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In the Dec. 1, 2015 issue, we have Donald Petersen reporting on "the adapting chiropractic practice," which includes multidisciplinary practice as an option; a ChiroPoll indicating 59 percent of DCs are seeing at least 21 patients per day and 27 percent are seeing more than 40.
Osteoporosis Isn't Always the Case
What is your diagnosis? The patient is a 58-year-old female with back pain. I am sure all of you see the compression fracture at L2; however, there are some findings that suggest this is not a compression fracture due to osteoporosis.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Preventing ACL Injuries in Female Athletes
For female athletes, the key to optimal athletic health lies in preventing ACL injuries. In medical terms, the anterior cruciate ligament (ACL) is the primary restraint to the anterior displacement of the tibia on the femur at all angles of the knee flexor.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Spine Surgery: A Tale of Greed and Corruption
All too often, where there's substantial money to be made, greed and corruption inevitably follow.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Sell Out: Using Research for the Wrong Reasons
The above chorus is from the ska band Reel Big Fish's 1997 hit song, "Sell Out," from their album, "Turn the Radio Off." In the song, the singer sarcastically relates the plight of a musician who is tired of "flipping burgers" and is willing to get "lots of money" by playing "what they want you to hear" in order to get a recording contract.
The MRI: When and Why to Order One
As I lecture around the country to both chiropractors and medical specialists, it's clear one of the main disconnects between the two professions is that of an accurate diagnosis.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
The Amazing Clinical Versatility of Milk Thistle (Part 1)
Most of us know that the standardized extract from the seeds of milk thistle (Silybum marianum) is probably the best-proven herb for protecting the liver from chemical and inflammatory damage.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Top 10 Fitness Trends for 2016
The American College of Sports Medicine (ACSM) published its annual fitness trend forecast in the November / December 2015 issue of ACSM's Health & Fitness Journal.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Elevated Shoulder? Check the QL
As you know, posture reveals a great deal about the body. Posture is a unique mental and physical landscape revealing compensations and adaptations to life. It's a classic mind-and-body story.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
News in Brief
A Winner in and Out of the Office; Ready for the "Have-A-Heart" Campaign? New Integrative Medicine Journal.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Do You Teach Patients How to Breathe Properly?
Spinal manipulation often produces quick results in terms of pain alleviation and improved range of motion. Unfortunately, once the patient is no longer in pain, they may discontinue therapy, only to be plagued by the same complaint at a future date.
November, 2007, Vol. 07, Issue 11
Cervical Disc Herniation
By Whitney Lowe, LMT
One of the most important aspects of assessment in massage is to determine if it's appropriate to work on a specific condition. While massage is safe in most cases, there are some instances where harm can be done if inappropriate treatment is applied.A cervical disc herniation is just such a condition. It's important to identify this condition, as it also should be evaluated by another health professional to make sure massage is appropriate. However, if performed appropriately, there are some beneficial massage approaches.
A herniated disc (also called herniated nucleus pulposus or HNP) results from sudden or long-term compression loads on the spine. Herniations are more common in the lumbar region than in the cervical, but can still produce significant pain or disability when they occur. Cervical disc herniations produce pain or neurological dysfunction in the neck or upper extremities. They are relatively common and frequently occur in asymptomatic individuals, so presence of a herniated disc does not necessarily imply a pathological problem.1
The intervertebral disc is designed to absorb shock and cushion compressive forces transmitted through the skeletal structures of the body. The center of the disc is composed of an inner gel-like substance called the nucleus pulposus. The nucleus is surrounded by concentric layers of collagen that make up the outer disc boundary, called the annulus fibrosus (Figure 1). When compressive loads are placed on the disc, the nucleus presses against the walls of the annulus. As the pressure increases, annulus fibers begin to tear and the disc changes shape (Figure 2). The disc usually is pushed in a posterior-lateral direction. Unfortunately, the cervical nerve roots are very close to where the disc herniation occurs, so the herniation frequently presses on the nerve roots producing sensory or motor nerve dysfunction.
Cervical disc herniations are most common in the lower cervical spine. The nerve roots in this region make up the brachial plexus. The nerves of the brachial plexus eventually course down through the length of the upper extremity, so nerve compression symptoms commonly are felt down all or part of the upper extremity.
In some cases, the disc herniation is an acute injury with a sudden load on the cervical spine. For example, herniations develop when an individual hits their head on the bottom of a shallow swimming pool after diving in. In other situations, a disc herniation may develop from significant compressive loads over time, such as those that occur from chronic forward head posture.
The primary symptoms from cervical disc herniation include pain, paresthesia or weakness in the neck or upper extremities. Pain or paresthesia can occur throughout the entire upper extremity or only in part of it. Muscle weakness may be evident in any of the upper - extremity muscles innervated by fibers of the affected nerves. Because symptoms may occur in any region of the upper extremity, it can be challenging to distinguish a cervical disc herniation from other nerve compression pathologies that occur in the upper extremity, such as thoracic outlet or carpal tunnel syndromes.
Suggestions for Treatment
While surgery was once considered almost essential for this condition, it's not as common now. Research shows that disc herniation problems may heal spontaneously without surgery or other invasive procedures.2 Some rehabilitative exercises are suggested to encourage the disc to return to a normal position away from affected nerve roots.3 It's important to consult with a physician or other health professional for recommendations on treatment.
While massage is not absolutely contraindicated for disc herniations, treatment methods should be used cautiously. The transverse processes protect the nerve roots from further compression during most massage techniques, but symptoms could be aggravated by minor vertebral movements that occur from pressure applied to the region. Massage is helpful to decrease muscle tension in the area and may reduce compressive loading on the disc. However, this massage also should be performed carefully and only once the extent of the disorder has been clarified.
Click here for more information about Whitney Lowe, LMT.
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