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International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
November, 2001, Vol. 01, Issue 11
The Role of CranioSacral Therapy in Addressing Post-Traumatic Stress Disorder
By John Upledger, DO, OMM
Author's note: When I wrote this column, the tragic events of September 11, 2001 had not yet transpired. Never could I have imagined the topic I had chosen would become so eerily apropos.With trauma of the magnitude our nation has experienced, we can expect to see an exponential rise in the incidence of Post-Traumatic Stress Disorder (PTSD) in years to come.
Since starting our PTSD program for Vietnam veterans more than eight years ago, it has always been our desire to make the program available to all victims of trauma who may suffer from this disorder. Up to this point, the funding simply has not been available. In light of everything that has happened recently, it is apparent that the time has come to expedite the outreach of this program.
As we begin the healing process, individually and as a nation, our thoughts and prayers remain especially with those directly affected by this tragedy: the survivors of the attacks; the loved ones and colleagues of those taken; the witnesses to the carnage; and the firefighters, police and rescue workers who put themselves in harm's way.
Throughout human history, those who have undergone or witnessed traumatic events have oftentimes experienced ongoing and uncontrollable fear, anxiety, depression, and other life-altering emotions. It has only been in recent times, however, that these symptoms have gained recognition, validation, and a name.
In 1980, Post-Traumatic Stress Disorder (PTSD) was first officially recognized by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders, Volume III. Before 1980, the condition existed only as titles such as "shell shock," "battle fatigue," "dissociative amnesia" and "physioneurosis." It was the rather high incidence of PTSD in Vietnam veterans that finally prompted inclusion of the condition as a mental disorder in the DSM III.
Although combat veterans comprise a significant percentage of PTSD sufferers, combat should not be considered the singular cause of the disorder. It can result from any experience a person feels is life-threatening, terrorizing or totally degrading. It can also result from viewing horrible or terror-inducing events that happen to others, especially loved ones.
The symptoms of PTSD may occur days to years after the related event. Once begun, the symptoms occasionally go into remission and then return. The disorder we now call PTSD may continue to affect the victim for years, decades, or the balance of a lifetime. Though classified as a mental disorder, PTSD has distinct physical origins. In our years of research and treatment of PTSD, we have encountered numerous symptoms that respond well to hands-on CranioSacral Therapy. The following are seven of the more prevalent symptoms that the PTSD patient may endure, and how we approach managing such symptoms:
1. Insomnia can result when the joints of the head and neck become jammed due to extreme backward or forward bending of the head during a traumatic occurrence. CST is used to release these pressures and improve the efficiency of fluid outflow at the occipital-cranial base (base of the skull). When successfully applied, insomnia significantly improves.
2. Hypervigilance is a state of heightened awareness in which any surprise or unexpected noise causes an excessive response that the PTSD person cannot control. (This also contributes to insomnia.) We use CST and its offshoot, SomatoEmotional Release, to locate and release energy cysts (contained areas of stress) throughout the body.
We concentrate particularly on the reticular activating system (RAS) of the brain and spinal cord, which is responsible for the secretion of adrenalin and other stress hormones and biochemicals. When we can reduce this system's level of ready alertness, both hypervigilance and hyperresponsiveness are significantly alleviated.
3. Intrusive thoughts continually interrupt a PTSD victim's ability to concentrate, and may even prove intellectually disabling. CST and its offshoots are used to balance fluids and release restrictions on the right and left sides of the cranium, thus enhancing the circulation of both blood and cerebrospinal fluid. As a result, nutritional supplies to brain cells are improved and toxic waste products are removed. The brain areas that help control conscious thoughts are also revitalized and become more effective.
4. Flashbacks involve the mental re-experiencing of the horrific events that caused the PTSD initially. Each time they occur, they are just as terrifying to the person as the original experience. Unlike normal memories, they do not mellow with each recall, nor can the person experiencing them describe them in words. While this kind of response can be considered appropriate at the time of the original traumatic event, it certainly is not appropriate 10 years later in a different and probably safe setting.
Studies have shown that, in PTSD, the left hemisphere of the brain is less functional than the right, and the hippocampus - thought to be an important factor in memory control - is smaller on the left side than on the right. CranioSacral therapists work to equalize the mobility and fluid flows of both sides of the brain. They also pass a lot of energy from right to left, focusing on the left-side speech area (plenum temporale).
Using this approach, we have seen clients become able for the first time to describe the flashback event(s). As this ability improves, the flashback comes under control and the experience can be recalled voluntarily. Eventually, the power of the event fades and the flashbacks discontinue.
5. Panic attacks mark the beginning of PTSD, but they fade and discontinue as hypervigilance, intrusive thoughts and flashbacks are successfully treated.
6. Long-term fear results in a PTSD patient faced with a short-lived, scary episode. On the other hand, the non-PTSD person might well react with momentary fear to the same episode. This long-term fear becomes chronic anxiety. As with panic attacks, this too wanes as the CST takes effect.
7. Depression and suicidal thoughts are common in PTSD-afflicted individuals. Our treatment focuses specifically on releasing abnormal compression at three junctions: where the sphenoid bone and base of the occipital bone meet (floor of the cranial vault); where the joints where the first cervical vertebra and occipital bone unite (base of the skull); and where the lumbar and sacrum come together (lower back into tailbone). Once alleviated, depression lifts and suicidal ideations discontinue.
Using this approach in a study with 22 Vietnam veterans, we found that, at the end of two intensive weeks of treatment, all of them tested much lower on the depression scale. Even the administering psychologist had trouble believing the results of his own tests. It may be difficult to understand how something as light-touch as CranioSacral Therapy could effect meaningful change in an individual suffering from Post-Traumatic Stress Disorder. You are not alone. Those of us who practice the technique still marvel at the responses we often witness. The body is a remarkable mechanism, full of mystery and capable of untold feats of self-preservation and healing.
My hope is simply that this brief discussion helps you gain a better understanding of how CranioSacral Therapy works to aid the PTSD sufferer - and perhaps clears up some misperceptions about this disorder along the way.
PTSD is not an incurable mental disorder. Our research with Vietnam veterans has shown just the opposite, producing some of the most dramatic and encouraging results I have ever witnessed. This is just the tip of the iceberg. I hope you will join our efforts in the years to come, as we seek to eliminate PTSD from the trauma equation.
Click here for previous articles by John Upledger, DO, OMM.
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