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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
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.
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.
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.
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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