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Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
May, 2001, Vol. 01, Issue 05
Snap, Crackle and Pop, Part I
By Neal Cross, PhD, NCTMB
The human temporomandibular joint (TMJ) is involved in the etiology of several clinical complaints, including jaw pain, tongue pain and headache. Although small, this joint has a rather complex structure and function.By placing your middle finger over the TMJ (just inferior and slightly anterior to the external auditory meatus) and slowly opening and closing your mandible, you should feel a nice smooth motion bilaterally. This motion will start as a jaw opening (depression); at the end of the movement ( at the point just prior to fully opening the jaw), you should feel the joint glide anteriorly. Some will feel one side move out of synch with the other; others may feel one or both sides suddenly "snap" anteriorly. A few may feel a "crackle" (crepitus) on one or both sides; still others may feel and/or hear a "pop" as the articular disc releases.
Let's consider some of the underlying anatomical and functional aspects of the TMJ. The TMJ is formed by parts of two bones: the temporal bone and the mandible. More specifically, the condyloid process of the mandibular ramus fits into the mandibular (glenoid) fossa of the zygomatic process of the temporal bone. This mandibular fossa is bounded posteriorly by the retroarticular process and anteriorly by the articular tubercle. There is a well-defined articular disc within the joint cavity and an articular capsule enveloping the joint. (Author's note: For more information, please refer to one of the atlas pictures listed below.) Interestingly, the disc separates the joint cavity into two functionally separate compartments: one inferior and one superior. Another unique feature of this joint is that the articular surfaces are covered by dense fibrous connective tissue instead of hyaline cartilage, as is usual in synovial joints. This type of connective tissue allows for joint remodeling. The disc attaches to bone medially, laterally and posteriorly, but blends with the articular capsule anteriorly. The articular capsule and the lateral ligament further stabilize this joint. Medially, the sphenomandibular ligament assists in TMJ stabilization. Posteriorly, the stylomandibular ligament assists in joint stabilization.
The TMJ is considered a compound joint, because it operates as two separate but related functional units. The articular disc and the mandibular condyle form the first functional unit. These two act together in most hinge-type movements. This is when the jaw is depressed. The condyle and the disc together move (glide) on the articular eminence for full mandibular opening. The jaw may also be protracted (protruding the mandible) or retracted. In addition, there is lateral displacement about the TMJ. The primary muscles producing these mandibular movements are: depression-lateral pterygoids with help from the digastric, mylohyoid and geniohyoid muscles; elevation-masseter, temporalis and medial pterygoids; retraction-posterior temporalis; protraction-lateral pterygoids; and lateral displacement-contralateral lateral pterygoid. Earlier descriptions of a separate "superior pterygoid" muscle acting solely upon the articular disc seem to have been unfounded.1
The innervation of the TMJ is derived from branches of the mandibular division of the trigeminal nerve; specifically, the masseteric and auriculotemporal branches. The blood supply is derived from the superficial temporal and maxillary branches of the external carotid artery. Lymphatic drainage is primarily into the deep cervical nodes.
Next month, I will discuss various TMJ dysfunctions as they relate specifically to the underlying anatomical features. It will then become clear why so many clinicians of various types treat TMJ dysfunction.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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