resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.