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Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
March, 2005, Vol. 05, Issue 03
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Author's note: There is a movement in the health sciences away from using the possessive form of a disease name. This makes some sense, since it's not really Parkinson's disease; it's the disease of those who live with it.Sometimes this change takes the form of turning a descriptive term into a noun (e.g., from Parkinson's to parkinsonism) and sometimes the apostrophe simply disappears (e.g., Alzheimer disease). Since my column "What's on Your Table" always strives to stay on the cutting edge of both grammar and science, I will do my best to incorporate this new adjustment to the language.
The consensus is clear: Parkinson's disease, also called parkinsonism, is the issue on the table for today. Parkinsonism is a fairly common progressive degenerative central nervous system (CNS) disorder that leads to dysfunction at the motor centers in the basal ganglia. It affects about one in 1,000 people in the U.S., and the majority of people with parkinsonism are mature. It is unusual to see diagnoses in persons under 50 years of age - Michael J. Fox is a famous exception to this rule.
Etiology: What happens? Understanding the etiology of this disorder is a little like playing "The House that Jack Built" because the sequence of events is so specific and predictable.
So the sequence goes like this: A voluntary impulse to stand on one foot begins in the cerebral cortex. It is sent through the basal ganglia where, because adequate dopamine is supplied by substantia nigra cells, this impulse travels to the prime movers and antagonists of the lower extremity and postural muscles in order to bend the knee (go ahead, try it).
Parkinsonism occurs when the cells in the substantia nigra unexpectedly and prematurely die. Consequently, dopamine is in short supply in the basal ganglia; it becomes difficult to initiate voluntary movement (this is called bradykinesia - the person often reports feeling "rooted to the floor"), and/or the balance between prime movers and antagonists is disrupted, leading to rigidity or tremor. Several other symptoms may develop as well; they will be discussed shortly.
Causes: Most of the time, it is unclear exactly why the substantia nigra cells die off. Genetics and environmental exposure (or the combination of both) are often thought to be contributing factors. Excessive exposure to carbon monoxide, heavy metals, pesticides or agricultural chemicals is sometimes suspected. Repeated head trauma causes a variation called pugilistic parkinsonism; this is the case with former boxer Muhammad Ali. Most cases of parkinsonism, however, are considered to be idiopathic (of unknown origin).
Signs and Symptoms: Parkinsonism presents very differently in different people, but most primary symptoms have to do with movement problems. A short list of primary and secondary symptoms includes the following:
Treatment: Chemical imbalances in the CNS are often difficult to treat because the blood-brain barrier (a layer of cells that wrap around blood vessels in the brain) blocks the introduction of many substances into this precious environment. Some drugs must be administered in high amounts to overcome this obstacle.
Treatment for parkinsonism often begins with a dopamine precursor, or dopamine agonists. These substances essentially try to replace what the damaged substantia nigra cells should be producing; however, remember that dopamine in the basal ganglia helps create coordinated movement, but too much dopamine in the frontal lobe can cause hallucinations - a significant side-effect! Furthermore, most patients eventually develop tolerance to these drugs, and they lose their efficacy.
Other drugs work to change dopamine metabolism and other brain activity, but at this time no permanent solution or cure for parkinsonism exists. Other options include surgery to affect the globus pallidus or thalamus (this helps to control very extreme tremor), deep-brain stimulation, and eventually the possibility of stem cell implantation with the goal of re-growing the damaged substantia nigra cells.
Massage? Parkinson's patients experience progressive stiffness and rigidity of voluntary muscles. Rigidity is safe for massage, especially when sensation is present, but it is important to remember that this comes about because of a CNS dysfunction, and won't be completely resolved, even with the most brilliantly applied bodywork.
Several different modalities have been quantifiably researched in the context of parkinsonism, including Trager, Alexander Technique and Swedish massage with specific muscle exercises. All modalities report improvement in function, from the reduction of rigidity and improvement of sleep, to the reduction of tremor and increase of daily activity stamina.
It is important to work in cooperation with a client's primary physician, because massage may impact the need for antidepressants and other medication. Be aware, however, that clients with Parkinson's disease do not have the freedom of movement that most other people do, and they may have great difficulty in getting on and off tables safely. Some massage therapists address this by working with these clients on chairs or floor mats.
On a final note, I'd like to recognize two people for their contributions to my preparation of this article. One is a reader named David Ponsonby, who has done an enormous amount of research on this topic and generously shared his information - this article barely scratches the surface of what he has collected on this topic. David has allowed me to put interested readers in touch with him for more information.
The other person is a massage therapist named Jan Mueller who, years ago, published a fascinating and lovely article on working with clients who have Parkinson's disease in the Massage Therapy Journal [Winter 1996, (35): 1]. I made mention of her wonderful work at a class I taught in Kentucky one time, and it turned out by chance that she was one of the participants! Thanks, Jan, for your pioneering work.
And now, loyal readers, a familiar plea: What will it be for next time? At the moment I'm on a progressive degenerative CNS disorder roll, and could easily continue with amyotrophic lateral sclerosis (a.k.a., Lou Gehrig's disease). If you have experience with clients who live with this disease, I invite you to share your wisdom with the rest of our readership. If you have other ideas about what you'd like to read about, let me know that, too. Please let me know: What's on your table?
Many thanks and many blessings,
Ruth Werner, LMP, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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