Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
January, 2004, Vol. 04, Issue 01
By Whitney Lowe, LMT
The highly refined palpation skills of massage practitioners are such that we often identify tissue abnormalities before the client is aware of them. An indication that we should refer a patient for further evaluation is when we identify something we aren't sure of but know shouldn't normally be there.One such example may occur with a synovial ganglion cyst, which occurs most commonly around the wrist, though they may occur elsewhere.
Exactly how and why these ganglions form is poorly understood. This makes it difficult to formulate a consistently reliable treatment. Despite the similarity in name, a ganglion cyst is different than the ganglion that is a collection of nerve cells. The ganglion cyst is a fibrous swelling that occurs near joints and is often associated with joint capsules or tendon sheaths. It contains a clear mucinous fluid that is different than the synovial fluid contained within joint capsules.
It is estimated that about 60 percent to 70 percent of all ganglions are dorsal wrist ganglions. Those on the volar surface of the wrist make up about 20 percent, and the remaining percentage occur in other regions of the body. The cysts are more common in women than men, and there does not appear to be any association with hand dominance. They are most commonly evaluated through clinical examination, although much greater detail about the makeup of the ganglion can be derived from a detailed diagnostic study, such as MRI. They usually become evident from a visible bump under the skin and may or may not be painful; however, as they get larger, they will likely become painful, especially if pressed. In some cases, the cysts may not be visible at all. These are called occult ganglions. You may discover them with palpation and treatment of the wrist region before the client is aware of them.
How and why ganglions occur is still something of a mystery. Various theories have suggested that they involve growths on the retinacula of tendons, knots of dysfunctional tissue, herniation of the synovial sheath of joints, or various other lesions. Some people report noticing them after an acute injury, but there is no significant evidence that suggests they are caused by another mechanical trauma to the region. Because the swelling can become pronounced, there is often concern about the nature of the problem. While for some it is a cosmetic issue, others may fear it is related to a more serious problem like a cancerous growth.
It is important to evaluate these other possibilities; however, the most likely pathology - especially with wrist ganglions - is not serious. In many cases, the ganglion itself will not be painful, but may cause pain because of where it is has developed. For example, ganglion cysts are one possible cause of pain from nerve entrapment in certain regions. Compression of the ulnar nerve in Guyon's canal or the median nerve in the carpal tunnel can occur from ganglions. Since nerve entrapments in these regions can be relatively common, it is easy to overlook the presence of the ganglion as a cause in favor of one of the more common explanations for nerve entrapment pain.
There are a number of options for treatment of ganglion cysts. Ironically, pressure directly on the ganglion is still advocated by some as a means of treating it; however, you should not treat the ganglion by pressing on it. It is better to leave treatment decisions to other professionals. The more common procedure for ganglions is aspiration with a needle to remove the excess fluid and then let the ganglion dissipate on its own.
Luckily, few people today advocate the former treatment, which was to whack the ganglions with the Bible! There are a number of reports in the medical literature about distal radius fractures that occurred from this "treatment." Knowing a little more about ganglions will help you address the problem when you come upon it.
Click here for more information about Whitney Lowe, LMT.
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