Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
February, 2001, Vol. 01, Issue 02
"Not Now, I Have a Headache!"
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
Sometimes Useful, but Not Inevitable
One of my instructors said that the most difficult part of treating a headache in China is figuring out whether the client has one or not.In China, it apparently is an accepted excuse for calling in sick to work, so many people show up at the clinic for a doctor's excuse.
In the U.S., it seems as if headaches are considered an inevitability of a stressful and busy life. An employer would not likely consider letting someone off work for a bodywork treatment! "Take some aspirin and get back to work!" would be a more likely response to an employee moaning about a headache.
When I interview clients and find they get headaches, they seem surprised when I ask detailed questions. "Can you help with THAT?" they ask, hardly daring to hope for relief. Luckily, it's fairly simple. By asking about the frequency, location, timing and quality of the pain, you can determine what is causing the imbalance and how to treat it. Accurate assessment of the problem is essential to get to the root cause.
You probably already know this, but it bears repeating. If a client comes to you in a state of disease you don't understand, refer, refer, refer! If a headache comes on suddenly, severely or is accompanied by nausea, tell the patient to use the acupressure point at the tip of the index finger to dial 911. I had a 41-year-old female client with those symptoms. She died in the parking lot in front of a hospital from a subarachnoid hemorrhage. Other causes of headaches that need medical intervention include meningitis, cerebral tumor, hypertension and ear infections. Be safe and get a medical diagnosis!
Looking at Patterns
In Chinese medicine, to reach an accurate assessment of a client's condition we need to look at the overall pattern based on the five elements and the zang-fu (the energetic actions of the organs); the quality of the pain; what makes it better and worse; and the location of the pain. I will give an example of each and delve more deeply into assessment by location, based on the meridians.
Five-element and zang-fu pattern discrimination look deeply at where the client is physically, emotionally and spiritually. These aspects have never been thought of as separate in Asia; they never suffered the Cartesian mind/body split as we did in the West.
When people have constipation, they are having trouble letting go of physical waste. This may manifest on an emotional level as well, in not being able to let go of waste in their lives. Maybe they are holding on to a lost love or friends that are obviously toxic to them. In Chinese medicine, these are all manifestations of a metal imbalance - encompassing the lung and large intestine meridians. So the treatment is the same, whether they are physically or mentally having trouble letting go of wastes. It's the same imbalance, which could result in headaches. There are approximately 17 different five-element/zang-fu types of headaches, so I obviously can't go into each one in this article.
The quality of the pain is going to give other information. For example, a dull ache indicates a deficiency condition. Slow, deep-but-gentle pressure with the intention to tonify is used to treat this condition. Sharp pain means there is an excess condition; quicker movements are used to disperse, going away from the head.
What makes the headache better or worse also gives useful information. For example, the person who says that their headache gets worse after they have sex has a kidney qi deficiency. If having sex relieves their headache, then it is most likely due to liver fire or liver qi stagnation.
Treating by Location
Determining the location of the headache is essential in developing a treatment plan in conjunction with zang-fu pattern discrimination. The four areas of the head (and corresponding headaches) are listed below:
Taiyang headaches are treated by working on the two taiyang meridians: the bladder and small intestine. It is important to work on local points, like GB 20, as well as distal points on the bladder and small intestine, like BL 60 and SI 3. All of these have a powerful affect on the neck and occiput region. A chronic headache in this region could be due to a kidney qi deficiency manifesting in the bladder meridian.
Temporal shaoyang headaches need gall bladder and triple heater meridian treatment. GB 8 and taiyang are useful local points. The distal points are on the shaoyang meridians - TH 5 and GB 41. I often teach GB 41 to clients with migraines. Someone once told me, "That's so funny! Whenever I have a headache, I'm intuitively drawn to pressing that area of my foot, and it helps!"
The location of this headache follows the course of the gall bladder meridian, which has a very close relationship with the liver. I can guarantee that the liver is somewhere behind the cause of that headache, whether it is liver-fire, liver-yang or liver-wind rising. Keep this in mind when you are doing a more detailed assessment.
Yangming frontal headaches require large intestine and stomach meridian balancing. A common mistake is to treat a headache in the forehead region with bladder meridian points, when in actuality, stomach and large intestine are much more effective. The stomach meridian internal pathway begins at LI 20, and as it goes up alongside the nose, reaches the forehead from BL 1.
Maybe the most famous acupressure point for headaches is LI 4, located on the webbing between the thumb and index finger. It is quite effective for headaches as a distal point, but only for yangming headaches! People that have tried this point with other types of headaches are most likely convinced this acupressure stuff is a bunch of hooey. Along with LI 4, use ST 44 as another distal point. Effective local points for this type of headache are St 8, yintang and ST 3. A yangming headache often is caused by dampness (tx SP 9) or phlegm (tx ST 40). Symptoms pointing to these pathogenic factors are a heavy, muddled feeling in the head, a sticky tongue coating and a rolling pulse. Brace yourself for a long haul, though, since these are the most difficult pathogenic factors to resolve!
Finally, jueyin headaches are at the top of the head. This is related to the liver meridian, which has an internal pathway up to that area. An effective local point is DU 20; an excellent distal point is LV 3. A jueyin headache could be due to deficient qi and blood as well. Best to look at all signs and symptoms.
The above examples are more useful for those who have gone through a complete program of Asian bodywork therapy. ABT is an ancient healing art that allows you access to a person's core being. You aren't going to get it by reading an article. Get out there and learn it! It's a whole new way of being in and relating to the world.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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