resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
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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