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Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
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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