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News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
October, 2001, Vol. 01, Issue 10
Unraveling the Lower Back Pain Puzzle
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
If you've practiced bodywork for more than a day, you've probably encountered a client with lower back pain! It is the single most common complaint from people who walk into my office, no doubt for you as well.Helping patients with lower back pain can greatly increase your skill in accurately assessing this condition, according to Chinese medical theories.
In Chinese medicine, there is never a direct correlation to Western assessment. For back pain or any other ailment, there isn't a silver bullet/magic acupressure point that will fix the problem. As I mentioned in previous articles, if someone has depression, you have to look at the Five Element correlation to effectively treat it. To treat a headache, we have to know where it is located to select meridians that will bring relief, based on the Six Divisions theory.
So, are there different elements that relate to the various types of back pain, or different types of back pain based on location? Nope, sorry! Knowledge of the Five Elements and Six Divisions will help you in treating lower back pain, but they are not the key. The Four Examinations and Eight Principles will give you the clues you need to solve your client's back pain puzzle once and for all. (To confirm your suspicion, just about all Chinese medical paradigms begin with a number, and there are a lot of them!)
The Four Examinations start with listening, as you get an idea of their condition based on the client's voice on the phone. Next is observing ,as you note posture and affect as the client walks in the door and you look at the tongue, face and any abnormalities along the meridian pathways. By now, you are asking questions and touching the client's pulses and meridians. The fun part is taking all of that information and making sense of it all.
Sorting it out is where the Eight Principles come in. Is the client's condition acute or chronic, superficial or deep, hot or cold, excess or deficient? Let's look at the main individual types of back pain to figure it all out.
This type of back pain is chronic, deep, usually cold and of course, deficient. We know that if the client has had the problem for a long time, there is definitely something depleted. Chronic conditions have moved deep into the body, and the pain has a more diffuse, dull nature. The pain is worse at the end of the day when the person is tired; back pain will take the form of a dull ache, rather than a sharp pain. Sexual activity will aggravate it. Kidney energy is something that gradually decreases with age; but too much sex, overwork, stress, drugs and alcohol will deplete it faster.
You will notice general Kidney symptoms, such as a pale face and tongue, frequent urination and fatigue. In addition, if it is a Kidney Yang Deficiency, there will be cold symptoms such as cold feet, and there will be some relief from the pain with the application of heat. If there are general Kidney deficiency symptoms plus a thin and rapid pulse, a red tongue with no coating and a vague, low-level anxiety, there is probably a Kidney Yin deficiency.
This is the type of back pain that gets worse when it is cold and rainy outside. You'll find that heat gives considerable relief. With dampness, there is a heavy feeling. It is excess in that it is caused by a pathogenic factor; you may be able to trace onset of the pain to a specific event, such as the client sitting in front of an air conditioner while covered with sweat. For example, I had one client that said his back pain started from when he was at his son's soccer game, sitting in the cold rain.
Stagnation of Qi and Blood
This is the type of back pain that improves with light exercise. You will find clients who say that when they get up in the morning, their back is sore, but after they move around and stretch for a bit, it feels better. This is a clear indication that there is stagnation blocking the free flow of Qi, causing pain. They usually have a history of a traumatic injury which never was treated properly, so it keeps reoccurring.
You may find that with the latter two excess types of back pain, there is an underlying Kidney Deficiency. Since the Kidneys rule the lower back area, there is an initial weakness that exposed them to injury, or that let in an external pathogenic factor, such as cold-damp. Even if the client didn't start off with much of a Kidney Deficiency, one will be created by long-term problems in the lower back. In any lower back pain treatment, make sure to include techniques that will tonify the Kidneys. Hold the Kidney shu points bilaterally with a tiger's mouth (thumb and index finger apart, like they are chomping the points) as you work up the Kidney meridian with your other hand, starting on the sole of the foot. Use deep, penetrating pressure, but not to the point that it is at all painful. You are trying to encourage qi into that area and sharp pain will make it want to go away. You can think of it like you are attempting to entice a reluctant cat: "Good qi, come on qi, here you go qi..." Use any technique that is going to have that vibe to it. Also, hold the area that is painful and work down the Bladder meridian.
If you are trained in using moxa, that is really one of the best techniques that you can do to add qi to an area. Make sure of course that the client is not showing any Heat symptoms such as a rapid pulse, red tongue/ face, feeling warm or inflammation. Choose points such as the Kidney shu, mu and ashiqi. Think of that little kitty that just likes gentle chin scratches. (Editor's note: For a more detailed explanation of shu and mu points and ashi points (painful points that make that make the client say, "Ah-sh...!") You want to use tonifying circles clockwise with a moxa pole in your right hand as you place the point between a V made by your index and third finger. When you feel your fingers getting warm, you know the point is also warm. You don't want the feeling to be painful to your client, as it will disperse, please read Barbra's columns from the July and September issues of Massage Today.
If the client has either of the later two excess types of back pain, you will need to use techniques that disperse the cold-damp or move the qi and Blood stagnation. For cold-damp, fire cupping is great to use with a TDP lamp. This is a pretty dramatic technique as you take a flaming meatball looking thing on a stick, insert it into a glass cup to take out the air, and quickly place a cup each over Du4 and the ashi/ painful points. This creates a suction and pulls apart the meridians (and fascia), allowing the pathogenic factors to be released. A TDP lamp is specifically designed to warm yang and expel cold. It can be placed over the area for the 10 minutes that you are using the cups. (Note: Do not try either of these techniques without training, as there is as much potential for causing harm as good!)
Another technique that you'll want to learn is gua sha. This is what I use if there is any qi and/or Blood stagnation; I follow this technique with stretching. Put an ointment on the area, such as Tiger Balm or Vicks Vapor Rub, depending on whether the client has cold or heat symptoms. Scrape it with a Chinese soupspoon or a smooth jar lid, just to the point where your client starts to feel uncomfortable. There is quite a contrast to how it feels and how it looks. It has a wonderful opening, freeing effect on the area that had stagnation, although it looks as if you have dragged your client along the road. You can see why caution is advisable!
You may be starting to see how your initial assessment is going to affect how you treat your client. You always will be successful treating points local to the problem, and distal on the affected meridian, but to affect long-term changes, you need to find and treat the underlying pattern of disharmony that is the cause of the problem.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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