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Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
October, 2002, Vol. 02, Issue 10
CranioSacral Therapy vs. Cranial Osteopathy: Differences Divide
By John Upledger, DO, OMM
CranioSacral Therapy, which I developed in the 1970s, is compared frequently to cranial osteopathy, developed by Dr. William Sutherland. Although Dr. Sutherland's discovery regarding the flexibility of skull sutures led to the early research behind CranioSacral Therapy - and both approaches affect the cranium, sacrum and coccyx - the similarities end there.
What was to become cranial osteopathy began as the idea of an osteopathic student in Kirksville, Missouri, in the early 1900s.Dr. William Sutherland saw that the bones of the skull were designed to allow for movement in relationship to one another. It was a radical idea that flew in the face of American and British anatomy textbooks, which taught that skull bones fuse together before adulthood.
To test his theory, Dr. Sutherland filled a skull with dry beans and added water. This caused the skull bones to move along the suture lines, and ultimately to disarticulate. He also performed makeshift experiments on himself with helmet-like devices that imposed variable controlled and sustained pressures on different parts of his head. His wife recorded personality changes, head pain and coordination problems he displayed in response to different pressure applications.
Based on his experiments, Dr. Sutherland developed a system of examination and treatment for the bones of the skull that became known as cranial osteopathy. Because so little was known about how it worked - and patient results seemed miraculous at times - Sutherland's system acquired an esoteric reputation.
Conversely, the origin of CranioSacral Therapy can be traced to the accidental discovery of the craniosacral system during a seemingly routine surgery in 1970. At the time, I had a unique view of the dura mater, the outer layer of the meningeal membrane in the neck. Ordinarily compromised as part of surgical procedure, the dura mater was deliberately left intact during this surgery to prevent any risk of meningeal infection.
My task as a surgical assistant was to hold the dura mater still while the surgeon scraped a calcium plaque off its surface. No matter how I tried, I was unable to do it. The membrane continued to move rhythmically at a rate of about 10 cycles per minute. Neither my colleagues nor any medical text I consulted could explanation this phenomenon.
Still curious about what I had seen, I enrolled two years later in a seminar that explained Dr. Sutherland's ideas and taught some of his evaluation and treatment techniques. Coupling my scientific background with tactile sensitivity, I surmised that the rhythmical motion I had seen during surgery could have been caused by a hydraulic-type system functioning inside a membranous sac encased within the skull and canal of the spinal column. After further study and research, I refined Dr. Sutherland's techniques and successfully incorporated them into my private medical practice.
In 1975, I was invited by Michigan State University to lead the world's first task force to study and verify the mobility of cranial sutures and bones. For the next five years, I led a team of anatomists, physiologists, biophysicists and bioengineers, and together we researched the basics and potential for performing therapy on the craniosacral system.
Through an extensive series of studies and experiments, we demonstrated how the craniosacral system could be used to assess and improve numerous health problems involving the brain and spinal cord. Yet this was a very different approach than that used in cranial osteopathy. Here we were focusing not on the bones of the skull, but on the membranes and cerebrospinal fluid surrounding the brain and spinal cord.
We verified that the craniosacral system does indeed operate like a semi-closed hydraulic system. Pressures build as the amount of cerebrospinal fluid increases in the system, forcing the fluid to move up and down the spinal cord. When the fluid moves, the membranes containing it also move, normally at a rate of 6-12 cycles per minute.
CranioSacral Therapy practitioners are trained to gently monitor this rhythm to detect and release imbalances and restrictions in the membranes that could potentially cause sensory, motor or neurological dysfunctions. As such, CranioSacral Therapy is never intended to cure disease, but simply to facilitate the body's ability to self-correct. It offers a comprehensive, whole-body structural and functional evaluation protocol.
Even today, the focus of cranial osteopathy remains on manipulating the sutures of the skull. With CranioSacral Therapy, the bones of the skull are involved in that they serve as "handles" for the practitioner to use to access and affect the membrane system that attaches to those bones.
Another major difference between the two approaches is in the quality of touch. In general, the manipulations used in cranial osteopathy are often heavy and directive. Practitioners of CranioSacral Therapy usually use a light touch, scientifically measured to be between 5 and 10 grams. That's about the weight of a U.S. nickel resting in the palm of your hand. This gentle quality often belies the effectiveness of the therapy. Most patients report feeling nothing more than subtle sensations during a typical session.
Yes, CranioSacral Therapy and cranial osteopathy are quite different. Yet they remain linked in history by two osteopaths who trusted their observations and continued undaunted in their quests to prove their theories.
Click here for previous articles by John Upledger, DO, OMM.
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