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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."
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.
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.
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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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."
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.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
October, 2003, Vol. 03, Issue 10
CranioSacral Therapy and Scientific Research, Part I
By John Upledger, DO, OMM
I cannot count the number of times I have been told by well-meaning friends and harsh critics that CranioSacral Therapy (CST) should be investigated using scientific methods. Many people say CST would be a real boon to health care - if only there were more scientific proof.In a recent article (www.massagetoday.com/archives/2003/03/07.html), I explained why I believe CST can never be adequately evaluated within the confines of the laboratory. In addition, many people don't realize that research has indeed been done. For you skeptics, I offer the following overview:
In the mid-1970s, I was approached by Michigan State University (MSU) to uncover the scientific basis for a premise put forth by William Sutherland, DO, in the 1930s: that the joints and sutures of the cranium do not fully ossify, as was once believed. From 1975 through 1983, I was a professor in the department of biomechanics at MSU's College of Osteopathic Medicine, where I led a team of anatomists, physiologists, biophysicists and bioengineers to test and document the influence of the craniosacral system on the body. Together we conducted research - much of it published - that formed the basis for the modality I went on to develop and name CranioSacral Therapy.
I first worked with neurophysiologist and histologist Ernest Retzlaff, PhD, to prove that under normal conditions, cranial sutures do not calcify before death. We studied numerous bone and suture samples taken from neurosurgery patients between the ages of seven and 57 years. Not only did these samples show living sutures completely free of calcification, but they were chock full of collagen and elastic fibers; arteries; arterioles; capillaries; venules; veins; nerves; and neuroreceptors.
After in-depth examinations, we demonstrated definitive potential for movement between the cranial sutures. Yet these results appeared to contradict anatomy-lab samples taken from cadavers whose skull sutures were calcified. These seemingly conflicting findings suggested that the calcification of skull sutures seen in preserved cadavers was due to postmortem changes and reactions to chemical embalming agents. Our findings supported those published in Anatomica Humanica by Italian professor Guiseppi Sperino, who noted that cranial sutures fuse before death only under pathological circumstances.
Once we saw the potential for motion in living sutures, our next step was to demonstrate that the motion we had hypothesized actually existed in the living skull. With the assistance of biophysicist Richard Ropell, PhD, we began using head (band) strain gauges on living subjects. These gauges demonstrated rhythmical expansion-contraction movements of the cranial circumferences at eight to 12 cycles per minute; however, there were other variables that could discredit these measurements as solid evidence of sutural movement, so we had measure the movements of one skull bone in relation to another. While we could not use humans for studies like this, we were able to use live monkeys from the university's pharmacology department.
In pain-free experiments, we anesthetized the monkeys and did minor surgery to cement an antenna directly to each parietal bone, about two centimeters lateral to the sagittal suture, and two centimeters posterior to the coronal sutures. We then wired these two 10-inch antennae so that we could broadcast a radio signal between them. In the recorded wavelengths, we discovered as the parietal bones moved independently of each other, the distances between antenna times changed. These changes demonstrated interparietal movement of about 12 cycles per minute. At one point, I placed a fingertip on the monkey's coccyx. With minimal pressure, I was able to stop the parietal bone motion.
Now we had evidence of a system that could move parietal bones rhythmically - and be stopped by pressure on the coccyx. This and a multitude of other factors caused me to deduce that the coccygeal pressure influenced the parietal motion via the hydraulic force of cerebrospinal fluid (CSF) moving through the dural membrane and myofascial system related to the spinal column and the cranium.
My first inkling that such a hydraulic system existed came some years earlier during a neck surgery I assisted. The lead surgeon had removed the spinous processes and part of the laminae of the middle cervical vertebrae (C4 and C5) in order to expose the meningeal dura mater and keep it intact. At that time, I witnessed a rhythmical rise and fall of CSF pressure at about eight cycles per minute. It became clear that a fluid pressure deep to the dura mater was causing its continual movement. This fluid had to be cerebrospinal, and its volume had to be increasing and decreasing cyclically. Why hadn't this phenomenon been noticed in surgeries before? The answer is surprisingly simple: In most cases, the dura mater was incised. (Fortunately, that's not always the case.) I recently received a letter from Professor Charles Probst, a prominent Swiss neurosurgeon. He reported seeing,
In the case of lumbar-puncture procedures, when the needle enters the CSF compartment, the fluid enters the manometer via the needle and an elbow apparatus. When the fluid rises to its peak pressure, a valve is opened to take a specimen. It was generally assumed that the CSF specimen that was removed accounted for the reduction of pressure in the manometer. Any cyclic drop in fluid pressure was thus overlooked.
Editor's note: Look for the conclusion of this article and its relevant references in the November issue.
Click here for previous articles by John Upledger, DO, OMM.
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