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What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
February, 2002, Vol. 02, Issue 02
The Tuina Treatment of Tennis Elbow
By Bob Flaws, LAc, FNAAOM (USA), FRCHM (UK)
In 1982, I was studying acupuncture at the Shanghai College of Chinese Medicine and working as an intern in the acupuncture department at the Long Hua Chinese Medical Hospital. Sometimes, during the heat of the summer, there were not that many patients to see in the acupuncture ward, so I would wander through the hospital to see what else I might learn.As a graduate of what was then the Boulder School of Massage Therapy (BSMT), I had practiced massage for several years prior to studying acupuncture. Thus, I was immediately fascinated by what I saw when I discovered the tuina, or Chinese medical massage, ward.
The movements I witnessed were unlike anything I had learned at BSMT. I was especially enamored with the idea of specific protocols lasting 15-30 minutes for the remedial treatment of specific conditions. Therefore, I arranged to study tuina the following year and to work as a tuina intern at the Yue Yang Chinese Medical Hospital, also in Shanghai. Eighteen years later, I am still as enthusiastic about tuina as I was then.
Below is the tuina protocol I learned for the treatment of tennis elbow. It is based on the rolling school (guan fa pai) of tuina popular in Shanghai founded by my personal teacher, Ding Ji-feng.1 Dr. Ding had been practicing this method for over 50 years when he taught it to me.
Western Medicine and Tennis Elbow
Lateral epicondylitis, also called tenosynovitis (and more colloquially, tennis elbow), consists of inflammation of the tendons attached to the lateral side of the elbow at the epicondyle of the humerus. Patients with tennis elbow experience pain in the lateral aspect of the elbow, which may radiate into the forearm, and occasionally into the hand. The pain occurs with grasping activities and may be accompanied by a sense of weakness. An achy discomfort may also be present at rest or at night after activity. This inflammation may be caused by a sudden violent injury, repetitive strain or microtrauma. Tennis elbow occurs equally in men and women and is most commonly seen in patients between the ages of 35-50. Tennis elbow is found not only in tennis players, but in baseball players; swimmers; carpenters; plumbers; meat cutters; musicians; or anyone who repeats an arm motion over and over.
The Western medical diagnosis of lateral epicondylitis mainly consists of physical examination of the affected area eliciting abnormal tenderness to palpation over the lateral epicondyle. X-rays may show calcium deposits on the lateral epicondyle but are not typically required to make this diagnosis. Bone spurs only occur in 20% of tennis elbow patients. The Western medical treatment of tennis elbow mainly consists of rest, anti-inflammatory medication and the application of ice. This is supplemented by stretching and strengthening exercises; straps; wrist braces; and cortisone shots. Surgery is indicated in approximately 5% of cases when all of the above measures have failed over a course of several months and pain continues to prevent activity. The success of tennis elbow surgery is generally 85-95% excellent relief of pain.2 However, patients typically require 3-6 weeks of recuperation before returning to work, and several months before returning to sports or heavy use of the arm.
Chinese Medicine and Tennis Elbow
Chinese disease categorization: Tennis elbow is called zhou lao (elbow taxation); zhou tong (elbow pain); and shang jin (damaged sinews) in Chinese medicine.
Chinese disease causes: Taxation detriment with possible contraction of wind cold evils.
Chinese disease mechanisms: Overwork taxation causes detriment and damage to the sinews and vessels of the elbow. On the one hand, there is insufficient blood to nourish the sinews; on the other hand, there is blood stasis obstructing the free flow of the vessels. This may be complicated by external contraction of wind cold evils due to defensive qi vacuity.
Treatment principles: Soothe the sinews and free the flow of the network vessels; quicken the blood and transform stasis; regulate the qi in the channels and vessels.
Other adjunctive measures may include the use of moxibustion locally on the elbow (either indirect, roll moxa or direct, non-scarring, "grain of rice" or thread moxa), or warming with a TDP heat lamp.3 Internal administration of Chinese medicinals based on the patient's individual pattern discrimination is also quite helpful.4
To get a satisfactory result with tennis elbow, the patient needs to refrain from all activities, be they work or play, that aggravate the condition. Until or unless the patient is willing to allow the inflammation of their lateral epicondyle to heal, no amount of tuina or Chinese medicinals is going to get a satisfactory effect. If the cause of this inflammation is work-related, the patient should be advised to modify their equipment or work habits. This may mean using a lighter hammer or tennis racket or seeking professional advice from an ergonomic specialist or kinesiologist.
While ice is indicated within Chinese medicine for recent traumatic injuries and acute inflammations with redness, swelling and palpable heat, it is usually contraindicated for tennis elbow. Even though Western medicine defines lateral epicondylitis as a species of inflammation, it does not usually present heat signs and symptoms according to Chinese pattern discrimination. In fact, given the common age range of patients with tennis elbow and its Chinese name, elbow taxation, this condition is usually a vacuity condition complicated by cold and/or blood stasis, all of which may be worsened by the application of cold. This is why the external application of warmth is usually so important for the treatment of this condition.
In my experience, both in China and the U.S., tuina is definitely an effective therapy for the remedial treatment of tennis elbow.
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