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News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
February, 2005, Vol. 05, Issue 02
We Get Letters and E-Mail
By Editorial Staff
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be edited for space and clarity, and published in a future issue or online.Please send all correspondence by e-mail to r regular mail to:
Editor's note: The following letter is in response to Cliff Korn's article "Thought on Being Part of Medicince" in the October issue (www.massagetoday.com/archives/2004/10/09.html).
"Instead of cramming to know it all, let's focus on turning out stunning graduates with solid basic skills"
Mr. Korn states that he finds it "important that we do both" (relaxation and clinical massage), then proceeds to put his expectations on the entire profession by assuming that "our public shares his expectations! Quite presumptuous!
Who exactly is "our public?" I've been a successful massage therapist for 14 years, practicing relaxation massage exclusively. My public has never had any problem with this, and it has not affected my ability to build a practice wherever I've lived. I feel relaxation massage is medical massage at its finest: preventative medicine, as stress accounts for over 70 percent of visits to doctors!
Since Mr. Korn is so fond of us being a part of medicine, let me ask how many patients expect to see one doctor for "orthopedic issues, stress-related issues, sports-injury prevention, etc." Family doctors are General Practitioners and as the title implies they practice general medicine, referring patients to specialists as necessary for treatment of more specific ailments. This is how I practice my profession as well, referring my clients to bodywork specialists when I feel they would benefit from a different approach.
I simply have no interest in practicing clinical massage but I am a huge proponent of its benefits and never hesitate to refer my clients to qualified rehab therapists. Nor do I hesitate to refer clients to energy workers, Shiatsu practitioners, nutritionists, aromatherapists, body movement therapists, etc. The list is endless as massage embodies the essence of holistic health! How can we hope to be experts in all such modalities? Impossible!
The fact is that true clinical massage requires a great deal of advanced training and hands-on practice to honor the ethic "do no harm," as we must do if it truly is "all about the clients." It is impossible to include this training/practice in a 500-hour entry-level program. And there's the rub!
Must we expand entry-level programs to accomodate this neurotic need to be a "part of medicine?" Many programs are moving up to 750-1,000 hours in order to include more clinical approaches. In my opinion this is a dangerous move. A little knowledge is indeed a dangerous thing and that's exactly what we have in students graduating from such programs. They have not yet mastered basic strokes, but they are expected to understand assessment and corrective techniques that take years of study and practice to grasp. Instead of cramming to know it all, let's focus on turning out stunning graduates with solid basic skills who may choose their own courses for further study!
Gail Frei, LMT
Editor's note: The following letters are in response to Bruce Klein's letter in the November issue (We Get Letters and E-mail, www.massagetoday.com/archives/2004/11/18.html).
"It's well known among spinal surgeons that cerebral spinal fluid does indeed pulse"
I am a massage therapist, exclusively practicing CranioSacral Therapy (CST). I also teach several courses for the Upledger Institute. Before becoming a massage therapist, however, I was a scientist. I have a PhD in theoretical physics from Rice University, and I did research in physics at the Massachusetts Institute of Technology for a number of years. I would like to address the question of why no movement of the cerebral spinal fluid (CSF) is discernable on an MRI and why serial CT scans are possible even if cranial bones move.
Leaving aside the question of whether placing the body in a very high magnetic field or bombarding it with X-rays will disrupt subtle physiological processes, how much fluid movement actually occurs and would one expect to be able to detect it if it were present? The amount of fluid movement within each cycle of the craniosacral rhythm (CSR) is very easily estimated. The average adult human has approximately 600ml of CSF in their system at any given time. That CSF is replaced on average 3 to 4 times per day. That means the brain produces about 600ml of CSF every 6 to 8 hours. The CSR has a frequency of 6 to 12 cycles per minute, or a period of 5 to 10 seconds per cycle. This corresponds to somewhere between 2,000 and 4,000 cycles of the CSR in a 6-hour period. Thus, the amount of CSF produced in a single cycle is somewhere between 0.15 and 0.3ml, much too small of a change to be detected by an MRI. There is movement of the CSF through the brain, but it is very slow. Any given cycle only moves the CSF a small amount, but cumulatively there is enough movement to replace the fluid several times per day.
Even though the fluid production in any one cycle is minute, the pressure changes that occur due to that fluid production are easily palpable. Dr. Upledger (et al.) has published several papers demonstrating rhythmic movement of cranial bones (citations for these papers are available from the Upledger Institute). He showed that cranial bones move rhythmically with average amplitude of about 0.010" or about the thickness of a piece of paper. A movement of this magnitude is easily palpable to the human hand. While I am not familiar with the resolution of a typical CT scanner, it would have to be of the order of 0.010" or less in order to detect the CSR. Even if it were able to detect it, such a small movement would cause only an imperceptible blurring of the image and would in no way prevent one from taking serial scans of a human head.
As a scientist, it does not surprise me at all that the CSR does not show up on MRIs or CT scans, nor does it surprise me that we can easily palpate the CSR - the human hand is a much more sensitive detection instrument than any imaging machine that is available today. What does surprise me is the continuing controversy over the existence of a rhythmic movement in the body that is easily palpable, even by laymen, and whose existence was clearly demonstrated by experiment many years ago.
Tim Hutton, LMP, CST-D
I would like to respond to Bruce Klein's letter challenging cranial movement. First, it's well known among spinal surgeons that cerebral spinal fluid (CSF) does indeed pulse. I observed a laminectomy (removal of the back half of the vertebrae, fully exposing the spinal cord in its coverings) on one of my patients. The CSF pulse was plainly visible - indeed, the neurosurgeon pointed it out. Second, saying that the cranial bones don't move shows that Dr. Klein is not current on his anatomy. Older anatomy texts claim that the bones are fused and don't move. Not so in those of more recent vintage. Actually, only the English anatomy tradition, which we by culture follow, once claimed that the skull bones don't move. The Italian anatomists have always acknowledged that they do.
As to why CSF-flow and cranial bone movement doesn't show in MRIs and CTs: The flow and the bone movements are dramatically slow compared to blood. Other tissues move during MRI exams - the lungs, esophagus, etc. - yet they visualize perfectly well. Cranial suture movement would probably show if one was specifically looking for it and had comparable images taken the few seconds apart between maximum and minimum displacement. But the easiest way to understand cranial-bone pulsing movement is to take the time to feel it for yourself; it's not all that hard to do.
Edward Rowland, MA, DC
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