Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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?"
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.
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.
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.
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.
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!
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.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
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.
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.
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.
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.
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.
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."
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.
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.
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.
June, 2004, Vol. 04, Issue 06
By Keith Eric Grant, PhD, NCTMB
There's nothing like a bit of personal involvement to motivate learning.With a disposition to burning the candle at both ends, a semi-addiction to exercise, and a tendency toward upper-respiratory allergies, I'm all too prone to catching a head cold from a school-bound offspring or world-traveling colleague. Generally, it's not the respiratory symptoms that impact me most, but the mental fog, tendency to nod off, and general malaise that comes with them. It's the immune system chemicals called cytokines, believed to result in the systemic response, that are the focus of this article. What's particularly fascinating about cytokines is that they show up in the literature on infections, allergies, exercise, stress responses, fibromyalgia, and chronic fatigue syndrome.
The local response to infection or tissue injury involves the production of cytokines, which are released at the site of inflammation. Cytokines facilitate an influx of lymphocytes, neutrophils, monocytes and other cells, which participate in the clearing of antigens and healing of tissue. The local inflammatory response is accompanied by a systemic response, known as the acute phase response.6
Similar to explicit tissue injury, strenuous exercise is also accompanied by an increase in circulating proinflammatory and inflammation-responsive cytokines.7 This effect is observed both from long events, such as marathons, and from shorter, intense episodes of eccentric exercise. The cytokine response following exercise is also affected by nutritional factors such as carbohydrate loading or restriction.6
Cytokines are potent mediators of immune activity. These chemicals carry messages from one cell group to another and invoke the most powerful of whole-body defense responses. The cytokines include the interferons and interleukins, which cause many of the symptoms of bacterial and viral infections - fever, headache, generalized aching, fatigue, weakness, and clouded consciousness.3 Injection of proinflammatory cytokines has reproduced many of these acute phase symptoms.
Cytokine production also responds to stress. It is now well established that the central nervous, endocrine and immune systems interact with each other; psychological stress can down-regulate the immune response by affecting the interplay of these systems. The interactions are complex, involving both the hypothalamic-pituitary-adrenal axis (HPA) and the autonomic nervous system.4
It's been proposed that cytokines, reacting to partial protein production by latent viral infections, could be a mechanism involved in chronic fatigue syndrome.4 The viruses could be partially reactivated; that is, viral proteins could be produced at levels high enough to cause a low-grade infection, but too low to be seen using current laboratory assays.5 Stress is also thought to play a role in viral reactiviation.
Cytokines may also play an important role in the more systemic effects of allergic rhinitis, symptoms that include fatigue and difficulty concentrating. One possibility is that allergy stimulates the release of cytokines, which have been shown to produce achiness and fatigue, as well as cognitive impairment. It may also interfere with adrenergic and cholinergic activity in the central nervous system, thereby impairing attention.1
In my December 2002 article, "Flushing Out Myths" (www.massagetoday.com/archives/2002/12/08.html) I advanced the opinion that post-massage reactions similar to flu might be due to an induced response of normally subclinical fibromyalgia; a concept advanced by Leon Chaitow.2 I noted: "I tend to think of a body's neurochemical system on the edge of its ability to adapt being pushed temporarily beyond the edge by accommodating to the work being done. This reaction may be exacerbated by effects of athletic overtraining or by a genetic metabolic predisposition." The post-massage production of proinflammatory cytokines would be a possible mechanism leading to this result. Chaitow has also noted the involvement of cytokines in fibromyalgia.
The possibility of inducing a proinflammatory response should caution us not to probe too deeply, too fast into the unknown client. It is better to start a first session moderately and then adjust based on following up the client's response. On the other hand, since the immune response is impacted by stress, reducing perceived stress and its effects within the musculature may help the client's body to cope with the otherwise unmanageable. Sometimes our lesser effort is more. It's all in the intention and the attention we bring.
Editor's note: Due to the transient nature of the Internet, some links may not be operational.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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