resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
March, 2006, Vol. 06, Issue 03
Spondylolisthesis: An Elusive Cause of Low Back Pain
By Whitney Lowe, LMTLow back pain (LBP) is one of the most prevalent orthopedic problems in the world. Yet, the cause of much LBP is poorly understood, which sometimes leads to improper treatment. Many times LBP is caused by muscular tightness or myofascial trigger point activity, and is effectively treated with massage. However, serious structural problems can exist in the spine. These conditions need to be referred to a physician for proper evaluation. Spondylolisthesis is just such a problem.
The term spondylolisthesis is derived from the Greek spondylo, meaning "spine," and listhesis, "to slide down an incline." Spondylolisthesis results from a stress fracture in a region of the vertebra called the pars interarticularis (Figure 1). Left untreated, the stress fracture might fully separate, causing one vertebra to slip forward in relation to another (Figure 2). The slippage is most common at the articulation between L5 and S1 junction due to the downward pull of gravity and the anterior and inferior sloping of the L5-S1 junction. If only a stress fracture exists without the vertebral sliding, the condition is called spondylolysis. Because the stress fracture occurs before the forward slippage of the vertebral body, spondylolysis generally is a precursor to spondylolisthesis.
The compressive forces that aggravate the condition are magnified if the individual has an exaggerated lumbar lordosis. When the lumbar lordosis is increased, the posterior vertebral arch bears a greater percentage of the upper body weight.
In addition, the exaggerated lordosis tilts the lower lumbar vertebrae even farther in an anterior and inferior direction, making forward slippage more likely.
Individuals engaged in certain sports or occupations are particularly susceptible to spondylolisthesis, especially if it involves repetitive flexion and extension of the spine. It is common in gymnastics, rowing, diving, swimming (especially the butterfly), tennis, wrestling, weightlifting and football. An increased incidence also has been identified in loggers and soldiers carrying heavy backpacks.1, 2 The condition is prevalent in adolescents due to the extremes of physical exertion in athletics and bones that are not fully formed.3 Females are affected more often than males, possibly due to strength differences in bone structure.
Hamstring tightness is evident in many individuals with spondylolisthesis. The hamstrings tighten in an effort to posteriorly rotate the pelvis. The posterior pelvic rotation decreases the potential for forward slippage of the lower lumbar vertebra and helps stabilize the lumbar region.1
The most common symptom in spondylolisthesis is dull, aching pain in the lower lumbar or upper sacral region. Pain also extends into the buttocks or posterior thigh in some cases. The client generally reports some repetitive flexion or extension activity prior to the onset of symptoms. Consider the client's report of recent activities that might produce aggravating stress on the posterior vertebral arch, especially if there is a corresponding exaggerated lumbar lordosis.
There usually is tenderness in the soft tissues in the lower lumbar and upper sacral region. However, the tenderness usually is not the primary pain-producing sensation of the stress fracture or vertebral slippage. Attempting to palpate tissues in this region also can produce pain because there is anterior pressure being applied to the vertebral structures. The anterior pressure might push the vertebra further into the position of slippage and aggravate the pain. In addition to tenderness, hypertonicity in the lumbar erector spinae, quadratus, lumborum, gluteals and hamstring muscles is likely.
In spondylolisthesis, pain increases with lumbar extension. Flexion decreases the pain, as this motion pushes the vertebra back toward the normal position. Pain might be aggravated during either lateral flexion or rotation, although there is not a clearly established pattern of this pain. Hip flexion with the knee in extension generally is limited due to hamstring tightness.
A special test called the one-leg lumbar extension test might help isolate spondylolysis or spondylolisthesis. To perform this test, the client is standing on one leg and balancing. While in this position, the client attempts to bend backward, thus extending the spine (Figure 3). The test is repeated on the opposite side. If back pain is felt during the spinal extension, there is a strong likelihood of a stress fracture in the pars interarticularis. If the stress fracture is only on one side, standing on the ipsilateral leg produces more pain.
If spondylolisthesis is suspected, the client should be referred to a physician for appropriate evaluation. Forward slippage of the vertebra has to be confirmed by X-ray and is not testable with physical examination alone. Soft-tissue therapies like massage can be helpful in reducing overall muscular hypertonicity associated with spondylolisthesis, but it's important to consult with the client's physician about appropriate treatment goals. For example, working on the hamstrings to relax their hypertonicity actually could be detrimental to the condition because the hamstring tightness is helping reduce forward vertebral slippage. Awareness of conditions such as spondylolisthesis highlights the importance of proper assessment so an appropriate referral and/or treatment approach can be developed.
Click here for more information about Whitney Lowe, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.