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Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
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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