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Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
September, 2006, Vol. 06, Issue 09
Dealing With Psoriasis
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
I was surprised to hear so little in response to my last piece on MRSA (methicillin resistant staphylococcus aureus); I had fully anticipated a lively discussion of this health threat to follow my article.Instead, the silence was deafening. I didn't get any suggestions for a topic for this article either, so I made an executive decision to pick up a topic of interest, at least to me: psoriasis.
What Is It?
The word psoriasis comes from the Greek root psora, which means "the itch." It's mainly a skin condition, although in some circumstances other systems can be involved as well. Psoriasis is quite common in this country, affecting 6 to 7 million Americans. It's most common in Caucasians. About 150,000 new cases are diagnosed every year.
How Does It Work?
Under normal circumstances, superficial skin cells are replaced roughly every 28 to 32 days. (Hmmm, a 28- to 32- day cycle. What does that make you think of?) What we see with psoriasis is that, in certain areas, skin cells replicate at a vastly accelerated rate: instead of a month-long turnover cycle, they are replaced every 4 to 6 days. The consequence is a patchy pile-up of keratinized epithelial cells, often with a silvery scale: these are the plaques of the most common form of psoriasis.
What we don't understand is why this happens. A genetic link might seem to be part of the picture, because the incidence of psoriasis is higher within families. Immune system anomalies are clear as well, and some experts classify psoriasis as an autoimmune disease - a situation in which immune system mechanisms are directed against healthy tissue by mistake. Psoriasis frequently appears with some other autoimmune disorders (ankylosing spondylitis, for instance), and it runs in cycles of flare and remission; both of these characteristics are common in autoimmune disorders.
Types of Psoriasis
Plaque psoriasis (Fig. 1) is the most common form of this disorder. It frequently appears over joints: knees and elbows are common. Some people have one small lesion that appears in the same place for a few weeks every year or so; others have huge lesions that might cover their back or trunk, scalp, hands or feet. Even when the condition goes into remission, the skin might sustain enough damage to appear permanently discolored and scarred. Other forms of psoriasis are less common, but good to know about:
Psoriasis doesn't usually involve dangerous complications, unless the lesions bleed and get infected, or unless a person with erythrodermic psoriasis has a fluid-loss crisis. However, about 10 percent of the people with psoriasis are at risk for a painful and possibly extreme form of arthritis, called psoriatic arthritis. If a client has psoriatic arthritis, treat it in the same way you would treat rheumatoid arthritis: avoid it when it's hot and inflamed and work for joint mobility and pain reduction when the joint is not actively inflamed.
We understand a lot about the process of how psoriasis develops, but this still is a basically idiopathic (of unknown origin) disease. Consequently, the treatment options for psoriasis are largely hit-and-miss efforts to control symptoms. Many people with psoriasis develop tolerance for medical interventions, and so, must constantly be looking for the next option.
Allopathic interventions include topical skin creams to reduce itching and help clear up plaques. Oral medication can work with controlled exposure to UV radiation to help this process. In very extreme cases, patients might be prescribed chemotherapeutic drugs to limit skin cell replication. All of these can help to control the frequency and severity of psoriasis outbreaks, but none of them are a permanent cure for the disease.
The newest strategy involves a group of drugs called TNF Blockers. TNF (tumor necrosis factor) is an immune system mediator associated with inflammation. Blocking its activity keeps the inflammatory process (and accompanying proliferation of extra skin cells) under control.
Alternative psoriasis treatments also vary widely. A search for "psoriasis cure" brings up dozens of products claiming to heal this disease. They range from herbal clay applications, to aromatherapy, to visiting the Red Sea so that a species of fish can nibble at the lesions (I am not making this up!).
Personally, I am open-minded to seeing dietary adjustments and herbal or homeopathic applications for psoriasis management, but I retain a healthy skepticism of any product that claims to "permanently cure" this condition.
In the olden days (as in, the days of Hippocrates), doctors were instructed to rub olive oil into psoriasis lesions. We know now that when psoriasis is acute, these are areas where cells already are hyperactive. Increasing energy or circulation to these sites might not be the best plan. However, it's important to point out that psoriasis is not contagious! Clients with psoriasis can benefit from bodywork that includes the whole body, as long as the stimulus doesn't increase itching or irritation. Herbal or aromatherapeutic agents could be useful in this context as well. If you have found an application you have seen to improve psoriasis symptoms, please share it with me and other Massage Today readers.
For Next Time
Gentle readers, let me remind you that this is your column! I am at your disposal to gather information on the pathology topics you want to read about. Please go through your client history notes and find one that makes you curious - and let us all know: what's on your table?
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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