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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.
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.
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.
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."
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."
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
December, 2004, Vol. 04, Issue 12
Medical Massage for Jaw and Joint Disorders
By Boris Prilutsky, MA
"Stay in Touch With..." is a periodic column designed to provide an overview of a particular technique or modality. If you would like to contribute to this column, please e-mail .
As a result of a tremendous exposure to stress, the development of temporomandibular joint (TMJ) disorders has reached pandemic proportions.TMJ sufferers experience high-intensity headaches, difficulty with chewing, painful joint clicking and popping, and other symptoms. With the progression of the pathology, individuals may even develop sleep disorders.
TMJ Anatomy: The TMJ is formed by the temporal and mandibular bones. Attached to the mandibular condyle is a fibrocartilage meniscus or articular disk, which allows the mandible to move smoothly. The masticatory muscles (temporalis, masseter, lateral pterygoid, and medial pterygoid) are responsible for movement and stabilization of the TMJ.
Bruxism: Due to stress, people often develop bruxism. Bruxism is a pathological clenching and grinding of teeth that usually occurs during sleep. Bruxism is caused by the hyperactive contraction of the masticatory muscles. Imagine any other muscles in our support and movement system kept under tight contraction for seven hours. Pathological hypertonus in these muscles will be formed, followed by restriction of range of motion, trigger point development, and other symptoms. With time, hypertonic condition in the masticatory muscles leads to the development of osteoarthritis in the TMJ, including negative effects on the articular meniscus. In such a case, the above-mentioned TMJ pathology starts producing severe headaches and painful "clicks."
Massage therapy and Post-Isometric Relaxation Techniques for TMJ Disorders: Massage therapy should be focused toward the reduction of tension in the masticatory muscles, releasing tension in fascia, and elimination of trigger points. Post-isometric relaxation is an extremely important tool for the restoration of the range of motion. Massage therapy steps for TMJ:
Mechanisms of Trigger-Point Therapy: A trigger point is a localization of pain. It can be found in muscles, periosteum, tendon attachment points to bone, as well as near muscle-tendon junctions. Even given the fact that most typical trigger points are developed in the middle of the muscle belly, at the place of nerve-muscle junction, I recommend two ways for discovery of trigger points: First, ask the patient to point to the exact localization of pain (trigger point); second, at the time of performing kneading and myofascial tissue release, ask your client to let you know if they feel a sharper level of pain under your fingers, which will be the trigger point.
The main mechanism of trigger point therapy is ischemic compression. Automatically, we can assume that in the area of the trigger point, arterial blood supply is significantly decreased. By gradually compressing the trigger point and reaching the threshold of pain, we additionally decrease this blood supply to the point. After 10 seconds of this ischemic compression, we ask our client to report their ability to tolerate additional compression (please do not overdo this pressure; stop at a pressure that your client indicates is sufficient, and do not increase it.
Do not increase the pressure if muscles demonstrate protective contraction to the pain sensation.) After 20 additional seconds of compression, quickly withdraw your fingers. While performing ischemic compression of trigger points, arterial blood will accumulate around the compressed point. With the fast withdrawal, arterial blood will rush to the area of the trigger point, and a vasodilation reflex will be awakened.
Mechanism of Post-Isometric Relaxation: One of the factors responsible for the restriction of range of motion is an energetic unbalance inside of the muscles, which is expressed in the form of different tension levels in the fibers of the same muscle. Imagine that in the same muscle, a portion of the fibers is in pathological hypertonus and the rest is in normal tonus. Every movement will increasingly overload the contracted part of the fibers.
This, of course, will cause a higher level of pathological accumulation of tension. At the time of isometric contraction, the fibers of the muscle are actively stretched, which leads to a balancing of the tonus between different fibers in the muscle. After 30 seconds of isometric tension following post-isometric relaxation (stretching), Golgi organs are activated, which in turn will contribute to normal tonus in muscles. In such a case, the muscle will be able to produce adequate energy during contraction and relaxation. The above-mentioned positive changes in muscular tissue will help to restore normal range of motion.
Full-Body Stress-Management Massage: As mentioned before, stress is the main cause of the development of bruxism and TMJ disorders; therefore, it is very important to those who suffer from TMJ disorders (in addition to the protocol which I offer you in this article) to receive full-body stress-management massage. From my experience, the phenomenon of bruxism can be reduced within five full-body stress-management massage treatments given on a weekly basis. Elimination of bruxism is an extremely important factor that will allow the masticatory muscles to be restored to normal metabolism and prevent re-accumulation of tension in the muscles.
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