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A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
March, 2002, Vol. 02, Issue 03
The Expanding Role of Cerebrospinal Fluid in Health and Disease
By John Upledger, DO, OMM
In 1971, I first witnessed the rhythmical activity of cerebrospinal fluid (CSF) as its hydraulic forces affected the patch of dura mater I was watching. At the time, I had no inkling of the incredible journey that was in store for me.
That small section of dura mater was only about 1-1/2 inches long and 2 inches wide.We had exposed it to remove a dime-sized calcium plaque from the outer surface of the dura. The operative site was the posterior aspect of the mid-cervical region of the patient.
My assignment was to hold the dura very still with a pair of forceps while the neurosurgeon delicately removed the calcium plaque without incising the dural membrane. In spite of my efforts, the exposed dural membrane repeatedly protruded and receded at about 10 cycles per minute.
That particular rhythm was a surprise to everyone in the operating room. It didn't synchronize with the anesthetist's breathing apparatus or the cardiac monitor. The only thing I could think of that could create this force was the pumping of CSF inside the dura mater.
The subject of CSF was quite contentious at the time. When I was in osteopathic college in the early '60s, CSF was considered mainly a shock absorber for the brain during swift starting and stopping movements. There was also some debate about whether CSF was a transport system delivering nutrients and removing waste, but no one was certain. Some cranial osteopaths even made vague references to CSF following nerve fibers to every cell of the body to deliver "mystical" energy.
Despite all these theories, scientific knowledge at that time stated firmly that CSF did not penetrate the brain's surface or leave the compartment formed by the dura mater. The fluid did appear to follow nerve roots peripherally from the brain and spinal cord, but only as far as the dura mater provided a sheath for the roots. This, it was thought, was to bathe the nerve roots and the surface of the brain.
Controversy even existed over whether the fluid in the subdural space should be considered CSF. There was evidence to support the concept that the arachnoid membrane was impermeable to CSF and, therefore, the fluid outside the arachnoid membrane, but inside the dura mater was not CSF, even though they were biochemically identical. This, of course, raised yet another question: Should a fluid be named by its biochemical characteristics, or by the compartment in which it resides?
It was against this backdrop that I observed the pumping activity of CSF in 1971. And it was in this environment that I went on to develop CranioSacral Therapy.
My initial focus with CranioSacral Therapy was to mobilize the meningeal membranes that related to the entire central nervous system and the proximal aspects of its major nerve roots. I used the bones that attach to these membranes, either directly or indirectly, to manipulate the meningeal membranes and release any mobility restrictions.
I found CranioSacral Therapy also released restrictions in membrane mobility and in the sutures between bones of the skull vault by effectively using the hydraulic forces provided by the pumping of CSF. The therapist simply drew those forces into restricted areas by gently inhibiting the areas of maximum (compensatory) compliance to the rhythmical rises of hydraulic forces. By continuing this gentle manual pressure, the fluctuating hydraulic forces helped release those restrictions naturally.
My colleagues and I were fascinated by the wide variety of patient improvements we witnessed using these new techniques and theories. Most positive responses came in cases of pain that were attributable to meningeal restrictions, in cases of painful sutural restrictions, and with learning disabilities that could be related to specific dysfunctions in this craniosacral system.
Yet what was truly difficult to explain were the positive results seen with diseases like Parkinson's, multiple sclerosis, chronic fatigue syndrome, and acute and chronic infections, including resistant staphylococcus and cytomegalovirus.
Indeed, there were many positive results from CranioSacral Therapy in areas that seemed untouchable based on concepts held about CSF at that time. Even now, as scientific research continues to uncover the secrets of CSF, we see more and more how CranioSacral Therapy helps in so many surprising ways.
Several research projects over the past few years have demonstrated that, contrary to previously held ideas, CSF is the interstitial fluid of the brain and spinal cord. That means it permeates the spaces between all the nervous and glial cells of the brain and spinal cord. In this way it carries nutrients; removes metabolic byproducts, waste and toxic molecules; strongly influences pH (acidity); and is now thought to influence the electromagnetic environment of the neurons and other cells of the central nervous system. (Author's note: For a complete overview of these research projects, see Science News, January 1999.]
In The New York Academy of Science Annals, Volume 854, an article entitled "Towards the Prolongation of a Healthy Life Span" reported that CSF contains low-molecular-weight chelating agents that remove metal atoms from the interstitial spaces of the brain and spinal cord, and from the neuronal and glial cell membranes. According to the article, CSF also protects against oxidation and toxic accumulations of nonmetallic toxins.
This is especially enlightening in cases of recent studies that have shown both Parkinson's and Alzheimer's diseases may be induced by toxic build-ups of heavy metals - within the basal ganglia in the case of Parkinson's, and in the cortical and subcortical regions in the case of Alzheimer's disease. Enhancing CSF circulation may well help prevent these two diseases, along with many other types of senility and deterioration problems.
In my own clinical practice, I've been able to break fevers, alleviate chronic viral infections, prevent flu... the list goes on and on. All these results suggest an enhancement of immune function, which is exactly what I believe CranioSacral Therapy does. It moves CSF and every other body fluid, especially the interstitial fluids. By whatever name, the fluids between cells must move in order to deliver molecules that not only nurture cells but also transport messages and patrol for antigens - all vital to strong immune function.
Physicians at Stanford University have also discovered that the exchange of CSF slows with age. While there is a complete turnover of CSF about four or five times a day in healthy middle-aged people, in the elderly that rate may be cut in half. In fact, the Stanford folks became so convinced that CSF turnover is important that they've placed shunts in a sample of nine patients with reduced turnover. They want to see whether the drainage of stagnant CSF enhances production and reduces certain substances in the CSF - and hence the central nervous system - that are believed to contribute to brain deterioration and Alzheimer's disease.
I firmly believe CranioSacral Therapy can help maintain or regain the normal daily turnover of fluids, with all of its attendant health benefits.
Click here for previous articles by John Upledger, DO, OMM.
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