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Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
The Future of Functional Neurology
Functional is the hot buzzword in health care these days; witness the rising popularity of functional medicine, functional testing and yes, functional neurology.
Do You Teach Patients How to Breathe Properly?
Spinal manipulation often produces quick results in terms of pain alleviation and improved range of motion. Unfortunately, once the patient is no longer in pain, they may discontinue therapy, only to be plagued by the same complaint at a future date.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
News in Brief
A Winner in and Out of the Office; Ready for the "Have-A-Heart" Campaign? New Integrative Medicine Journal.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Elevated Shoulder? Check the QL
As you know, posture reveals a great deal about the body. Posture is a unique mental and physical landscape revealing compensations and adaptations to life. It's a classic mind-and-body story.
The MRI: When and Why to Order One
As I lecture around the country to both chiropractors and medical specialists, it's clear one of the main disconnects between the two professions is that of an accurate diagnosis.
Preventing ACL Injuries in Female Athletes
For female athletes, the key to optimal athletic health lies in preventing ACL injuries. In medical terms, the anterior cruciate ligament (ACL) is the primary restraint to the anterior displacement of the tibia on the femur at all angles of the knee flexor.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Sell Out: Using Research for the Wrong Reasons
The above chorus is from the ska band Reel Big Fish's 1997 hit song, "Sell Out," from their album, "Turn the Radio Off." In the song, the singer sarcastically relates the plight of a musician who is tired of "flipping burgers" and is willing to get "lots of money" by playing "what they want you to hear" in order to get a recording contract.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Osteoporosis Isn't Always the Case
What is your diagnosis? The patient is a 58-year-old female with back pain. I am sure all of you see the compression fracture at L2; however, there are some findings that suggest this is not a compression fracture due to osteoporosis.
Top 10 Fitness Trends for 2016
The American College of Sports Medicine (ACSM) published its annual fitness trend forecast in the November / December 2015 issue of ACSM's Health & Fitness Journal.
Spine Surgery: A Tale of Greed and Corruption
All too often, where there's substantial money to be made, greed and corruption inevitably follow.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
We Get Letters & Email
In the Dec. 1, 2015 issue, we have Donald Petersen reporting on "the adapting chiropractic practice," which includes multidisciplinary practice as an option; a ChiroPoll indicating 59 percent of DCs are seeing at least 21 patients per day and 27 percent are seeing more than 40.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
The Amazing Clinical Versatility of Milk Thistle (Part 1)
Most of us know that the standardized extract from the seeds of milk thistle (Silybum marianum) is probably the best-proven herb for protecting the liver from chemical and inflammatory damage.
September, 2001, Vol. 01, Issue 09
Miles, Myths and Musings
By Keith Eric Grant, PhD, NCTMB
Last Sunday was one of those idyllic summer days on which the inland temperatures were moderated by a gentle inflow over the hills from the San Francisco Bay. I found myself sitting with friends at a table outside of a coffeehouse in the early afternoon, pouring over maps and charts spread out before us. What had brought us together was the common purpose of running a 199-mile relay from Calistoga to Santa Cruz.
The preamble to this meeting for me has been a spring and summer reckoned by a week-to-week increase in my running. It has meant a return to some familiar places and routes, after several years of letting my distances dwindle amid the pulls of professional and parental responsibilities. In an interesting synchronicity, I had started increasing my running about six weeks before I was asked to join the relay team. It was a reminder for me that, when we set ourselves to a goal, things often occur around us to aid and further motivate us. As I've spent time running up ridges and over hills, I've had opportunities to muse on the physiology and psychology of training.
Challenging Our Lactate Threshold
There is a persistent myth that massage relieves muscle soreness by flushing out lactic acid. In truth, lactic acid, which dissociates in solution into lactate and hydrogen ions, is only present in excess during and immediately following high-intensity exercise. It is metabolized within 30-60 minutes after such exercise ceases. Moreover, lactate is not a toxic end-product; it is an efficient energy-storage and transportation medium.
As we increase the pace of exercise, our bodies produce pyruvate, the end product of glycolysis, faster than it can be processed. To keep us moving, our bodies perform a metabolic "trick" of sorts, shuttling the pyruvate to lactate. The lactate formed from pyruvate can slip quickly and quietly out of cells and into surrounding tissues and blood, where it can be picked up and used as an energy source by less active muscles . As long as our exercise intensity is only producing lactate within our body's ability to process it, blood lactate limits will only rise slightly, then stabilize. If we exceed this level of exercise intensity, the lactate levels in our blood will increase dramatically - we have passed through our lactate threshold (LT). The good news is that by designing our training to regularly challenge our LT for short intervals, our LT will increase. In running, LT is one of the best predictors of race performance.
Delayed Onset Muscle Soreness (DOMS)
Soreness occurring 24-72 hours after exercise is termed Delayed Onset Muscle Soreness (DOMS). The exact mechanisms involved in DOMS are uncertain, but researchers believe they involve micro-trauma to individual muscle fibers resulting in calcium ion leakage and a cycle of inflammation response. Most DOMS is experienced following suddenly increased workouts, particularly those resulting in eccentric contractions - muscles being lengthened while resisting against the lengthening, as in walking down stairs or running downhill. Increasing eccentric exercise gradually conditions our muscles and avoids the soreness.
Musings on Exercise and Massage
Eliminating lactic acid removal as the focus of post-exercise massage, we are left with a therapy that sports experience shows to be effective, yet lacks a clear mechanism for such effectiveness. Research indicates that the simple post-exercise administration of effleurage does not result in a increase in local blood flow or in accelerated recovery. Other research indicates that massage, combined with an active cool-down, increases the rate of recovery during short breaks between maximal efforts.
One difficulty in interpreting such results comes from the early 20th century tendency to view the body as a simple machine. We mistakenly look for massage to have direct mechanical effects. What seems more likely is that massage acts as a new input to a system with a memory. In my observation, fatigued muscles tend to remain hypertonic and shortened. When we cajole specific muscles to relax and lengthen via mechanical and neurological input, we reduce their metabolic activity and the compression they exert on surrounding tissue. In my opinion, it is not the direct action of massage, but the action of massage to create a new homeostasis, that allows the natural process of recovery to occur more efficiently.
When I run intensely, I notice results beyond the obvious. Running involves not just my legs, but the core muscles of my trunk, the stabilizers of my hips and ankles, and the coordinated movement of my arms. It requires training my determination and mental focus to challenge my muscles and breath when going up hills, and the speed and efficiency of my neuromuscular motion patterns when going down hills. At times, the fatigue and soreness bring an increased sense of vulnerability and the need for nurturing human contact - another role that massage can fill for athletes.
As I finish writing this article, I'm preparing for a backpack trip into the eastern escarpment of the Sierras -- a journey with a loaded pack along a creek, from the sagebrush-covered hillsides of the trailhead, through the miles and several thousand feet of climbing, to a high alpine lake nestled at the foot of an even higher pass. It strikes me as the perfect preamble for a massage.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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