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Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
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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