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ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
February, 2002, Vol. 02, Issue 02
The Tuina Treatment of Tennis Elbow
By Bob Flaws, LAc, FNAAOM (USA), FRCHM (UK)
In 1982, I was studying acupuncture at the Shanghai College of Chinese Medicine and working as an intern in the acupuncture department at the Long Hua Chinese Medical Hospital. Sometimes, during the heat of the summer, there were not that many patients to see in the acupuncture ward, so I would wander through the hospital to see what else I might learn.As a graduate of what was then the Boulder School of Massage Therapy (BSMT), I had practiced massage for several years prior to studying acupuncture. Thus, I was immediately fascinated by what I saw when I discovered the tuina, or Chinese medical massage, ward.
The movements I witnessed were unlike anything I had learned at BSMT. I was especially enamored with the idea of specific protocols lasting 15-30 minutes for the remedial treatment of specific conditions. Therefore, I arranged to study tuina the following year and to work as a tuina intern at the Yue Yang Chinese Medical Hospital, also in Shanghai. Eighteen years later, I am still as enthusiastic about tuina as I was then.
Below is the tuina protocol I learned for the treatment of tennis elbow. It is based on the rolling school (guan fa pai) of tuina popular in Shanghai founded by my personal teacher, Ding Ji-feng.1 Dr. Ding had been practicing this method for over 50 years when he taught it to me.
Western Medicine and Tennis Elbow
Lateral epicondylitis, also called tenosynovitis (and more colloquially, tennis elbow), consists of inflammation of the tendons attached to the lateral side of the elbow at the epicondyle of the humerus. Patients with tennis elbow experience pain in the lateral aspect of the elbow, which may radiate into the forearm, and occasionally into the hand. The pain occurs with grasping activities and may be accompanied by a sense of weakness. An achy discomfort may also be present at rest or at night after activity. This inflammation may be caused by a sudden violent injury, repetitive strain or microtrauma. Tennis elbow occurs equally in men and women and is most commonly seen in patients between the ages of 35-50. Tennis elbow is found not only in tennis players, but in baseball players; swimmers; carpenters; plumbers; meat cutters; musicians; or anyone who repeats an arm motion over and over.
The Western medical diagnosis of lateral epicondylitis mainly consists of physical examination of the affected area eliciting abnormal tenderness to palpation over the lateral epicondyle. X-rays may show calcium deposits on the lateral epicondyle but are not typically required to make this diagnosis. Bone spurs only occur in 20% of tennis elbow patients. The Western medical treatment of tennis elbow mainly consists of rest, anti-inflammatory medication and the application of ice. This is supplemented by stretching and strengthening exercises; straps; wrist braces; and cortisone shots. Surgery is indicated in approximately 5% of cases when all of the above measures have failed over a course of several months and pain continues to prevent activity. The success of tennis elbow surgery is generally 85-95% excellent relief of pain.2 However, patients typically require 3-6 weeks of recuperation before returning to work, and several months before returning to sports or heavy use of the arm.
Chinese Medicine and Tennis Elbow
Chinese disease categorization: Tennis elbow is called zhou lao (elbow taxation); zhou tong (elbow pain); and shang jin (damaged sinews) in Chinese medicine.
Chinese disease causes: Taxation detriment with possible contraction of wind cold evils.
Chinese disease mechanisms: Overwork taxation causes detriment and damage to the sinews and vessels of the elbow. On the one hand, there is insufficient blood to nourish the sinews; on the other hand, there is blood stasis obstructing the free flow of the vessels. This may be complicated by external contraction of wind cold evils due to defensive qi vacuity.
Treatment principles: Soothe the sinews and free the flow of the network vessels; quicken the blood and transform stasis; regulate the qi in the channels and vessels.
Other adjunctive measures may include the use of moxibustion locally on the elbow (either indirect, roll moxa or direct, non-scarring, "grain of rice" or thread moxa), or warming with a TDP heat lamp.3 Internal administration of Chinese medicinals based on the patient's individual pattern discrimination is also quite helpful.4
To get a satisfactory result with tennis elbow, the patient needs to refrain from all activities, be they work or play, that aggravate the condition. Until or unless the patient is willing to allow the inflammation of their lateral epicondyle to heal, no amount of tuina or Chinese medicinals is going to get a satisfactory effect. If the cause of this inflammation is work-related, the patient should be advised to modify their equipment or work habits. This may mean using a lighter hammer or tennis racket or seeking professional advice from an ergonomic specialist or kinesiologist.
While ice is indicated within Chinese medicine for recent traumatic injuries and acute inflammations with redness, swelling and palpable heat, it is usually contraindicated for tennis elbow. Even though Western medicine defines lateral epicondylitis as a species of inflammation, it does not usually present heat signs and symptoms according to Chinese pattern discrimination. In fact, given the common age range of patients with tennis elbow and its Chinese name, elbow taxation, this condition is usually a vacuity condition complicated by cold and/or blood stasis, all of which may be worsened by the application of cold. This is why the external application of warmth is usually so important for the treatment of this condition.
In my experience, both in China and the U.S., tuina is definitely an effective therapy for the remedial treatment of tennis elbow.
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