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How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
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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