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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.
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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).
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.
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%.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
November, 2005, Vol. 05, Issue 11
The Inside-Out Paradigm: Survival vs. Quality of Life Part 1
By Dale G. Alexander, LMT, MA, PhD
Editor's Note: Part 2 of Survival vs. Quality of Life will appear in the December 2005 issue of Massage Today, along with a complete list of references.
The survival-oriented prime directives of our biology and nature's endowments for implementing these directives have reached a tipping point in our collective evolution.They now are competing with our capacity for quality of life and have become contributors to many of our most common chronic ailments. Chronic conditions emerge from how human physiology accretively tends to react to stressful and traumatic circumstances, over time. Let us begin by reviewing a distillation of the research of Hans Selye, M.D., who is considered the father of our modern understanding of stress.
Dr. Selye was an endocrinologist, thus, his initial research was launched with the intent to discover the linkages between chemoreceptors, which were potentiated by hormonal influence. What he discovered were central basics of physiology which continue to be guideposts for our profession today. Most notably, he concluded that the inflammatory process was the body's stereotypic biochemical response to a host of ailments which afflict humans: spanning infections, injuries and trauma.
Selye's notion of stereotypic responses and my 25 years of investigation have inspired me to extrapolate that nature has evolved other similar default responses. Physically, all soft tissues do basically one thing, they contract. Contraction both produces motion and inhibits motion. Consequently, in response to stress or trauma our soft tissues contract, sometimes morphing into varying states of contracture or painful spasm. Mentally, when humans are stressed, they tend to dissociate, allowing nature's primitive programming for fight/flight/freeze to take over. More specifically, we distance ourselves from our bodies and present time awareness is diminished. Conscious choice and taking responsibility for the effects of our behavior also diminishes.
Let's expand even further to explore the survival legacy of human experience. As I see it, the prime directives of biology relate to four survival mandates:
Nature's prime directives are designed help to ensure survival and reproduction, to ward off individual death and species extinction. Of course, nature has provided us with specific endowments which assist the completion of these prime directives: The Mind, creates survival-based models of the world; Hormones, crucial to initiating and lubricating physical growth and reproductive maturity, but significantly decrease between the ages of 35 to 55; Righting Reflexes, nature's hedge against pre-mature traumatic death; and Sympathetic Dominance, which governs our primitive responses of fight/flight/freeze.
Now, let's walk through our biological prime directives and nature's endowments beginning with an infant's first task to Fit In. As babies, we must survive the protracted time of our dependency upon our caretakers. We perceive energetically and feel everything around us. We do not distinguish where we end and others begin. Our experience of events is timeless: always and never. Thus, human learning is an inverted pyramid beginning in utero, more reflective of the energetics and emotions of our caretakers than any symbolic capacity to describe or physical ability to act upon our environment. We are immersed in our environment. There is no separation.
As we grow, we learn through association, building a matrix through our five senses. Somewhere between 2 1/2 and 4 years of age we have compiled enough symbolic sets to develop models of our world and can express them through language. These models grow from sets of "do's" and""don'ts" and associated cause and effect relationships. Sadly, the models typically reflect a massive number of motoric inhibitions. The permissions for exploration that do remain are reflected in the""old saw" that humans only use 10% of their mental capacity. More accurately, the Mind consumes 90% of our neural capacity, leaving only the remaining 10% for curiosity, exploration and experimentation in order to fit into our birth family's social grouping.
The Mind is nature's primary endowment for the creation of these models. It's not wrong or bad. Its goal is survival. We are its beneficiaries. However, the mind is not our brain and spinal cord, nor our psyche, and is certainly not our soul or spirit. It's only a sliver of consciousness: a slice of the pie, not the whole pie by itself. The mind gathers the associations compiled in our early life and retroactively "assigns meaning" to these experiences. This is how the basic models which guide our decision making are initially formed.
Our extraordinary capacity to adapt to the circumstances of our upbringing is a mixed blessing, for it leaves us restrained from updating our models of the world as we age. Consequently, we tend to be""perfectly adapted to circumstances in which we no longer live." A corroborating corollary of this notion is reflected in the difficulty we have with changing our first impressions. What seems to expand this enormous restraint and fixity is new sensory experience through touch and movement and emotional discovery.
The basic apparatus of the mind keeps us playing ping pong with the hurts and self-doubts anchored in the past and caroms us forward in time to fret and fume and worry about future scenarios. Much of our energy and creativity is consumed by this ping-pong, yet it's the self-talk familiar to us all.
Anticipation is a wonderful thing when it's harnessed toward positive outcome. However, its dark side can plummet one's body chemistry into the abyss of inflammatory and/or immune suppressing states with the accompanying feelings of anxiety and depression, doing a dirty dance of inner torture with our physiology. The mind does this by commandeering the sympathetic division of the autonomic nervous system to drive the adrenals. This is another link to Dr. Selye's research, which concluded that the adrenals were neurally driven rather than regulated via the hormones of the endocrine system.
The prime directive of Don't Fall generally is accepted as our species singular genetically linked fear. Our large body righting reflexes are sub cortically regulated, (i.e., we don't think about them, they simply take over in times of emergency). Most of the time they transmute a major accident to a minor scrape. However, in my clinical experience, these reflexes tend to be perpetuators of chronic musculoskeletal dysfunction following traumatic episodes.
The endowments of the mind and the righting reflexes together reflect our species' collective genetic genius to be able to adapt to damn near anything. The problem is that once we have adapted, whether to our family of origin and/or to trauma, our mind and our reflexive calibrations resist new experience, new information and expansion beyond the set of parameters that have come to be considered normal. It's usually only when what used to work becomes very dysfunctional and painful that we look to changing the core elements of our being.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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