene J.
Miglioretti, Diana L.
Deyo, Richard A.
The Clinical journal of pain
Little is known about the effectiveness of therapeutic massage, one of the most popular complementary medical treatments for neck pain. A randomized controlled trial was conducted to evaluate whether therapeutic massage is more beneficial than a self-care book for patients with chronic neck pain.
Sixty-four such patients were randomized to receive up to 10 massages over 10 weeks or a self-care book. Follow-up telephone interviews after 4, 10, and 26 weeks assessed outcomes including dysfunction and symptoms. Log-binomial regression was used to assess whether there were differences in the percentages of participants with clinically meaningful improvements in dysfunction and symptoms (i.e., > 5 point improvement on the Neck Disability Index (NDI); > 30% improvement from baseline on the symptom bothersomeness scale) at each time point.
At 10 weeks, more participants randomized to massage experienced clinically significant improvement on the NDI (39% vs. 14% of book group; RR= 2.7; 95% confidence interval (CI) = 0.99–7.5) and on the symptom bothersomeness scale (55% vs. 25% of book group; RR=2.2; 95% CI=1.04–4.2). After 26 weeks, massage group members tended to be more likely to report improved function (RR=1.8; 95% CI=0.97–3.5), but not symptom bothersomeness (RR=1.1; 95% CI=0.6–2.0). Mean differences between groups were strongest at 4 weeks and not evident by 26 weeks. No serious adverse experiences were reported.
This study suggests that massage is safe and may have clinical benefits for treating chronic neck pain at least in the short term. A larger trial is warranted to confirm these results.
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Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain
Little, Paul
Lewith, George
Webley, Fran
Evans, Maggie
Beattie, Angela
Middleton, Karen
Barnett, Jane
Ballard, Kathleen
Oxford, Frances
Smith, Peter
Yardley, Lucy
Hollinghurst, Sandra
Sharp, Debbie
BMJ : British Medical Journal
Objective To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain.
Design Factorial randomised trial.
Setting 64 general practices in England.
Participants 579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription.
Interventions Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling.
Main outcome measures Roland Morris disability score (number of activities impaired by pain) and number of days in pain.
Results Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks was lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported.
Conclusions One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.
Trial registration National Research Register N0028108728.
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Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study
Moraska, Albert
Chandler, Clint
The Journal of Manual & Manipulative Therapy
Investigations into complementary and alternative medicine (CAM) approaches to address stress, depression, and anxiety of those experiencing chronic pain are rare. The objective of this pilot study was to assess the value of a structured massage therapy program, with a focus on myofascial trigger points, on psychological measures associated with tension-type headache. Participants were enrolled in an open-label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week periods) and a follow-up phase. Eighteen subjects with episodic or chronic tension-type headache were enrolled and evaluated at 3-week intervals using the State-Trait Anxiety Inventory, Beck Depression Inventory, and the Perceived Stress Scale. The Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Twice weekly, 45-minute massage therapy sessions commenced following the baseline phase and continued for 6 weeks. A significant improvement in all psychological measures was detected over the timeframe of the study. Post hoc evaluation indicated improvement over baseline for depression and trait anxiety following 6 weeks of massage, but not 3 weeks. A reduction in the number of events deemed stressful as well as their respective impact was detected. This pilot study provides evidence for reduction of affective distress in a chronic pain population, suggesting the need for more rigorously controlled studies using massage therapy to address psychological measures associated with TTH.
Beck Depression Inventory; Complementary and Alternative Medicine; Daily Stress Inventory; Myofascial Pain; State-Trait Anxiety Inventory
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Dosing study of massage for chronic neck pain: protocol for the dose response evaluation and analysis of massage [DREAM] trial
Sherman, Karen J
Cook, Andrea J
Kahn, Janet R
Hawkes, Rene J
Wellman, Robert D
Cherkin, Daniel C
BMC Complementary and Alternative Medicine
Despite the growing popularity of massage, its effectiveness for treating neck pain remains unclear, largely because of the poor quality of research. A major deficiency of previous studies has been their use of low "doses" of massage that massage therapists consider inadequate. Unfortunately, the number of minutes per massage session, sessions per week, or weeks of treatment necessary for massage to have beneficial or optimal effects are not known. This study is designed to address these gaps in our knowledge by determining, for persons with chronic neck pain: 1) the optimal combination of number of treatments per week and length of individual treatment session, and 2) the optimal number of weeks of treatment.
In this study, 228 persons with chronic non-specific neck pain will be recruited from primary health care clinics in a large health care system in the Seattle area. Participants will be randomized to a wait list control group or 4 weeks of treatment with one of 5 different dosing combinations (2 or 3 30-min treatments per week or 1, 2, or 3 60-min treatments per week). At the end of this 4-week primary treatment period, participants initially receiving each of the 5 dosing combinations will be randomized to a secondary treatment period of either no additional treatment or 6 weekly 60-min massages. The primary outcomes, neck-related dysfunction and pain, will be assessed by blinded telephone interviewers 5, 12, and 26 weeks post-randomization. To better characterize the trajectory of treatment effects, these interview data will be supplemented with outcomes data collected by internet questionnaire at 10, 16, 20 and 39 weeks. Comparisons of outcomes for the 6 groups during the primary treatment period will identify the optimal weekly dose, while comparisons of outcomes during the secondary treatment period will determine if 10 weeks of treatment is superior to 4 weeks.
A broad dosing schedule was included in this trial. If adherence to any of these doses is poor, those doses will be discontinued.
Trial registration
This trial is registered in ClinicalTrials.gov, with the ID number of NCT01122836
Therapeutic massage; Optimal dose; Chronic neck pain
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The effect of foot massage on long-term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial
Moyle, Wendy
Cooke, Marie
O'Dwyer, Siobhan T
Murfield, Jenny
Johnston, Amy
Sung, Billy
BMC Nursing
Caring for a person with dementia can be physically and emotionally demanding, with many long-term care facility staff experiencing increased levels of stress and burnout. Massage has been shown to be one way in which nurses' stress can be reduced. However, no research has been conducted to explore its effectiveness for care staff working with older people with dementia in long-term care facilities.
This was a pilot, parallel group, randomized controlled trial aimed at exploring feasibility for a larger randomized controlled trial. Nineteen staff, providing direct care to residents with dementia and regularly working ≥ two day-shifts a week, from one long-term care facility in Queensland (Australia), were randomized into either a foot massage intervention (n=9) or a silent resting control (n=10). Each respective session lasted for 10-min, and participants could receive up to three sessions a week, during their allocated shift, over four-weeks. At pre- and post-intervention, participants were assessed on self-report outcome measures that rated mood state and experiences of working with people with dementia. Immediately before and after each intervention/control session, participants had their blood pressure and anxiety measured. An Intention To Treat framework was applied to the analyses. Individual qualitative interviews were also undertaken to explore participants' perceptions of the intervention.
The results indicate the feasibility of undertaking such a study in terms of: recruitment; the intervention; timing of intervention; and completion rates. A change in the intervention indicated the importance of a quiet, restful environment when undertaking a relaxation intervention. For the psychological measures, although there were trends indicating improvement in mood there was no significant difference between groups when comparing their pre- and post- scores. There were significant differences between groups for diastolic blood pressure (p= 0.04, partial η2=0.22) and anxiety (p= 0.02, partial η2=0.31), with the foot massage group experiencing greatest decreases immediately after the session. The qualitative interviews suggest the foot massage was well tolerated and although taking staff away from their work resulted in some participants feeling guilty about taking time out, a 10-min foot massage was feasible during a working shift.
This pilot trial provides data to support the feasibility of the study in terms of recruitment and consent, the intervention and completion rates. Although the outcome data should be treated with caution, the pilot demonstrated the foot massage intervention showed trends in improved mood, reduced anxiety and lower blood pressure in long-term care staff working with older people with dementia. A larger study is needed to build on these promising, but preliminary, findings.
Trial registration
Anxiety; Blood pressure; Care staff; Complementary and alternative medicine; Dementia; Long-term care; Massage; Mood state; Pilot; Randomized controlled trial
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Effectiveness of focused structural massage and relaxation massage for chronic low back pain: protocol for a randomized controlled trial
Cherkin, Daniel C
Sherman, Karen J
Kahn, Janet
Erro, Janet H
Deyo, Richard A
Haneuse, Sebastien J
Cook, Andrea J
Chronic back pain is a major public health problem and the primary reason patients seek massage treatment. Despite the growing use of massage for chronic low back pain, there have been few studies of its effectiveness. This trial will be the first evaluation of the effectiveness of relaxation massage for chronic back pain and the first large trial of a focused structural form of massage for this condition.
Methods and Design
A total of 399 participants (133 in each of three arms) between the ages of 20 and 65 years of age who have low back pain lasting at least 3 months will be recruited from an integrated health care delivery system. They will be randomized to one of two types of massage ("focused structural massage" or "relaxation massage"), or continued usual medical care. Ten massage treatments will be provided over 10 weeks. The primary outcomes, standard measures of dysfunction and bothersomeness of low back pain, will be assessed at baseline and after 10, 26, and 52 weeks by telephone interviewers masked to treatment assignment. General health status, satisfaction with back care, days of back-related disability, perceived stress, and use and costs of healthcare services for back pain will also be measured. Outcomes across assigned treatment groups will be compared using generalized estimating equations, accounting for participant correlation and adjusted for baseline value, age, and sex. For both primary outcome measures, this trial will have at least 85% power to detect the presence of a minimal clinically significant difference among the three treatment groups and 91% power for pairwise comparisons. Secondary analyses will compare the proportions of participants in each group that improve by a clinically meaningful amount.
Results of this trial will help clarify the value of two types of massage therapy for chronic low back pain.
Trial registration
Clinical Trials.gov NCT 00371384.
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A Pilot Feasibility Study of Massage to Reduce Pain in People with Spinal Cord Injury during Acute Rehabilitation
Chase, Theresa
Jha, Amitabh
Brooks, C. A.
Allshouse, Amanda
Spinal cord
To determine the feasibility of conducting a randomized controlled trial of massage therapy for patients with new spinal cord injury (SCI) during acute inpatient rehabilitation.
A pilot single-center, randomized, single-blind, cross-over clinical trial.
Free-standing, not-for-profit, comprehensive rehabilitation center specializing in SCI rehabilitation
Forty adults ages 18 years and older undergoing acute rehabilitation following spinal cord injury reporting any type of pain.
Rehabilitation nurses trained to give broad compression massage (BCM) and a control light contact touch (LCT) treatments. Participants were randomized to receive either BCM or LCT first, in six 20 minute treatment sessions over two weeks, with a one week wash-out between the two-week treatment periods.
Main Outcome Measures
Primary outcomes were changes in pain intensity and in fatigue, measured daily. Secondary outcomes included depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9) and an assessment of pain medication usage.
Pain intensity was higher at baseline and reduced more in the LCT-first group compared to the BCM-first group in period 1 (p=0.014); although this pattern was not found in period 2 (p=0.58). LCT and BCM groups did not significantly differ on any secondary measures except PHQ-9.
This study demonstrates the feasibility of using rehabilitation nurses to provide tactile therapy to patients with SCI and suggests a model for controlled clinical trials examining the efficacy of massage therapies. While efficacy was difficult to assess, broad compression massage was safe and well tolerated.
spinal cord injury; massage; randomized clinical trial
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Jay, Kenneth
Sundstrup, Emil
Søndergaard, Stine D.
Behm, David
Brandt, Mikkel
Særvoll, Charlotte A.
Jakobsen, Markus D.
Andersen, Lars L.
International Journal of Sports Physical Therapy
Muscle soreness can negatively interfere with the activities of daily living as well as sports performance. In the working environment, a common problem is muscle tenderness, soreness and pain, especially for workers frequently exposed to unilateral high repetitive movements tasks. The aim of the study is therefore to investigate the acute effect of massage applied using a simple device Thera‐band roller Massager on laboratory induced hamstring muscle soreness, and the potential cross over effect to the non‐massaged limb.
22 healthy untrained men (Mean age 34 +/− 7 years; mean height 181.7 +/− 6.9 cm; mean weight 80.6 +/− 6.4 kg; BMI: 24.5 +/− 1.3) with no prior history of knee, low back or neck injury or other adverse health issues were recruited. Participants visited the researchers on two separate occasions, separated by 48 hours, each time providing a soreness rating (modified visual analog scale 0‐10), and being tested for pressure pain threshold (PPT) and active range of motion (ROM) of the hamstring muscles. During the first visit, delayed onset muscular soreness of the hamstring muscles was induced by 10 x 10 repetitions of the stiff‐legged dead‐lift. On the second visit participants received either 1) 10 minutes of roller massage on one leg, while the contralateral leg served as a cross over control, or 2) Resting for 10 minutes with no massage at all. Measurement of soreness, PPT and ROM were taken immediately before and at 0, 10, 30 and 60 min. after treatment.
There was a significant group by time interaction for soreness (p < 0.0001) and PPT (p = 0.0007), with the massage group experiencing reduced soreness and increasing PPT compared with the control group. There was no group by time interaction for ROM (p = 0.18). At 10 min. post massage there was a significant reduction in soreness of the non‐massaged limb in the cross over control group compared to controls but this effect was lost 30 minutes post massage.
Massage with a roller device reduces muscle soreness and is accompanied by a higher PPT of the affected muscle.
Level of Evidence:
2c; outcomes research
Cross over effect; delayed onset muscle soreness hyperalgesia; pain
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The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences
Eghbali, Maryam
Safari, Reza
Nazari, Fatemeh
Abdoli, Samereh
Iranian Journal of Nursing and Midwifery Research
Humans have been involved with the phenomena of pain and pain relief from the ancient times. Back pain is the most common pain. In fact, eight out of ten people experience it in their lifetime. However, individuals with specific jobs, including nurses, are faced with this problem more. Nursing is in the top ten careers suffering from the most severe musculoskeletal injuries. There are non-pharmacologic and pharmacologic treatments to relieve back pain. One of the non-medical treatments of pain is called reflexology which is a branch of complementary and alternative therapies. This research has been conducted to investigate the effect of reflexology on chronic low back pain intensity.
Materials and Methods:
This study was a double-blind clinical trial. The study population consisted of 50 female and male nurses suffering from chronic low back pain working in hospitals affiliated with Isfahan University of Medical Sciences. The participants were divided into two groups of reflexology and non-specific massage. A questionnaire was completed through interviews and a 40 minute sessions of interventions were performed three times a week for two weeks. Pain intensity was measured by Numerical Analogue Scale for pain before and after the intervention. Descriptive and inferential statistics, including independent t-test and chi-square test, were used to analyze the data.
The results showed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention as compared with the non-specific massage group. However, the non-specific massage was also significantly effective in reducing pain.
Reflexology can be effective in reducing the severity of chronic back pain, i.e. it is able to reduce pain from moderate to mild. Thus, this technique is recommended to be performed by nurses as a complementary therapy in patient care.
Pain; complementary therapies; nursing; reflexology; back pain
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A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain: A Randomized, Controlled Trial
Cherkin, Daniel C.
Sherman, Karen J.
Kahn, Janet
Wellman, Robert
Cook, Andrea J.
Johnson, Eric
Erro, Janet
Delaney, Kristin
Deyo, Richard A.
Annals of internal medicine
Few studies have evaluated the effectiveness of massage for back pain.
To evaluate the effectiveness of two types of massage for chronic back pain.
Single-blind parallel group randomized controlled trial.
Integrated health care delivery system in Seattle area.
401 persons 20 to 65 years of age with non-specific chronic low back pain.
Ten treatments over 10 weeks of Structural Massage (intended to identify and alleviate musculoskeletal contributors to pain through focused soft-tissue manipulation) (n=132) or Relaxation Massage (intended to decrease pain and dysfunction by inducing relaxation) (n=136). Treatments provided by 27 experienced licensed massage therapists. Comparison group received continued usual care (n=133). Study presented as comparison of usual care with two types of massage.
Primary outcomes were the Roland Disability Questionnaire (RDQ) and the Symptom Bothersomeness scale measured at 10 weeks. Outcomes also measured after 26 and 52 weeks.
At 10 weeks, the massage groups had similar functional outcomes that were superior to those for usual care. The adjusted mean RDQ scores were 2.9 and 2.4 points lower for the relaxation and structural massage groups, respectively, compared to usual care (95% CIs: [1.8, 4.0] and [1.4, 3.5]). Adjusted mean symptom bothersomeness scores were 1.7 points and 1.4 points lower with relaxation and structural massage, respectively, versus usual care (95% CIs: [1.2, 2.2] and [0.8, 1.9]). The beneficial effects of relaxation massage on function (but not on symptom reduction) persisted at 52 weeks, but were small.
Restricted to single site; therapists and patients not blinded to treatment.
This study confirms the results of smaller trials that massage is an effective treatment for chronic back pain with benefits lasting at least 6 months, and also finds no evidence of a clinically-meaningful difference in the effectiveness of two distinct types of massage.
Primary Funding Source
National Center for Complementary and Alternative Medicine
Related Articles
Evaluating the Influence of Massage on Leg Strength, Swelling, and Pain Following a Half-Marathon
Dawson, Lance G.
Dawson, Kimberley A.
Tiidus, Peter M.
Journal of Sports Science & Medicine
Massage therapy is commonly used following endurance running races with the expectation that it will enhance post-run recovery of muscle function and reduce soreness. A limited number of studies have reported little or no influence of massage therapy on post-exercise muscle recovery. However, no studies have been conducted in a field setting to assess the potential for massage to influence muscle recovery following an actual endurance running race. To evaluate the potential for repeated massage therapy interventions to influence recovery of quadriceps and hamstring muscle soreness, recovery of quadriceps and hamstring muscle strength and reduction of upper leg muscle swelling over a two week recovery period following an actual road running race. Twelve adult recreational runners (8 male, 4 female) completed a half marathon (21.1 km) road race. On days 1,4, 8, and 11 post-race, subjects received 30 minutes of standardized massage therapy performed by a registered massage therapist on a randomly assigned massage treatment leg, while the other (control) leg received no massage treatment. Two days prior to the race (baseline) and preceding the treatments on post-race days 1, 4, 8, and 11 the following measures were conducted on each of the massage and control legs: strength of quadriceps and hamstring muscles, leg swelling, and soreness perception. At day 1, post-race quadriceps peak torque was significantly reduced (p < 0.05), and soreness and leg circumference significantly elevated (p < 0.05) relative to pre-race values with no difference between legs. This suggested that exercise-induced muscle disruption did occur. Comparing the rate of return to baseline measures between the massaged and control legs, revealed no significant differences (p > 0.05). All measures had returned to baseline at day 11. Massage did not affect the recovery of muscles in terms of physiological measures of strength, swelling, or soreness. However, questionnaires revealed that 7 of the 12 participants perceived that the massaged leg felt better upon recovery.
Key PointsMassage does not appear to affect physiological indices of muscle recovery post exercise.Massage does appear to positively influence perceptions of recovery.More research needs to be completed on the purported benefits of massage.
Recovery; running; perception; massage
Related Articles
The Effect of Massage Therapy by Patients' Companions on Severity of Pain in the Patients Undergoing Post Coronary Artery Bypass Graft Surgery: A Single-Blind Randomized Clinical Trial
Najafi, Sied Saeed
Rast, Fazlola
Momennasab, Marzieh
Ghazinoor, Mahmood
Dehghanrad, Fereshteh
Mousavizadeh, Sied Ali
International Journal of Community Based Nursing and Midwifery
Background: Pain on mid sternotomy incision site after Coronary Artery Bypass Graft Surgery (CABG) is a common problem that causes sleep disturbance, delayed wound healing, and increased use of analgesic drugs. Massage therapy which is mostly performed by healthcare providers is a non-pharmacological approach for managing this pain. The present study aimed to determine the effect of massage therapy by patient's companion on the severity of pain in post CABG patients.
Methods: In this randomized single-blind clinical trial, 70 post CABG patients were randomly divided into an intervention and a control group. The intervention group received massage by one of their relatives who was trained by an expert nurse. The control group, on the other hand, received routine care. The pain intensity was assessed by Visual Analogue Scale (VAS) before and immediately, 30, 60, and 120 minutes after the intervention. Then, the data were entered into the SPSS statistical software (version 16) and analyzed using repeated measures ANOVA and post-hoc test (Scheffe).
Results: At the beginning of the study, no significant difference was found between the two groups regarding the pain severity. In the intervention group, the pain severity significantly decreased in all the four time points after the intervention (P=0.001). However, no significant difference was observed in this regard in the control group.
Conclusion: Massage therapy by patient's companion trained by a nurse was an effective strategy for pain management in post CABG patients. This could also promote the patient's family participation in the process of care.
Trial Registration Number: IRCT201208218505N3.
Massage Therapy; Companion; Pain; Coronary Artery Bypass Graft Surger
Related Articles
A Descriptive Study of the Practice Patterns of Massage New Zealand Massage Therapists
Smith, Joanna M.
Sullivan, S. John
Baxter, G. David
International Journal of Therapeutic Massage & Bodywork
Massage therapy has grown in popularity, yet little is known globally or in New Zealand about massage therapists and their practices.
Purpose and Setting:
The aims of this study were to describe the practice patterns of trained Massage New Zealand massage therapists in New Zealand private practice, with regard to therapist characteristics; practice modes and settings, and therapy characteristics; referral patterns; and massage therapy as an occupation.
Research Design and Participants:
A survey questionnaire was mailed to 66 trained massage therapist members of Massage New Zealand who were recruiting massage clients for a concurrent study of massage therapy culture.
Most massage therapists were women (83%), NZ European (76%), and holders of a massage diploma qualification (89%). Massage therapy was both a full- (58%) and part-time (42%) occupation, with the practice of massage therapy being the only source of employment for 70% of therapists. Nearly all therapists (94%) practiced massage for more than 40 weeks in the year, providing a median of 16 – 20 hours of direct client care per week. Most massage therapists worked in a "solo practice" (58%) and used a wide and active referral network. Almost all therapists treated musculoskeletal symptoms: the most common client issues or conditions treated were back pain/problem (99%), neck/shoulder pain/problem (99%), headache or migraine (99%), relaxation and stress reduction (96%), and regular recovery or maintenance massage (89%). The most frequent client fee per treatment was NZ$60 per hour in a clinic and NZ$1 per minute at a sports event or in the workplace. Therapeutic massage, relaxation massage, sports massage, and trigger-point therapy were the most common styles of massage therapy offered. Nearly all massage therapists (99%) undertook client assessment; 95% typically provided self-care recommendations; and 32% combined other complementary and alternative medicine therapies with their massage consultations.
This study provides new information about the practice of massage therapy by trained massage therapists. It will help to inform the massage industry and other health care providers, potential funders, and policymakers about the provision of massage therapy in the NZ health care system.
Complementary and alternative therapies; massage therapy; New Zealand; integrative care; practice patterns
Related Articles
Therapeutic Massage Provides Pain Relief to a Client with Morton's Neuroma: A Case Report
Davis, Faith
International Journal of Therapeutic Massage & Bodywork
Morton's neuroma is a common cause of pain that radiates from between the third and fourth metatarsals and which, when symptomatic, creates sensations of burning or sharp pain and numbness on the forefoot. Many conservative and surgical interventions are employed to reduce associated pain, but not enough research has been conducted to recommend patients to any one approach as the most reliable source of pain management.
The objective of this case report is to describe the effect of massage therapy on one woman with symptomatic Morton's neuroma.
A physically active 25-year-old female with diagnosed symptomatic Morton's neuroma who has not found relief with previous conservative intervention.
Six session of massage therapy once weekly for 60–75 minutes focused on postural alignment and localized foot and leg treatment. The client also completed an at-home exercise each day. Change was monitored each week by the massage therapist reassessing posture and by the client filling out a pain survey based on a Visual Analog Scale.
The client reported progressive change in the character of the pain from burning and stabbing before the first session to a dull, pulsing sensation after the third session. She also recorded a reduction in pain during exercise from a 5/10 to 0/10 (on a scale where 10 is extreme pain).
This study describes how massage therapy reduced pain from Morton's neuroma for one client; however, larger randomized control studies need to be done in order to determine the short- and long-term effects of massage therapy on this painful condition.
intermetatarsal neuroma; foot health; entrapment neuropathy; Mulder's sign; forefoot; deep transverse metatarsal ligaments
Related Articles
To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS)
Imtiyaz, Shagufta
Veqar, Zubia
Shareef, M.Y.
Journal of Clinical and Diagnostic Research : JCDR
Objectives: To compare the effects of vibration therapy and massage in prevention of DOMS.
Methods: Pre-test and Post-test Control-Group Design was used, 45 healthy female non athletic Subjects were recruited and randomly distributed to the three groups (15 subject in each group). After the subject's initial status was measured experimental groups received vibration therapy (50 Hz vibration for five minutes) or massage therapy (15 minutes) intervention and control group received no treatment, just prior to the eccentric exercise. Subjects were undergoing the following measurements to evaluate the changes in the muscle condition: muscle soreness (pain perception), Range of Motion (ROM), Maximum Isometric Force (MIF), Repetition maximum (RM), Lactate dehydrogenase (LDH) and Cretain Kinase (CK) level. All the parameters except LDH, CK and 1RM were measured before, immediately post intervention, immediately post exercise, 24 hours post exercise, 48 hours post exercise and 72 hours post exercise. LDH, CK and 1 RM were measured before and 48 hours post exercise.
Result: Muscle soreness was reported to be significantly less for experimental (vibration and massage) group (p=0.000) as compared to control group at 24, 48, and 72 hours of post-exercise. Experimental and control group did not show any significant difference in MIF immediate (p=0.2898), 24 hours (p=0.4173), 48 hours (p=0.752) and 72 hours (p=0.5297) of post-exercise. Range of motion demonstrated significant recovery in experimental groups in 48 hours (p=0.0016) and 72 hours (p=0.0463). Massage therapy showed significant recovery in 1RM (p=0.000) compared to control group and vibration therapy shows significantly less LDH level (p=0.000) 48 hours of post exercise compare to control group. CK at 48 hours of post exercise in vibration group (p=0.000) and massage group showed (p=0.002) significant difference as compared to control group.
Conclusion: Vibration therapy and massage are equally effective in prevention of DOMS. Massage is effective in restoration of concentric strength (1 RM). Yet vibration therapy shows clinically early reduction of pain and is effective in decreasing the level of LDH in 48 hours post exercise periods.
Vibration therapy; Massage therapy; DOMS ligament
Related Articles
The effect of chair massage on muscular discomfort in cardiac sonographers: a pilot study
Engen, Deborah J
Wahner-Roedler, Dietlind L
Nadolny, Anita M
Persinger, Colleen M
Oh, Jae K
Spittell, Peter C
Loehrer, Laura L
Cha, Stephen S
Bauer, Brent A
BMC Complementary and Alternative Medicine
Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises.
A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention. Outcome measures were scores of the QuickDASH instrument and its associated work module at baseline and at 10 weeks of intervention. Data were analyzed with standard descriptive statistics and the separation test for early-phase comparative trials.
Forty-four participants completed the study: 15 in the control group, 14 in the massage group, and 15 in the massage plus stretches group. Some improvement was seen in work-related discomfort by the QuickDASH scores and work module scores in the 2 intervention groups. The separation test showed separation in favor of the 2 interventions.
On the basis of the results of this pilot study, larger trials are warranted to evaluate the effect of massages with or without stretching on work-related discomfort in cardiac sonographers.
Trial Registration
NCT00975026 ClinicalTrials.gov
Related Articles
Enhanced clinical outcome with manual massage following cryolipolysis treatment: A 4-month study of safety and efficacy
Boey, Gerald E
Wasilenchuk, Jennifer L
Lasers in Surgery and Medicine
Background and Objectives
Cryolipolysis procedures have been shown to safely and effectively reduce the thickness of fat in a treated region. This study was conducted to determine whether the addition of post-treatment manual massage would improve efficacy while maintaining the safety profile of the original cryolipolysis treatment protocol.
Materials and Methods
The study population consisted of an efficacy group (n = 10) and a safety group (n = 7). Study subjects were treated on each side of the lower abdomen with a Cooling Intensity Factor of 42 (−72.9 mW/cm2) for 60 minutes. One side of the abdomen was massaged post-treatment and the other side served as the control. Immediately post-treatment, the massage side was treated for 1 minute using a vigorous kneading motion followed by 1 minute of circular massage using the pads of the fingers. For the efficacy group, photos and ultrasound measurements were taken at baseline, 2 months, and 4 months post-treatment. For the safety group, histological analysis was completed at 0, 3, 8, 14, 30, 60, and 120 days post-treatment to examine the effects of massage on subcutaneous tissue over time.
Post-treatment manual massage resulted in a consistent and discernible increase in efficacy over the non-massaged side. At 2 months post-treatment, mean fat layer reduction was 68% greater in the massage side than in the non-massage side as measured by ultrasound. By 4 months, mean fat layer reduction was 44% greater in the massage side. Histological results showed no evidence of necrosis or fibrosis resulting from the massage.
Post-treatment manual massage is a safe and effective technique to enhance the clinical outcome from a cryolipolysis procedure. Lasers Surg. Med. 46:20–26, 2014. © 2013 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
body contouring; cryolipolysis; non-surgical fat reduction; post-treatment massage
Related Articles
Biofeedback is superior to electrogalvanic stimulation and massage for treatment of levator ani syndrome
Chiarioni, Giuseppe
Nardo, Adriana
Vantini, Italo
Romito, Antonella
Whitehead, William E.
Background & Aims
Levator ani syndrome (LAS) might be treated using biofeedback to teach pelvic floor relaxation, electrogalvanic stimulation (EGS), or massage of levator muscles. We performed a prospective, randomized controlled trial to compare the effectiveness of these techniques and assess physiological mechanisms for treatment.
Inclusion criteria were Rome II symptoms plus weekly pain. Patients were categorized as "highly likely" to have LAS if they reported tenderness with traction on the levator muscles, or as "possible" LAS if they did not. All 157 patients received 9 sessions including psychological counseling plus biofeedback, EGS, or massage. Outcomes were reassessed at 1, 3, 6, and 12 months.
Among patients with "highly likely" LAS, adequate relief was reported by 87% for biofeedback, 45% for EGS, and 22% for massage. Pain days per month decreased from 14.7 at baseline to 3.3 after biofeedback, 8.9 after EGS, and 13.3 after massage. Pain intensity decreased from 6.8 (0–10 scale) at baseline to 1.8 after biofeedback, 4.7 after EGS, and 6.0 after massage. Improvements were maintained for 12 months. Patients with only a "possible" diagnosis of LAS did not benefit from any treatment. Biofeedback and EGS improved LAS by increasing the ability to relax pelvic floor muscles and evacuate a water-filled balloon, and by reducing the urge and pain thresholds.
Biofeedback is the most effective of these treatments, and EGS is somewhat effective. Only patients with tenderness on rectal examination benefit. The pathophysiology of LAS is similar to that of dyssynergic defecation.
Proctalgia; Biofeedback; Electrogalvanic stimulation; Dyssynergic defecation
Related Articles
Massage Therapy Techniques as Pain Management for Erythromelalgia: A Case Report
Dicks, Krista
Rizek, Philippe
International Journal of Therapeutic Massage & Bodywork
Erythromelalgia is characterized by temperature-dependent redness, pain, and warmth in one or more extremities. It may be a primary disease, or it may occur secondarily because of underlying illness. It is a chronic, debilitating condition often resistant to medical treatment.
The present report evaluates massage as a complementary therapy to reduce pain and other symptoms associated with erythromelalgia.
A 31-year-old female with a long-standing history of erythromelalgia bilaterally in the lower extremities presented with complaints of acute pain exacerbation, anxiety, decreased quality of sleep, and difficulty with activities of daily living for prolonged periods of time. She had no previous experience with massage therapy or any other complementary therapies.
Massage therapy was introduced over the course of 9 treatments, each 1 hour in duration, using various massage therapy techniques, remedial exercise, and recommended home care.
In this patient with erythromelalgia, effleurage and petrissage as massage therapy techniques provided temporary pain relief in the lower extremities and long-term benefits that relieved anxiety, which improved restorative sleep and increased the patient's participation in activities of daily living.
For this treatment protocol, therapist observation and patient feedback suggest that massage therapy may lead to a state of increased relaxation, decreased stress, decreased muscle tension, and improved sleep. These positive effects may have an indirect role in the ability of the patient to cope with erythromelalgia day to day.
Erythromelalgia; massage therapy; pain management
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2 Reviews
Delicious!! I made two changes: I reduced the mayo to only what was in the mix (using light mayo), opting NOT to spread any additional on the bread slices. And I just had iceberg lettuce on hand, instead of the red leaf. This was crunchy, flavorful and just a delicious egg salad that was even better the next day. I love the crunch of the celery & the salty bite of the olives. I think I'll add a little diced onion next time. Thanks!
The recipe title is indeed true! This recipe takes the lowly egg salad sandwich to new levels. I personally am not a big egg salad fan, but an excess of boiled eggs left over from Easter sent me searching for a way to use them. This recipe definitely changed my attitude about egg salad. What a great combination of flavors! Thanks for sharing.

subset: commoncrawl


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"Current debates about contextualism in epistemology begin with Philosophical Relativity, where Unger gives the term 'contextualism' the meaning that, in many philosophical circles, it enjoys today, and gives the position designated by the term its first serious and systematic treatment. Few are likely to accept Unger's 'relativistic' conclusion that the advantages and disadvantages of contextualism and its rival, invariantism, balance out in such a way that there simply is no fact of the matter which is the correct theory, but all who want to think seriously about the issue should confront the challenging arguments in this seminal book."--Keith DeRose, Yale University
"If you didn't read this book first time, read it now. It packs a punch fit to stop a whole school of philosophy dead in its tracks, with no guarantee that it will ever move again. Those who think that a philosophical inquiry has to start with a decision about the exact meanings of the key terms need to work out their answer to this one from Peter Unger."--Edward Craig, Cambridge University
"Philosophical Relativity is a seminal text in the debate on contextualism, which blames philosophical problems on the hidden dependence of meaning on context. Unger's questions are even more urgent today than when he wrote."--Timothy Williamson, Oxford University
"First-rate philosophy, philosophy as it ought to be done."--Gilbert Harman, Princeton University
"OUP has done well to reissue Peter Unger's books in epistemology, both Ignorance and Philosophical Relativity Unger follows the argument to great depth, wherever it may lead, and the reader who follows along will be amply rewarded, which shows how impressively fresh and relevant this work remains after all these years."--Ernest Sosa, Brown University
"In his last book, Peter Unger set out to persuade us of a thorough-going skepticism; in the present one, he sets out to persuade us that it is fundamentally indeterminate whether (for example) the thorough-going skeptic of the person of common sense is right. But even if this is his newest doctrinal anarchism, there is nothing anarchic about the style of Philosophical Relativity. The argument is well-organized, and the exposition is lucid. Nor is there anything bombastic in Unger's medium to match his would-be devastating message; the reader is coaxed along gently but persistently."--Jennifer Hornsby, University of London
"This is an intelligent and highly original critique, clearly and even gracefully written, with a refreshing absence of pedantry."--Sir Peter Strawson, Oxford University
About the Author
Peter Unger is Professor of Philosophy at New York University. He is the author of Ignorance (OUP 1975, 2002), Identity, Consciousness, and Value (OUP 1990), and Living High and Letting Die (1996)


text: On Dec 12, 2007 3:45 AM, Nikodemus Siivola <nikodemus@...> wrote: > On Dec 11, 2007 9:04 PM, Daniel Farina <drfarina@...> wrote: > > Here's a small patch for you to run with. I don't expect it to make a > difference, > but it may yield a bit more information, specifically, whether it's > *CURRENT-THREAD* > of MUTEX-OWNER that's getting clobbered. All the changes are around the > recursion check. > > (I pretty much refuse to believe that a thread doesn't see it's own write, so > something else pretty much has to be writing where it should not.) > > You can just load this into a running SBCL. No, I didn't actually test the > changes -- so you're best of 1st giving it a whirl by deliberately grabbing > a lock twice and seeing that it does what it's supposed to... > > Cheers, > > -- Nikodemus > > (in-package :sb-thread) > > (defun get-mutex (mutex &optional new-owner (waitp t)) > #+sb-doc > "Acquire MUTEX for NEW-OWNER, which must be a thread or NIL. If > NEW-OWNER is NIL, it defaults to the current thread. If WAITP is > non-NIL and the mutex is in use, sleep until it is available. > > Note: using GET-MUTEX to assign a MUTEX to another thread then the > current one is not recommended, and liable to be deprecated. > > GET-MUTEX is not interrupt safe. The correct way to call it is: > > (WITHOUT-INTERRUPTS > ... > (ALLOW-WITH-INTERRUPTS (GET-MUTEX ...)) > ...) > > WITHOUT-INTERRUPTS is necessary to avoid an interrupt unwinding the > call while the mutex is in an inconsistent state while, > ALLOW-WITH-INTERRUPTS allows the call to be interrupted from sleep. > > It is recommended that you use WITH-MUTEX instead of calling GET-MUTEX > directly." > (declare (type mutex mutex) (optimize (speed 3)) > #-sb-thread (ignore waitp)) > (let ((self *current-thread*)) > (unless new-owner > (setq new-owner self)) > (let ((old-owner (mutex-%owner mutex))) > (when (eq new-owner old-owner) > (error "Recursive lock attempt on ~S, mutex already owned by ~S.~%~ > Current thread: ~S" mutex old-owner self)))) > #+sb-thread > (progn > ;; FIXME: Lutexes do not currently support deadlines, as at least > ;; on Darwin pthread_foo_timedbar functions are not supported: > ;; this means that we probably need to use the Carbon multiprocessing > ;; functions on Darwin. > ;; > ;; FIXME: This is definitely not interrupt safe: what happens if > ;; we get hit (1) during the lutex calls (ok, they may be safe, > ;; but has that been checked?) (2) after the lutex call, but > ;; before setting the mutex owner. > #+sb-lutex > (when (zerop (with-lutex-address (lutex (mutex-lutex mutex)) > (if waitp > (with-interrupts (%lutex-lock lutex)) > (%lutex-trylock lutex)))) > (setf (mutex-%owner mutex) new-owner) > t) > #-sb-lutex > (let ((old (sb-ext:compare-and-swap (mutex-state mutex) > +lock-free+ > +lock-taken+))) > (unless (or (eql +lock-free+ old) (not waitp)) > (tagbody > :retry > (when (or (eql +lock-contested+ old) > (not (eql +lock-free+ > (sb-ext:compare-and-swap (mutex-state mutex) > +lock-taken+ > +lock-contested+)))) > ;; Wait on the contested lock. > (multiple-value-bind (to-sec to-usec) (decode-timeout nil) > (when (= 1 (with-pinned-objects (mutex) > (futex-wait (mutex-state-address mutex) > (get-lisp-obj-address +lock-contested+) > (or to-sec -1) > (or to-usec 0)))) > (signal-deadline)))) > (setf old (sb-ext:compare-and-swap (mutex-state mutex) > +lock-free+ > +lock-contested+)) > ;; Did we get it? > (unless (eql +lock-free+ old) > (go :retry)))) > (cond ((eql +lock-free+ old) > (let ((prev (sb-ext:compare-and-swap (mutex-%owner mutex) > nil new-owner))) > (when prev > (bug "Old owner in free mutex: ~S" prev)) > t)) > (waitp > (bug "Failed to acquire lock with WAITP.")))))) > Here is a backtrace when running with the new GET-MUTEX. Unfortunately, it seems everything as one might expect with a naive recursive lock. fdr debugger invoked on a SIMPLE-ERROR in thread #<THREAD "initial thread" {A70D719}>: Recursive lock attempt on #S(SB-THREAD:MUTEX :NAME "GC lock" :%OWNER NIL :STATE 0), mutex already owned by #<SB-THREAD:THREAD "initial thread" {A70D719}>. Current thread: #<SB-THREAD:THREAD "initial thread" {A70D719}> Type HELP for debugger help, or (SB-EXT:QUIT) to exit from SBCL. restarts (invokable by number or by possibly-abbreviated name): 0: [ABORT] Exit debugger, returning to top level. (SB-THREAD:GET-MUTEX #<unavailable argument> #<unavailable argument> #<unavailable argument>) 0] WARNING: Starting a select without a timeout while interrupts are disabled. backtrace 0: (SB-THREAD:GET-MUTEX #<unavailable argument> #<unavailable argument> #<unavailable argument>) 1: ((FLET SB-UNIX::WITHOUT-INTERRUPTS-THUNK) NIL) 2: (SB-THREAD::CALL-WITH-MUTEX #<CLOSURE (FLET SB-THREAD::WITH-MUTEX-THUNK) {B79DAD0D}> #S(SB-THREAD:MUTEX :NAME "GC lock" :%OWNER NIL :STATE 0) #<SB-THREAD:THREAD "initial thread" {A70D719}> T) 3: ((FLET SB-UNIX::WITHOUT-INTERRUPTS-THUNK) #<unavailable argument>) 4: ((FLET SB-UNIX::RUN-WITHOUT-INTERRUPTS)) 5: (SB-UNIX::CALL-WITHOUT-INTERRUPTS #<CLOSURE (FLET SB-UNIX::WITHOUT-INTERRUPTS-THUNK) {B79DADFD}>) 6: (SB-KERNEL:SUB-GC) 7: ("foreign function: call_into_lisp") 8: ("foreign function: funcall0") 9: ("foreign function: maybe_gc") 10: ("foreign function: interrupt_handle_pending") 11: ("foreign function: handle_trap") 12: (MAKE-ARRAY 8212) 13: (SB-IMPL::DATA-VECTOR-FROM-INITS (8212) 8212 (UNSIGNED-BYTE 8) NIL NIL NIL NIL) 14: (MAKE-ARRAY 8212) 15: ((SB-PCL::FAST-METHOD TRIVIAL-GRAY-STREAMS:STREAM-WRITE-SEQUENCE (FLEXI-STREAMS:FLEXI-OUTPUT-STREAM "#<...>" . "#<...>")) #<unavailable argument> #<unavailable argument> #<unavailable argument> #<unavailable argument> #<unavailable argument> #<unavailable argument>) ...truncated for brevity


text:
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text:
More words related to winning
adj. undefeated
adj. attractive
adj. victorious
verb. succeed in doing
verb. bring to successful conclusion; reach a goal
- accomplish
- acquire
- actualize
- attain
- bring about
- bring off
- bring to pass
- cap
- carry out
- carry through
- close
Roget's 21st Century Thesaurus, Third Edition Copyright © 2013 by the Philip Lief Group.Cite This Source


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They get you to open up, to look inside yourself, to really think about how you connect to nature and to God. You learn more about yourself, but also about your classmates; you connect with them on a different level.
— Travis Valmon '15
Every year, each class leaves the classroom to go on retreat with their classmates, mentors and faculty chaperones.
On this one-day retreat, students experience liturgy celebrated away from campus as they hike the Appalachian Trail. Through this liturgical procession, students are called to examine the ways in which they have found God in the world around them during their first year at Prep.
The goal of this overnight retreat is to lead the sophomores to reflect upon their upcoming role as upperclassmen. Students examine Christian leadership and community through a night of peer-led activities and talks followed by a day at a ropes challenge course.
The four-day junior retreat, Kairos, encourages the student to examine his life through the relationships he has experienced. The retreat challenges the student to deeper self-examination than previous retreats. Many students long remember Kairos as the highlight of their Prep experience.
Through the three-day Senior retreat and Ignatian seminar, the senior will learn to discern the action of the Spirit in his life guiding him toward vocation.
For seniors who exhibit interest and facility with discernment, an advanced course in Ignatian Spirituality is available. Over a semester, students work closely with a spiritual director in performing part of the 19th annotation of The Spiritual Exercises. The extent to which the retreat is finished depends upon the individual student's openness to the work of the Spirit.
Freshman Retreat 2012: Finding God In All Things
Georgetown Preparatory School 10900 Rockville Pike, North Bethesda, MD 20852 301.493.5000
A Catholic, Jesuit day and boarding school for young men, grades 9 through 12


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Type: Posts; User: anne13
Thank you all HVAC experts for your help. We appreciate your knowledge and advice!
Thank you jtrammel for your thorough explanation.
I appreciate everyone giving their advice!
One more question, please.
The contractor is adding a Honeywell all house humidifier to the...
Thank you Bald Loonie,
Didn't know that the needs of the furnace and a/c were so very specific to the thermostat. You are further explaining what Beeshvac said too.
Have any of you experts had...
Beshvac and Beenthere -
Don't know how to edit my own post and remove the prices. Sorry. I thought it would help answer Beshvac's question. But, if someone feels like they can answer the...
Oops - sorry HVAC team - didn't know about the prices thing - apologies to all.
Can you tell me, though, what would happen if a Honeywell was put on a Bryant system? What specifically, makes the...
Thanks beshvac for your quick response!
To answer your question...No, the contractor did not give me a quote for the Evolution nor the Honeywell stat.
He said that the quote included a basic no...
HVAC experts -
I would appeciate your help. New to this website and I think it's the most informative, honest hvac site on the net - bravo!
After an 18 year old Lennox Pulse...


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N -9º 0' 0.0" / W +115º 0' 0.0"
Tel: (62) 361 751261Fax: (62) 361 766002
Check-in after 14:00h
Check-out until 12:00h
Located in the heart of Kuta (Bali) and a short distance from a beach which is ideal for surfers, Matahari square, the traditional market, Waterbom park and Discovery shopping mall, the Kuta Beach Club is the best choice for a stay in Kuta thanks to its excellent location, comfortable facilities and the quality of its services.
The Kuta Beach Club provides 95 rooms with private balcony and fabulous views of the hotel gardens; different dining spaces (Tommy's Tavern / Agung Bar / Sunken Pool Bar); 2 outdoor pools surrounded by gardens and sunbeds; a Spa; a large, bright hall with shops and a meeting room. It is perfect for enjoying a family holiday in one of the most attractive destinations in Bali.


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Using the newest free version of The Events Calendar
Any information typed in the fields on the admin side is not being remembered. If I enter all the venue information and publish the event, everything is updated on the site just fine but when I go back to edit that event all the fields are now blank again.
Any idea how I could go about trying to fix this? This plugin offers little support for the free users so I'm not too sure where to turn. Any specific code or directory I should start searching through?
Any help would be much appreciated! :)


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Cornflake Kisses
|1⁄4 Teaspoon
|2⁄3 Cup (10.67 tbs)
|Chopped pecans/Chopped walnuts
|1⁄2 Cup (8 tbs)
|1 1⁄2 Cup (24 tbs) (Use Crisp Variety)
Beat egg whites and salt until just stiff enough to hold moist peaks; then add sugar gradually about 1 heaping tablespoon at a time continuing to beat after each addition, until whites form soft peaks.
Fold in nuts using a fork; then fold in the cornflakes.
Drop mixture by teaspoonfuls onto a baking sheet covered with smooth unglazed paper.
Bake in a slow oven (300° F.) for 25 to 30 minutes.
Remove from paper to a cake rack immediately.
Makes about 3 dozen kisses.
Recipe Summary
Rate It
Nutrition Rank
Nutrition Facts
Serving size: Complete recipe
Calories 1141 Calories from Fat 343
% Daily Value*
Total Fat 41 g63.1%
Saturated Fat 3.5 g17.6%
Trans Fat 0 g
Cholesterol 0 mg
Sodium 946 mg39.4%
Total Carbohydrates 197 g65.6%
Dietary Fiber 7.8 g31.1%
Sugars 140.1 g
Protein 10 g19.7%
Vitamin A 23.7% Vitamin C 24.1%
Calcium 4.2% Iron 110.7%
*Based on a 2000 Calorie diet


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Stay "in the know" throughout the school year with the following Benjamin School print and online publications:
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At the beginning of each school year, The Benjamin School publishes an all-school Directory. Print copies of the Directory are mailed to Benjamin families, faculty and staff. Additional copies are available for purchase in the Nook School Store.
A directory listing of Faculty and Staff is available online. A password protected Family Directory is also available online.
Lower School Curriculum Guide
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All-School Calendar - The Academic Year Calendar and the annual Event Calendar are published online. Also published online are calendars specific to Admission, Alumni, The Arts, Athletics, Lower School, Middle School and Upper School.
The Benjamin School
Lower/Middle School & Mailing Address11000 Ellison Wilson Road North Palm Beach, FL 33408 Ph: 561.626.3747
Upper School & Benjamin Hall 4875 Grandiflora Road Palm Beach Gardens, FL 33418 Ph: 561.472.5998
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text: Academics / Legal Writing Program print Upperclass Writing Courses First Year Curriculum Upperclass Writing Courses Legal Writing Faculty Legal Writing News and Programs Building on a Solid Foundation Brooklyn Law School's award winning Legal Writing Program also includes a wide variety of elective upperclass writing courses that satisfy the upperclass writing requirement. These writing courses build on the foundations of the first year Fundamentals of Law Practice course. They include classes such as Fundamentals of Legal Drafting, designed to expose students to litigation, transactional and rule-making documents; Appellate Advocacy; and Advanced Legal Research, which may be taken in the areas of Securities Law, New York Civil Practice, or International Law. These courses are limited to 12 to 14 students and offer intense instruction and extensive writing and research challenges, and often group students to work in teams. View our Legal Writing & Research Courses in the Courses by Area Listing Upper Class Writing Requirement After completing the first year legal writing course, every student at Brooklyn Law School must successfully complete, prior to graduation, an upperclass writing requirement consisting of significant supervised research and writing. The goals of the upperclass writing requirement are to provide each student with: 1) a significant research experience; 2) an opportunity for in-depth study and analysis(involving sustained reflection) of a particular area of the law; 3) an opportunity to articulate his or her own ideas and evaluation of the law; and 4) a faculty supervised writing experience involving at least one re-write of a substantial piece of the student's writing. All four of these goals must be met for a project or projects to satisfy the upperclass writing requirement. Meet the new Director of Legal Writing and Associate Professor of Law Heidi K. Brown Related Links: Law Journals Moot Court Library Academic Success Program Have questions? We have answers. Heidi K. Brown Director of Legal Writing and Associate Professor of Law 250 Joralemon Street Brooklyn, NY 11201 Telephone: (718) 780-7519 Email: email@example.com


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Reception Catering
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Chesapeake Bay Beach Club
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Ocean Lesson Plans
Welcome to the Educators' Corner
The ocean provides the air we breathe, food we eat, and water we drink. Just as we need the ocean, the ocean needs each one of us.
Our Ocean Portal Educators' Corner provides you with activities, lessons and educational resources to bring the ocean to life for your students. We have collected top resources from our collaborators to provide you with teacher-tested, ocean science materials for your classroom. We hope these resources, along with the rich experience of the Ocean Portal, will help you inspire the next generation of ocean stewards.
Help us make this site better! Please provide your comments or suggestions
From Our Collaborators
This activity is a fun, basic craft, but can be adapted to incorporate structure and function lessons in a classroom setting. Students will build their own fish from a paper plate, decorate it,...
Students learn why coral reefs are important, and what can be done to protect them from major threats.
What discoveries and human benefits have resulted from exploration of the Earth's deep oceans? Students will be able to describe at least three human benefits that have resulted from explorations...


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(average rating based on 109 reviews)
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Reviewed by 109 customers
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Very Comfy
By Karen
from Miramichi (New Brunswick)
Although I believed that they were made in Canada, they were not. I was a little surprised at that, but be that as it may, they are good quality, and extremely comfortable.
Bottom Line Yes, I would recommend this to a friend
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( 8 of 9 customers found this review helpful)
Made Where?
By DianeSam
from Calgary, AB
Made in Vietnam is the label on my moccasin !!I like the product but, for whatever reason, thought this line was made in Canada, providing employment here. When I look closer it says designed in Canada but made in China. Mine says made in Vietnam.Not really a Canadian product, and likely not producing Canadian jobs.I do like my purchase and will purchase more, just somewhat surprised.
( 6 of 6 customers found this review helpful)
Problems with the side seam
By Karina
from Oshawa Ont
My mother bought these for me last year to wear around the house and not outside. I am used going barefoot in the house, so needless to say, I have worn them only a few times...not more than 5 at the most. Admitted, they are comfortable. I just noticed today that the side seam on the left shoe has come apart...after only a few wears. I am more concerned for my mother, who is on a fixed income and who paid for these, than anything else. It is too late to send them back. I will continue to use them once in a while, but they sure don't look nice with the side seam split. The leather has completely pulled away from the stitiching. Btw, the right shoe is fine. Go figure.I expected better quality for the price. My mother is now out of the money she spent on these.
Bottom Line No, I would not recommend this to a friend
( 9 of 9 customers found this review helpful)
Shoe came apart at the seam
By Kteen
from Mississauga, Ontario
I was so excited to wear my new canoe shoes only to have them fall apart at the top seams after a handful of wears.. I contacted TSC but was told that I had to contact the company directly as it was past 30 days. I contacted the company only to find out that they can only do something within 90 days after they prove it wasn't improperly used. It takes them forever to contact you back and sad to say I am without my canoe shoes and out of pocket...so disappointed.
( 10 of 10 customers found this review helpful)
By SEdbr
from Comox Valley
I love Manitobah Mukluks... but was very disappointed with this pair. Have been wearing for about 2 hours and the seam around the toes came apart. Also, disappointed that these are not actually Canadian made only Canadian designed.
Came apart at seam
By Mrs. Ponytail
from Montreal, QC
I really liked these moccasins and I think I originally gave a good review (but I don't see my review here). They are super comfy but after three months the seam fell apart. I noticed when I first received them that the right seam was crooked. but I kept them anyway. I should have returned them when I saw that because that is exactly where they fell apart. Beware if you get a pair with crooked seams. The left one is still in good shape.
( 3 of 3 customers found this review helpful)
My favourite shoe
By Zuzu
from Flamborough, On
I received a pair a couple of years ago as a gift. I wear them outdoors from spring to fall. They are so comfortable, like wearing slippers. I'm sure I will end up with every style on many colours.
( 1 of 1 customers found this review helpful)
very comfortable
By jeanne
from N.B.
comfort and quality
( 19 of 19 customers found this review helpful)
Not really Canadian
By Suzanne
from Surrey, British Columbia
I recently received a pair of these mocassins in the grey. I have been wanting a pair for a long while and was very excited to finally have some. However, I was quickly disappointed. Within 2 days of light wear in the house, I had to tie the laes at least 50 times and on the second day, the lace on the right foot sanpped while tying it. I also noticed on the box that the mocasins were in fact not hand made in Canada, but factory made in China which surprised me. I have sincce recceived a replacement pair, which are made in Vietnam. I had been under the impression that Manitobah Mukluks was a Canadian company, employing native craftsmen/artisans, but it seems that only the designs are of Metis origin. All in all, although the mocassins are indeed comfortbale and stylish, I am very dissappointed that they are not Aboriginal made. I could have bought something similar for a lesser price in the local mall and been just as pleased. I chose to pay the extra price for Manitoba Mukluks based upon the assumption that I was buying a genuine Metis product.
( 2 of 2 customers found this review helpful)
Fit is not the same
By Colleen
from Edmonton
I bought two pairs the same size but different colours. The fit smaller on the black but I think it will stretch. I had to undo the tie at the top to stretch and now it will not stay tied. They are nice


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Great year, great hunt. Here is the buck I got this year. I passed on a couple of other nice deer and saw a few real nice ones. I was actually hunting one of them, which we estimated with about 27-28 outside spread and real high horns, when this one showed up instead. I couldn't hold back any longer and I'm very pleased to have him, he is going on the wall. Thanks to everyone who helped me out on this hunt.
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Bill Cunningham
No Purses at Paul Brown Stadium?
Posted August 13th, 2013 @ 2:35pm
The NFL adopted a new policy for the 2013 season that limits bag sizes and types of bags at stadiums across the country, and here at our very own Paul Brown Stadium. This new policy includes women's purses... that's right. NO PURSES ON GAMEDAY.
What are your thoughts? Are they taking it too far, or playing it safe?
Read more about the NFL policy here.


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Sense Of Impending Doom - 08-14-2010, 09:56 AM
Does anyone here experience anxiety attacts? I'm pretty sure I've had about 6, two of which occured in the last 24 hours (one last night and one this morning) and one last week.
From what I can tell, Anxiety Disorder mainly says it's all sudden and with no obvious onset, but I get my attacks from being highly over-stressed. Does that mean they're not panic attacks? That I don't have a disorder even though I'm getting them more frequently?
I have a lot going on in my life right now. A lot. So anytime something else it piled on top of my already about-to-tip load I react uncontrolably.
Intense sense of impending doom, rapid breathing (I've hyperventilated twice due to the rapid breathing), excessive sweating, uncontrolable fits, depression, etc.
I don't know what to do about it? Since all I can find is that the disorder is mainly brought on by no obvious reason then what am I supposed to do when mine is brought on for obvious reasons? Should I still go see a doctor?
My husband used to have mild panic attacks in crowded public areas and the doctor gave him some pills to take during an attack that calmed him down. Those would be the reason why I would like to see a doctor, but I'm afraid that since my attacks are brought on by obvious stress that they'll just tell me to suck it up?
Anyone treated with Anxiety Disorder or other, with obvious stressors causing the issue? Or is it only those without obvious onsets that get treated?
This whole thing is really starting to mess up my life. I had a test to take today. A HUGE life-changing test. My panic attack last night kept me up all night and I woke up exhausted and got another one. I missed the test which will only bring on more attacks so I'd like to do something about it before it gets worse.
Suggestions, tips, stories, advice, anything at all you can tell me to help me out?
I have severe social anxiety and have dealt with panic attacks before. I think I'm the only person on here with anxiety and I'm a psych major.
Panic attacks are actually very common and many people experience them without ever having a disorder, frequently when stress is high in their lives. You actually would not qualify for anxiety disorder(generalized or specific, I have a specific one), so that would be why you think it sounds wrong. The symptoms are not quite yours. What you may qualify for eventually is actually panic disorder(which is characterized by severe panic attacks, worrying about more panic attacks, etc), so that may be something you'll want to look into more to see if that matches what you are experiencing better. Also, there are such thing as cued panic attacks(when a specific thing triggers you), but stress is a bit too general and may not make yours cued.
If they are becoming more frequent, you should speak to your doctor. They may prescribe pills or direct you to sessions about strategies to handle it. Treatment of disorders usually is a mixture of both, with a strong reliance on the changing of your behaviors leading up to, during, and after a panic attack. They will not brush you off and if they do, find another doctor. Panic attacks can be very serious, sometimes resulting in a need for medical aid, so you need someone to take you seriously.
I can't really offer you much help since I have a hard time coping when I do have panic attacks, but I find the best thing to do is to just try to keep my stress down. It doesn't mean not doing stressful things, but that I try to balance it out. Breathing exercises tend to be important and are the most commonly used. It sounds lame, but just sitting down, taking a break and breathing in and out and only focusing on that does help. You should talk to a doctor though if you keep having trouble, its the best thing you can do.
Av & Sig Credit: Me
Wow, I can't believe I never updated this?
Thank you so much for all your help Kitty! And I know this is sort of grave-digging, but I wanted to add in my info in case some other poor soul comes across this thread for help in the future.
As it turns out I had some serious hormonal problems that needed tending to. I had NO idea that I had these problems, though there's no way I could have since my circumstances were rare.
Aparently I have PCOS (Polycystic Ovarian Syndrome...or w/e) It's a serious thing and can be very scary, though I have not researched it much BECAUSE it scares me. So if you're curious about it, you'll have to brave Google yourself, lol.
All I know, that I can handle knowing, is that my ovaries don't produce enough female hormones, but I've got either an abundance of, or at least an obviously outweighed amount of, male hormones (EVERY woman is supposed to have BOTH hormones btw...).
Anywho, I'm normally on birth control, which gives me female hormones, so I never knew the difference that my body wasn't making them on it's own. I've always had severe PMS, but the reason behind that is the overload of male hormones when the pill stopped giving me female hormones for my period. When I stopped the birth control, as we were contemplating starting our family, my periods stopped with it. It had happend before and happens to 10% of women who stops taking the pill. (Amenorrhea...or however it's spelled, lol. It's the lack of a period.) There's another pill that can jump-start your period but you can wait it out and it will usually start in/around about 3 months of absense. After 4-5 months of absense I began to worry, so I went to the doctor. They said they COULD give me the pill to jumpstart my period, but they could instead run tests to figure out WHY I never started, which would be ideal information for when we decide to start our family as you have to have ovulation to get pregnant, and I wasn't doing that.
After several several tests, and several several visits, we came to the conclusion of possible PCOS. It was POSSIBLE because normal symptoms include excess and heavy periods, but I was having NONE. So they jump started my period and I had to wait a month to see if it would be any different.
I had 2 heavy periods with only ONE WEEK seperating them. I'm used to LIGHT periods with 3 1/2 weeks seperation. There were also several other embarassing symptoms too...So, it was concluded that I should be tested for PCOS. Which obviously turned out positive as I just mentioned it above. xD
Once my period was jumpstarted I had most of the symptoms of PCOS, the only thing stopping me from seeing those was that I was part of that 10% of women who develop Amenorrhea (lack of period) after quitting BC.
The panic attacks were triggered by my over abundance of male hormones, which embarassing to say, as you couldn't find anyone more dainty than me, was testosterone.
I was put back on my BC so I could keep my female hormones up to par, and if I ever want to have kids there's a hormone pill I can take that does not have BC effects. My doctor presribed some panic attack pills for whenever my hormones get out of balance all of a sudden, which I absolutely HATE taking them as they knock me out cold for several hours.
So all in all...there are more than the obvious outcomes for symptoms of Panic Attacks and probably other things too... Be sure to go to your doctor and tell them EVERYTHING, even if you don't think it's relevant. Believe you me, I didn't have A CLUE that my lack of a period was linked with the block in the solution for my panic attacks, the only reason I mentioned it was because I went to the doctor with a list of things I wanted them to fix, lol. Thankfully my doctors are curious people and want to SOLVE problems, not just fix them. xD
Oh and btw, I don't get panic attacks when I'm on BC...I've taken an unfortunate pause in taking it though as I forgot to pick some up for the past 4 weeks and my PCOS is still strong. I've been on a period for several weeks now on and off, though thankfully only the initial week was heavy. I've had several panic attacks in my duration of being off the BC/Hormones. I expect them all (the freaking annoying and persistant periods/spotting, the panic attacks, and other symptoms) to go away as soon as I go pick up my darned BC. I hate that I have to rely on it for more than one reason now. But I have no choice now. This is something I'll have to deal with the rest of my life, and will have to constantly take hormones for to avoid.
I'm glad you found out what was causing your panic attacks. Its so scary when they happen. I know somtimes they happen for no reason, or can be caused by things in your life, but I didnt know they could be caused by hormonal problems.
It makes me feel kinda better it know that I'm not the only one here who has panic attacks. With mine, I always hyperventilate during it, and lose all feeling in my legs and arms, which causes me to collapse. They happen more during school for some reason. I've had to be takin out in an ambulance twice.
I know what you mean about the meds, I hate taking them, they make me so tired and I can't focus. My school understands whats been going on and they always let me get outta class so the other students dont see it, because I don't want them to.
Any type of stress causes me to have them, but I can't say the main reason cause I'd end up having one...
I have severe anxiety which has been a result of both my rather terminal lung failure, a past suicide attempt and reaction to a prescription drug I had. All that combined can make it difficult for me to get to sleep due to flash backs, sense of impending doom etc.
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Treasurer: Vt sells $86.7 million in bonds in a week
MONTPELIER Vermont Treasurer Beth Pearce said the state had a successful week selling bonds to support infrastructure improvements.
Pearce said Vermont sold $86.7 million in bonds this week to help finance construction of a new state psychiatric hospital and rebuild the Waterbury state office complex. Both were flooded by Tropical Storm Irene in 2011.
This weeks three bond sales included $25 million in Vermont Citizen Bonds, which are geared for investment by residents of the state. Successful bidders for two other sets of bonds were Wells Fargo and Morgan Stanley.
Other projects include school construction, phosphorus removal from Lake Champlain, construction of state police barracks in Brattleboro and Rockingham, and building the state health laboratory in Colchester.MORE IN This Just InPHILADELPHIA Many delegates from Vermont arrived at the Democratic National Convention this... Full StoryWhite River Junction A Windsor Superior Court judge this week denied a prison sentence... Full StoryBARRE A Maine woman is accused of forging checks and selling off items that didnt belong to her. Full Story
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I bought a new gaming computer about two weeks ago. It is randomly crashing after 5 minutes, sometimes 10 minutes or more. Is there a software or a place where I can see what cause the crash? Like a log file?
Maybe useful info: At first when I assembled the computer, I got the POST sound error of long short short beep. This error corresponds to a memory RAM error. I tried changing ram, switching sockets... but still the same error. I finally dissembled and reassembled the computer. It worked well until today.
The system:
- Graphics: EVGA 02G-P4-3660-KR GeForce GTX 660 Ti 2GB 192-bit GDDR5 PCI Express 3.0 x16
- Motherboard :ASUS SABERTOOTH 990FX R2.0 AM3+ AMD 990FX
- CPU : AMD FX-8150 Zambezi 3.6GHz Socket AM3+ 125W Eight-Core
- RAM: CORSAIR Vengeance 16GB (2 x 8GB) 240-Pin DDR3 SDRAM DDR3 1866
- HD: Western Digital WD Black WD1002FAEX 1TB 7200 RPM 64MB Cache
- PSU: 700W A 170$ case with 2 Big fans (larger than my hand)