resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
November, 2005, Vol. 05, Issue 11
By Erik Dalton, PhD
Most of the human race suffers some form of neck and back pain during their lifetime just as common as a headache, stomach ache or knee pain. "Until it was turned into a medical condition in the early 20th century, back pain was considered an inevitable human experience," said Canadian surgeon Hamilton Hall, MD."There is no simple cure because there is usually not a clear-cut precipitating trigger associated with many forms of musculoskeletal pain," notes Hall.
Despite the liberal use of the words "back injury" across modern societies, most episodes of back pain do not have an obvious cause. "Research indicates that approximately two of every three people who experience pain in the spine are unable to identify any specific event that may have caused their problems," states Hall. Back pain simply happens!
The modern perspective that neck and back pain is a variable, intermittent illness rather than a one-time condition should not be considered a threatening event for our clients. In the vast majority of cases, recurrences of these painful conditions are not signs of advancing disease, an omen of chronic disability or even a cause for significant worry.
Some researchers draw an analogy between back pain and upper respiratory infections. Many individuals get colds or respiratory infections several times each year, yet are typically not viewed as a significant threat to their health. Colds don't require high-tech diagnostic testing, heroic treatment interventions or significant absence from work. These conditions, like most cases of neck/back pain, simply are bumps in the road.
However, some have begun to question the possibility of previously unrecognized neurobiological processes that might unravel the question: Why are some people more susceptible to pain than others? One interesting new area of pain management research that is gaining a great deal of attention proposes alternative ways that nerve impulses are transmitted and learned by the central nervous system.
For decades, it was thought that spinal cord, brain and peripheral pain transmission pathways were hardwired circuits whose job was simply to communicate pain signals from injured or diseased parts of the body to specific message centers in the brain. But based on recent scientific research, new ideas are emerging on how pain transmission actually works and how the brain has the ability to create the conscious experience of pain.
A process called sensitization has become a topic of great interest to neuroscientists studying transmission mechanisms of painful stimuli. The puzzling question is: How are pain messages actually delivered? A discussion of sensitization might help somatic practitioners better understand why a client's chronic pain can be so severe, but in some cases, seem out of proportion to the degree of injury or disease in the affected body tissues. This understanding also might help explain why specific treatments directed at pain relief often provide'only limited benefit.
The neurobiology of sensitization is extremely complex, but the basic idea behind it is fairly straightforward. When pain signals are transmitted from injured or diseased tissues, these signals can then activate (sensitize) pain circuits in the peripheral nervous system, spinal cord and brain by burning a memory pathway (See Figure).
The process of sensitization can be compared to overly adjusting the volume control on a stereo system, thereby amplifying and sometimes distorting the pain message. This results in a painful condition that is severe and out of proportion to the actual dysfunction or original injury. Sensitization has the innate ability to alter all regions of the central nervous system that process pain messages. This includes the sensing, feeling and thinking centers of the brain. Here lies one explanation why chronic pain often is associated with, not only physical disorders, but also emotional and psychological suffering as well.
Phantom Limb Pain
A perfect example of the workings of sensitization can be found in the sometimes mysterious condition called phantom limb pain. In the presence of phantom limb pain, the client might feel intense pain in an area where the body part is missing. Common examples are seen in amputated arms and legs, as well as in women experiencing abdominal pain years after undergoing a hysterectomy. The difficult-to-treat problem of phantom limb pain is consciously actualized by persistent activation (sensitization) of the pain transmission pathways from the site of amputation up to the brain.
But what about the presence of sensitization in various pain conditions where amputation or surgeries to remove diseased organs don't exist? Too often, manual therapy treatments in such cases are directed to body areas that were once actual pain-generators, (i.e., where the injured or diseased tissues once existed). Regrettably, "chasing the pain" by directing therapy to where the client currently is hurting will have little effect on the sensitized pain pathways in the spinal cord and brain. As a result, little benefit is experienced.
Having said that, the author has found that application of specific deep tissue and assisted stretching techniques to torsioned and compressed joint-related soft tissues co-activates and desensitizes noxious mechanoreceptive activity leading to a reduction in pain. Successful outcomes require the therapist concentrate treatment to areas proximal to the previously injured or amputated tissues (usually beginning in the lamina groove). Proper treatment to deep intrinsic muscles, spinal ligaments, joint capsules, and visceral structures co-activates a wider range of neuro-receptors, which enhances the desensitization process.
Click here for previous articles by Erik Dalton, PhD.
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