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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.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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%.
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).
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.
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.
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.
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).
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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.
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.
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.
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.
July, 2006, Vol. 06, Issue 07
Methicillin-Resistant Staphylococcus Aureus: A Moving Target
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Last time, I promised to look at an emerging condition: MRSA, or methicillin-resistant staphylococcus aureus. This is based on several communications, including this one from a massage therapist in the Northeast:
Anyone who works in a hospital setting probably is already familiar with methicillin-resistant staphylococcus aureus, or MRSA, but this pathogen is now being found in community settings. Since we work so closely with people, it's in our best interest to be well-educated about this bug.
What Is MRSA?
Staphylococcus Aureus (named staphyle, Greek for grapes, and aureus for its yellow color under a microscope) is a group of bacteria known for colonizing human skin and nasal passages. Staph has two mechanisms to cause damage to humans: active tissue invasion through the building of abscesses, and the release of corrosive toxins that can kill cells. MRSA is an antibiotic-resistant form of staph that usually colonizes the skin, respiratory tract, or urinary tract. It's estimated that about 1 percent of the population carries MRSA.
We all know that bacteria can be transmitted from one person to another, but they also can be transmitted from one area to another within the same person. In other words, if a child wipes his nose and then scratches his scabbed knee, it's possible his knee injury could develop a staphylococcus infection. Further, once such an infection is established, it's possible for the staph bacteria to travel through the bloodstream to set up infections elsewhere. Pneumonia, bone and joint infections, heart valve damage and varieties of toxic shock syndrome are all possible complications of superficial staph infections. These are particular risks for people who already are immune-compromised.
MRSA has been a relatively common nocosomial (hospital-based) infection since the 1950s, but in the past several years it has been identified in nursing homes, outpatient treatment centers, prisons, athletic facilities, and others; these outbreaks are called community-acquired infections. MRSA is considered an emerging disease because it's easily communicated from one person to another, and its incidence is rising quickly. It has been identified in about 12 percent of all cultured boils outside of hospital settings.
Signs and Symptoms: Community-acquired MRSA infections usually are picked up through skin-to-skin contact, cuts and abrasions or contaminated surfaces. They often look like a boil or spider bite: a single pustule that is large, red and might be mildly to extremely painful. Fever and fatigue might accompany the lesion, which gets progressively worse. It does not respond to topical or oral applications of methicillin, penicillin, oxacillin or amoxicillin.
Treatment Options: Treatment for MRSA requires long doses of antibiotics that are not in the penicillin family. Infections can recur if antibiotic treatment is not completed. MRSA currently is sensitive to vancomysin, but vancomysin-resistant bacteria have already been observed in some settings, and the crossover from MRSA to vancomysin-resistant staph is a distinct possibility. In addition to antibiotic prescriptions, MRSA infections might be lanced and drained. Pain usually is managed with NSAIDs.
The continuing evolution of this and other pathogens makes prevention of infection vitally important for any person who comes in close contact with other people. Preventive measures include washing and carefully covering all open sores, avoiding picking at or touching open sores, not sharing any personal items like towels or razors, and disinfecting all surfaces touched by many people.
The recommended protocols to prevent the spread of MRSA are the same as those to prevent the spread of any contagious condition: observe standard precautions by covering any skin lesions, and cleaning all surfaces and fabrics that clients contact.
Any client with an undiagnosed skin lesion, especially if it's inflamed, painful and showing signs of infection (i.e., pus), should consult his or her primary care physician before getting massage. Certainly, if a boil-like lesion is accompanied by fever and malaise, the massage needs to be rescheduled and the client should be counseled to see a doctor. MRSA is a contagious and potentially dangerous bacterial infection that must be cleared before any modality that moves lymph or blood increases the risk of spreading infection.
Massage therapists who develop boils themselves and worry about whether they've been exposed to MRSA would be well-advised to consult their doctors, too. As long as the therapist is treating his or her diagnosed infection appropriately (this means taking the correct antibiotics exactly as prescribed), and as long as any lesions are carefully covered and not in an area that comes in contact with clients, giving massage is safe.
One resource available to people with concerns about contagious diseases is your local hospital. If you call and ask for the infection control department, they will connect you with a person whose job is to answer exactly these kinds of questions. Whenever I have done this I have left messages and received a call back within a day. This is a wonderful community resource and I encourage everyone to use it!
For Next Time
I've been on a communicable disease track for a while. In the past several issues, I have written about avian flu, whooping cough, and now MRSA. I am content to stay here: I could do a piece on meningitis, or mononucleosis ("kissing disease"). Or, we could pick up a new thread with a common, stubborn chronic skin condition: psoriasis. It's up to you - let me know, what's on your table?
Many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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