resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
February, 2003, Vol. 03, Issue 02
CranioSacral Therapy and the AIDS Patient
By John Upledger, DO, OMM
CranioSacral Therapy relies on extremely tender, supportive hands-on contact, accompanied by a sincere intention to assist the patient in any way possible. The therapist serves as a facilitator to the patient's own healing processes.In my experience, this delicate, caring approach is highly welcomed by the majority of AIDS patients.
Consider the messages you send a patient through the use of intentioned touch. Combine that with the fact that this corrective work is done on a core physiological level, applied directly and indirectly to the craniosacral system, and it seems clear that CranioSacral Therapy can potentially effect change on many different levels in a patient's body.
The craniosacral system is essentially a semi-closed hydraulic system. Its boundaries are formed by the dura mater within the cranial vault and vertebral canal. The system includes the dural sleeves, as they invest the spinal nerve roots outside the vertebral canal as far as the intervertebral foramina, and the caudal end of the dural tube, which ultimately becomes the cauda equina, and blends with the coccygeal periosteum.
Cerebrospinal fluid (CSF) flows within this semi-closed hydraulic system. Fluid inflow and outflow are regulated by the choroid plexuses within the brain's ventricular system, and by the arachnoid granulation bodies. The latter structures are located largely within the venous sinuses that service the brain's circulatory system.
To qualify as a semi-closed hydraulic system, fluid inflow and outflow must be regulated. The model that essentially explains the control mechanisms for inflow involves a feedback system from intrasutural stretch and compression receptors. These receptors communicate via the nervous system to the choroid plexuses, and provide a rhythmical on-and-off activity for CSF production into the system.
While CSF outflow is not rhythmically interrupted, its rate may be adjusted. This is done through intracranial membrane tension patterns that are broadcast primarily via the falx cerebri and tentorium cerebelli to the anterior end of the straight venous sinus, where an aggregation of arachnoid granulation bodies is located. This concentration of arachnoid granulation bodies is known to affect venous back pressure, which in turn affects the reabsorption of CSF into the blood-vascular system. The craniosacral system also includes all of the bones of the cranium; the second and third cervical vertebrae; the sacrum; and the coccyx.
Clinical research and observations have demonstrated that dysfunctions of the craniosacral system can manifest as a wide variety of syndromes, symptoms and degenerative processes. The craniosacral system influences the physiological milieu in which the central nervous system lives. It also has powerful influence over the pituitary and pineal glands, due to their anatomical intimacies. Therefore, it has powerful effect on brain and spinal cord function, and the endocrine system.
Indeed, CranioSacral Therapy has been shown to have positive effect on a diversity of brain dysfunctions, ranging from seizure problems to dyslexia and attention deficit disorder. It also has positive effects on the autonomic nervous system, both through the central control nuclei in the brain stem, and the spinal cord's segmental effects on the sympathetic nervous chains and ganglia.
The latter effect comes from CranioSacral Therapy's ability to desensitize spinal cord segments that have become hypersensitized or "facilitated" secondary to chronic excessive input. These hypersensitive segments often result from such conditions as chronic localized infections or painful musculoskeletal or myofascial dysfunctions.
Hypersensitive or facilitated segments send unwarranted and excessive outflow to their related end organs. These organs, in turn, send excessive sensory input back to these already hypersensitive segments. In this sense, the situation becomes self-propagating. In addition, the sympathetic system input from the related hyperactive segments is increased, raising total sympathetic tonus with all of its attendant problems.
Using thermography, I have seen that hand warming occurs during CranioSacral Therapy. This indicates a reduction of sympathetic tonus. Concurrently, blood pressure and cardiac rate, when elevated, as is often the case in sympathetic hypertonus, move toward normal. Subjective pain improves almost invariably as the CranioSacral Therapy treatment progresses.
In my experience, it is clear that AIDS patients, with their multitude of painful visceral, neuromusculoskeletal and myofascial dysfunctions, can be made more comfortable and functional by the regular application of CranioSacral Therapy. In addition to the positive effects already mentioned, it appears from clinical observations that CranioSacral Therapy can enhance fluid motion on an interstitial level, and across cell membranes. It also seems to enhance arteriovenous and lymphatic activity, as evidenced by the reduction of clinical edema during the treatment process. This result is probably largely the result of its effect on the autonomic nervous system.
This enhancement of the microcirculation of all fluids undoubtedly has a positive effect upon the toxic effects of accumulated waste products within static fluids. All patients, including those with AIDS, benefit when fluid stasis is transformed into fluid motion.
Another benefit of CranioSacral Therapy is its apparent positive effect upon the immune response - for example, the reduction of virus-induced fever characteristic of many childhood diseases. Following CranioSacral Therapy, it is not uncommon for the child to suffer no further febrile episodes subsequent to the fever reduction. Instead, he or she simply begins the recovery phase.
It seems that AIDS patients might best be served by methods that allow them to rechannel energies from dealing with pain and secondary dysfunction, into directions more constructive in terms of body-resistance enhancement. CranioSacral Therapy would seem to be one of these methods. There is still much to learn in this area, but we certainly seem to be on the right track.
Click here for previous articles by John Upledger, DO, OMM.
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