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Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
April, 2001, Vol. 01, Issue 04
A Comparison of the Somatosensory Effects of Therapeutic vs. Medical Massage, Part II
By Gregory T. Lawton, DN, DC
Editor's note: Part I of this article appeared in the March 2001 issue of Massage Today.
Mechanoreceptors and nociceptors are somatic receptors that act as biological sensors in response to physiological stimuli.The nociceptors respond to abnormal stimuli and transmit this information, most often as pain signals to the higher neurological centers. Mechanoreceptors respond to normal stimuli and transmit this information. Each of these two types of biological sensors tends to dampen or inhibit the other.
Nociceptors are found in the skin and throughout the musculoskeletal system. Nociceptors have been found in almost all connective tissue, with the exception of joint cartilage, synovial membranes, and certain parts of the inner vertebral disc. Nociceptive stimulation due to noxious stimuli has dramatic effects on the nervous system, and has been shown to promote segmental responses such as muscle spasm and increased sympathetic activity. Nociceptor stimulation can also stimulate suprasegmental activity that affects the hypothalamus and can cause sweating, nausea, weakness, pallor and dizziness. A commonly recognized problem in chronic pain is the continuing stimulation of nociceptors.
Mechanoreceptors respond to normal tissue environment and report this homeostatic activity to the central nervous system. Mechanoreceptors appear to respond to weak mechanical signals, gentle movement and pressure, and normal range of motion activities of the joints. Mechanoreceptors do not respond to noxious stimuli and are in fact inhibited by nociceptive input.
The two previous paragraphs, regarding nociceptors and mechanoreceptors are vitally important in understanding what constitutes effective medical massage therapy. Rather than basing our understanding and application of massage therapy technique simply on the theories or pet techniques of a few massage therapists, or upon inaccurate models of physiological function, we should seek to understand the scientific literature that reveals the deeper secrets of physiological function as it pertains to connective tissue therapy.
Based on what is scientifically known about mechanoreceptors and nociceptors, we can suggest the following principles as applied to medical massage therapy:
The above eight principles provide the medical massage therapist with both a mandate and an outline for delivering medical massage therapy. In addition, the medical massage therapist can use the scientific evidence from studies on mechanoreceptors and nociceptors to judge and evaluate massage therapy technique. Clearly, the scientific literature supports manual therapy technique that promotes responses in mechanoreceptors and any technique or activity that dampens or inhibits nociceptors. Four aspects of clinically effective treatment can be identified from the eight principles outlined above:
Therapeutic massage techniques (or any system of massage therapy) that stimulates nociceptor activity via painful and improper technique, will retard and delay the healing of injured connective tissues. Specifically, techniques that are improperly applied such as trigger point therapy and periosteal or deep tissue techniques will stimulate nonciceptive input, muscle spasm, pain, sympathetic hyperactivity, and supra-segmental physiological responses.
It should now be clear that the proper application of medical massage technique should include the avoidance of technique that stimulates nociceptive responses in the nervous system. This stimulation has a negative effect on the outcome of the treatment and the patient's healing process. From this viewpoint, pain is not gain. The massage therapist who wishes to apply the principles presented here in the clinical application of massage therapy technique probably needs to make subtle changes in manual technique. These changes include the following:
Medical massage therapy is a scientifically based method of manual therapy. Medical massage seeks a clear understanding of the scientific principles of physiology that affect connective tissue healing and treatment. Many currently utilized therapeutic massage techniques unnecessarily inflict patient pain and exacerbate the patient's condition, due to a faulty and erroneous viewpoint regarding biological sensory input and "proproceptors." This material is offered to all massage therapists, to clarify this issue and to offer more effective treatment methods. The next time you see an article showing (r a massage instructor demonstrating) trigger point therapy with the elbow buried an inch into the levator scapula and trapezius, consider the nociceptive stimulation this technique is provoking and reconsider the value of this type of technique.
Regardless of what we call or label the manual therapy techniques that we apply to clinical cases, we must, as massage professionals, recognize the need to thoroughly investigate current scientific research regarding connective tissue pathophysiology and reconsider our technique and treatment protocol based on this knowledge. For those massage therapists who prefer to practice general relaxation massage in recreational settings, while they may voluntarily choose not to practice medical massage, they must also recognize and understand the higher mechanisms of connective tissue rehabilitation and the ability of the medical massage therapist to treat connective tissue pathology.
The pet techniques of the massage therapist should not determine the patient's treatment. Treatment should be based on the findings, diagnosis, causation and symptoms of the patient's presenting problem or condition.
The allied medical professions and the chiropractic profession can also benefit from a detailed education in medical massage technique and protocol. The application of non-exacerbating technique directed at the primary area of pathology in most musculoskeletal disorders, the joint complex, is of profound value to medical massage therapists, chiropractors, physical therapists, occupational therapists, nurses and physicians who treat connective tissue disorders. Medical massage therapy may effectively become the pivot point where many of these health care practitioners come together in a common understanding of massage therapy.
References and suggested reading:
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