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What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
January, 2007, Vol. 07, Issue 01
Your Services Are Sorely Needed
With so many suffering from chronic pain and dissatisfied with allopathic treatment, is a new era of pain management on the horizon?
By Julie Engebretson
The Centers for Disease Control and Prevention (CDC) has released its 30th annual report on the health status of the nation, Health, United States, 2006.This document, prepared by the Secretary of the Department of Health and Human Services for the President and Congress, frames a general picture of health and trends in health care utilization, resources and expenditures. While the overall health of the nation seems to be improving or holding steady in many areas, results from the National Health Interview survey highlight the need for appropriate management of one particular condition: pain. Pain was such a prevalent complaint among those interviewed, researchers devoted a special section of the 2006 report solely to this condition. Titled "Special Feature: Pain," this section of the report focuses on pain as it affects various anatomical locations, including the low back, head, neck, face and joints.
As noted, the health of the nation continues to improve in several respects. This kind of improvement is attributable in part to the significant resources devoted to public health programs, research, health care and health education. All in all, life expectancy in this country is continuing a steady, upward trend. But as Americans are living longer, the question remains, "Are they living well?" Between 1999 and 2002, more than 25 percent of Americans over the age of 20 reported suffering pain, of any kind, that persisted for longer than 24 hours. Nearly 60 percent of adults older than 65 who reported pain indicated their pain lasted for an entire year or longer.
Adults 18 years and older were instructed to report whether they had experienced any of four types of pain during the three months prior to interview: low back pain, migraine/severe headache, neck pain, and facial ache in the jaw or joint in front of the ear. Respondents were asked to report only pain in the above-listed regions that lasted an entire day or more, excluding minor aches and pains. Low back pain was the most commonly reported of the four types of pain, the most common cause of job-related disability, and a leading contributor to missed work and reduced productivity. Though the percentage of adults reporting low back pain has remained stable in recent years, women of all ages, race and ethnicity groups and income levels reported experiencing low back pain more frequently than men. According to a 2003 study in the Annals of Internal Medicine, more than 100 million people suffer from low back pain and approximately $25 billion a year is spent in search of relief. This study showed that massage therapy provided better results and reduced the need for painkillers by 36 percent, as compared to other therapies.
The second most frequently reported chronic pain type in the CDC survey was severe headache and/or migraine. "In 2004, 15 percent of adults reported migraine/severe headache and 15 percent also reported neck pain. Adults 18 to 44 years of age reported migraine/severe headache pain almost three times as frequently as adults 65 years and older." The survey also revealed that severe headache pain was particularly prevalent among women still in their reproductive years. According to an August 2006 study in the Annals of Behavior Medicine, people receiving massage therapy exhibited fewer migraines and better sleep quality during the weeks they received the therapy, as well as three weeks following their massage therapy treatments. Study participants who did not receive massage therapy did not fare as well in finding relief for their migraine headaches. Massage also is believed to increase serotonin levels, which help to regulate sleep, mood and appetite.
Overall, the prevalence of severe joint pain increased with age. The knee was the site of joint pain most commonly reported, followed by the shoulder, fingers and hips. According to the report, "almost one-third of adults age 18 years and over and one-half of adults age 65 years and over reported joint pain, aching, or stiffness (excluding the back or neck) during the 30 days prior to interview." Results varied also by race and income. On a related note, the number of hospitalizations to replace painful hips and knees has increased substantially since 1992 and 1993.
The prevalence of pain among U.S. adults also was measured by the use of prescription narcotics. The numbers are quite shocking. According to the report, "Between 1988-1994 and 1999-2002, the age-adjusted percentage of women reporting narcotic drug use in the month prior to interview increased by almost one-half, from 3.6 percent to 5.3 percent. During this period, use of narcotic drugs rose by almost 75 percent among women 45-65 years of age, to 5.7 percent; and by more than 50 percent among women 65 years and over, to 6.8 percent."
The impact of pain, particularly chronic pain, is far-reaching. It can affect everything from one's day-to-day activities and quality of life to the level of employee productivity at America's most powerful corporations. Conventional treatment of chronic pain is time-consuming and often very expensive, particularly over the course of several years. In a recent survey conducted by the American Massage Therapy Association, 98 percent of Generation X respondents believed massage was an effective way to relieve pain and 37 percent of those already have used massage therapy to ease and relieve chronic pain. In fact, pain is such a prominent health care issue that the 106th U.S. Congress passed Title VI, Sec. 1603, of H.R. 3244, declaring the period between Jan. 1, 2001 and Dec. 31, 2010 the "Decade of Pain Control and Research."
As Americans are living longer, frustration with conventional approaches to pain management is evident. In fact, the CDC report speculates that pain among older adults often goes unreported due to many simply giving up, "and skepticism about the beneficial effects of potential treatments." With so many Americans in pain and dissatisfied with conventional treatment options, massage therapists may have a real opportunity to take the lead in a new era of pain management.
For a copy of Health, United States, 2006, including the section, "Special Feature: Pain," please visit www.cdc.gov/nchs/hus.htm. For a copy of the 2006 AMTA Consumer Survey, visit www.amtamassage.org.
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