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Wellness: A New Buzzword at the Aging in America Conference
Aging in America is "the nation's largest gathering of a diverse, multidisciplinary community of professionals in healthcare, social service, government, business and philanthropy with expertise in providing services and products for older adults."
The Boston Benevolent Chiropractic Clinic: Standing Up for the Needy
Our chiropractic assistant, Bridget, greeted an arriving patient at the Emmanuel Church in downtown Boston. She said, "Hi, Michael, good to see you. It's been awhile. Have a seat and Dr. Ken will see you soon."
Employers Need Chiropractic First and Sooner
From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP).
Vibrational Medicine: Frequency Micro-Current and Color Acupuncture
Vibrational medicine involves the application of various forms of energy frequencies to the body for pain relief, healing and rejuvenation. Vibrational medicine will become a major growing trend in our medical systems for the following reasons:
New Leadership Era at the WFC
The World Federation of Chiropractic recently announced not only a new president, as is customary every two years, but also an incoming secretary-general, marking the first time since the WFC's inception in 1988 that someone other than David Chapman-Smith, Esq., will serve in that capacity.
Don't Trust What Your Patients Say
When a patient presents to the office for care, they typically have a specific complaint – lower back pain, whiplash, sinus congestion, sciatica, etc. They are often not interested or engaged in what they consider "unrelated" personal health history.
Working With The Yuan-Source Level: Resonance and the Extraordinary Vessels
How do we stay fresh with our medicine? As healers, how do we balance our medical selves with creative artistry? Chinese Medicine is not a fixed dogmatic entity, but a living system, reliant on a mysterious force called "resonance."
Medial Knee Pain: 11 Potential Causes (and Corrections)
We have all seen patients with medial knee pain that either has no traumatic origin or lasts well beyond when it should be resolved. How can we help these patients? Here is an overview of clinical scenarios and how we can provide conservative care.
CRREW Rallies for Ongoing Acupuncture Relief Effort in the Philippines
On November 8, 2013, Typhoon Yolanda (Haiyan) made her way through the Philippine Islands, leaving in her wake at least 7,000 people dead, millions homeless and complete communities destroyed.
Medical Qigong for the Heart: Part I
According to the Center for Disease Control and Prevention, heart disease is the leading cause of death in the United States, affecting people of all ages and backgrounds. Coronary heart disease, in just the United States alone, costs close to 109 billion dollars a year.
Deciphering the New CMS-1500 Claim Form
Q: I am confused about how and when to use the new 1500 form, particularly block 14 and block 15. What is required and how do I properly fill out these fields? And do I actually have to use this new form or may I continue using the old version?
Don't Trust What a Patient Says
When a patient presents to the office for care, they typically have a specific complaint in mind – lower back pain, whiplash, sinus congestion, sciatica, etc.
News in Brief
D'Youville Vet Program Gets High Praise; A Moment of Silence for Dr. Paul Reginald ("Reg") Hug.
"Doctor ... Always Do the Right Thing"
So says "Da Mayor" in the iconic Spike Lee movie. As a fresh grad questioning in-network versus out-of-network, it struck me that some doctors have explicitly skirted the issue, while others have argued adamantly for the latter and "sticking it to the man."
Home Sweet Medical Home
While the Affordable Care Act (ACA) has received its fair share of praise and criticism since its adoption, few question the value of its emphasis on collaborative, patient-centered health care.
We Get Letters & E-Mail
Imagine What More Could Be Achieved With Your Support; A Lesson in Hygiene: What Do You Do in Your Office? Open Letter to the Profession.
Changes in Herbal Medicines from Ancient Times to the Present
The classical literature of Chinese medicine remains highly relevant in the modern era, as many of the basic theories and herbal combinations emphasized in clinical practice were first established in texts that are nearly 2000 years old.
The Importance of Knowing Mainstream Lingo
There is a secret lingo within mainstream medicine of which the vast majority of acupuncturists and Chinese medical professionals are unaware.
The Search for the Origin of the Wiggle Technique
When Bob had adjusted me previously, most of the time I knew what he was doing. But this time, he had me lie on the treatment table in the usual side-posture position, and he "wiggled" my sacroiliac with the fingers of both hands, while stabilizing my pelvis with his forearm.
News In Brief
Pacific College of Oriental Medicine obtains grant funding from NIH; Yo San University of Traditional Chinese Medicine Announces New President; Kentucky Gets Licensed; PCOM Receives Approval from WASC to Offer FPD.
Halt Allergies With Moxibustion Therapy
An allergy is an immune system disorder in which the body is hypersensitive to normally harmless substances in the environment.
Shared Mechanisms Between Computer-Assisted Mechanical Adjusting and Contemporary Acupuncture?
Can contemporary acupuncture provide clues to the mechanisms responsible for pain relief provided by computer-assisted mechanical adjusting instruments, and clarify whether certain mechanical frequency combinations are superior to others for modulation of acute peripheral pain?
Replenishing and Restoring Jing
I learned an important principle from my great Taoist Master Sun Hak. He taught me that all people "leak" Jing, and that we can mitigate or stop this leaking, and as a result strengthen our life force, develop enhanced adaptability and lengthen our life.
Low Melatonin Linked to Risk of Advanced Prostate Cancer
Epidemiological and experimental studies suggest the hormone melatonin, which plays a role in regulating the sleep-wake cycle, may play a role in the development of prostate cancer, as lower melatonin levels have been associated with an increased risk of prostate (and breast) cancer.
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.
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