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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."
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.
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.
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.
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.
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.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
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.
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.
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.
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.
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.
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.
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.
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!
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.
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.
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."
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
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.
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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