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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.
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.
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.
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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."
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.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
October, 2006, Vol. 06, Issue 10
By Whitney Lowe, LMT
Osteoarthritis is the most common type of joint disease and involves degenerative changes at synovial joints in the body. It's a challenging condition to treat and is becoming an economic burden to the health care systems in many countries.In the U.S., for example, the number of adults with arthritis is projected to increase from 42.7 million in 2002 to around 65 million in 2030, due to the aging population.1
Synovial joints are the ones affected in osteoarthritis. Within the synovial joint are the articulating bones, articular cartilage, a fibrous joint capsule and synovial membrane, synovial fluid, and joint cavity. These structures work together to create smooth gliding movement where adjacent bones contact each other. Maintaining this surface is especially important in the weight-bearing joints, such as the hip or knee, as excessive compressive stress can lead to bone degeneration.
Osteoarthritis is divided into two categories: primary and secondary. Primary osteoarthritis develops gradually from excessive wear on the joints, but the specific factors that lead to the condition are not well understood. Repetitive stress to the joints of the hips, knees and hands in certain occupations could play a role in creating the problem for some clients.
Secondary osteoarthritis develops as the result of some other disease or pathological condition. Traumatic injury to the joint can initiate joint damage that leads to cartilage degeneration. In other cases, surgery, obesity or various activities are directly related to the condition's onset. The condition is prevalent in soccer players due to impact trauma, and in weight lifters because of their increased body weight.2,3 Greater weight and joint degeneration also can increase the likelihood of lower extremity postural distortions, such as genu varum (bow leg) and genu valgum (knock-knee). Both of these distortions lead to more joint wear and increased chance of developing osteoarthritis.
In some cases, inflammation from osteoarthritis stimulates bone spurs to form around the joints, causing further pain and dysfunction. The spurs are common in the interphalangeal joints of the fingers. They are called Heberden's nodes when they develop at the distal interphalangeal joints and Bouchard's nodes at the proximal interphalangeal joint.4 Spurs that develop from spinal osteoarthritis (also called spondylitis) can press on adjacent nerve roots and mimic intervertebral disc herniation.4
Osteoarthritis produces pain in the joints that is aggravated with movement. Due to continual use, pain usually is worse later in the day. Joint swelling might increase with activity. Pain sometimes arises from long periods of immobility or even from changes in weather, although the association between weather and arthritis symptoms still is not clear.5 Unlike systemic forms of arthritis, such as rheumatoid arthritis, there are no effects to organs or other remote tissues. The tissue damage is confined to the surfaces of the affected joints, although pain can be referred to other locations.
Osteoarthritis typically affects the fingers, spine, hips and knees. While it periodically occurs in other joints, it is not common in the shoulder, elbow, wrist or ankle. It does appear to have a hereditary pattern, but a direct congenital cause of osteoarthritis has not been established. There is a greater incidence in younger males and females over 45 years of age.6 Pain usually is worse in the later part of the day, and the client also might complain of swelling, heat, and crepitus in the joint. Reports of aggravated pain with changes in the weather are common. The client also might report an increase in symptoms as a result of long periods of immobility, especially if the condition is more advanced. Joint swelling is evident in many cases, but absence of visible swelling does not indicate absence of the condition.
Characteristics in Physical Examination
The affected joints might be tender to palpation due to increased swelling in the area. Tenderness is more common if the condition is advanced or if palpation presses the affected joint surfaces together. Bone spurs, if present, can sometimes be felt around the affected joint, especially in the fingers.
Active and passive motions can cause pain in any direction the joint is moved. However, pain can fluctuate with the time of day or the degree of aggravation of the joint. If the affected joint is a weight-bearing joint, pain is worse when active movement is performed while bearing weight. Edema, muscle spasm or bone spurs could all prematurely limit the available range of movement. The end feel for joint motions tends to be a bit leathery and a capsular pattern of restriction typically is evident. In some cases, pain and weakness is evident during resisted motions.
A Role for Massage
While cartilage degeneration cannot be reversed, massage and stretching can be used to reduce muscle spasm and decrease compressive forces associated with the joint disorder. These approaches also are helpful in reducing edema resulting from inflammation. Avoiding activities that increase joint irritation, compression or inflammation is important. Weight reduction, rest, supportive braces and some exercise can be helpful, especially for osteoarthritis in the weight-bearing joints. If osteoarthritis is suspected, it's advisable to have it confirmed by a physician through X-ray. It also would be helpful to consult further with the physician for the most appropriate role for massage in the treatment process.
Click here for more information about Whitney Lowe, LMT.
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