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Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
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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