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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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
January, 2008, Vol. 08, Issue 01
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Happy New Year! I hope your holiday season has been peaceful, fulfilling, inspiring and rejuvenating to help get you through winter's months ahead.
After a prolonged departure from my usual "What's on Your Table?" fare, we return today to a discussion of a particular pathological condition - one that several practitioners have requested more information about - post-polio syndrome (PPS). Polio itself is almost an anachronism; but to understand PPS, we need to revisit a few key features of this infection.
Poliovirus is a pathogen spread most efficiently through oral-fecal contamination. When a person picks up some virus through contaminated water, it concentrates in the gastrointestinal tract and the feces. If any symptoms develop at this time they include high fever, aches, headache, nausea and diarrhea (which helps spread the virus), and then for most people the infection is completely over. Less than 1 percent of all people exposed to poliovirus in this way progress to develop a second-tier infection. The motor neurons begin in the ventral horn of the spinal cord and control muscle function. The resulting destruction to motor neurons leads to muscle atrophy and paralysis. This often occurs in the lower extremities, but a particularly serious form of the infection affects breathing muscles. (One interesting mystery about polio is that we have never figured out how the virus migrates from the intestines to the central nervous system.)
Even with such a low rate of serious infection, polio traditionally has been viewed as a significant public health threat. After all, if 1,000 children swim in a contaminated lake or drink from a contaminated well, this means 10 could become partially paralyzed. And because young children are especially vulnerable, this disease has also been called "infantile paralysis."
People familiar with the history of massage may remember that Sister Kinney, an Australian nurse, pioneered the use of hydrotherapy and intense rubbing to help her polio patients recover some muscle function in the 1930s before polio vaccines were available.
The good news for us is that wild polio (polio that is not connected to a vaccination series) is practically extinct. The last recorded case of wild polio in the Western hemisphere was in Peru in 1991; the last case in Europe was in 1998. As of 2003, wild polio was endemic to only India, Pakistan, Nigeria, Niger, Afghanistan and Egypt. One of the consequences of the extremely successful world-wide polio eradication program is that a bodywork practitioner working in the U.S. today is extremely unlikely to have a client with an acute polio infection. However, we estimate that some 440,000 people in the U.S. had polio infections during childhood and these people are vulnerable to a long-term complication related to the virus: post-polio syndrome.
Post-Polio Syndrome: No New infection!
When a person develops polio-related paralysis, some of his or her motor neurons have been destroyed and the muscle cells those neurons controlled are likewise prone to atrophy. However, remaining functioning nerve cells have a tendency to develop new axon tips to support some muscle fibers. In other words, the motor unit (a single functioning motor neuron and all the muscle fibers it supplies) becomes larger. Over the course of years, this can lead to cumulative fatigue, stress and wear-and-tear both on the overworked motor neurons and on the under-stimulated muscle cells. The result is that anywhere from 10 to 40 years after an initial polio infection, a person may experience a sudden onset of symptoms that include muscle weakness, pain, breathing and sleeping problems, and debilitating fatigue; this is PPS.
It's important to emphasize that while a polio survivor has new symptoms, often with a sudden or specific onset, PPS definitively is not a resurgence of the virus as a new polio infection. It's simply the result of decades of overuse of tissues that have limited capacity for growth and adjustment. The most typical pattern for PPS is that a middle-aged person who had polio as a child develops the symptoms listed above and the symptoms tend to run in cycles: During flares the person loses function, and during remission the person is stable, but may not regain lost function. People most at risk are those who followed their original polio infection with a rigorous and aggressive physical therapy program to rebuild strength in damaged muscles. We see now that the nervous system can't keep up with long-term demands in this way.
Massage for Post-Polio Syndrome
Polio itself involves motor paralysis but no sensory deficit. This makes it safe for bodywork, since the client can accurately report how intense or safe the pressure feels. Post-polio syndrome is the same: it involves pain and weakness related to neuromuscular dysfunction, but the pain is not related to any attack or inflammation of sensory neurons. Furthermore, numbness is not a reported symptom of PPS. Typically, people with this condition are counseled to adjust their posture and movement patterns to take advantage of their strongest muscle groups, rather than the ones that were damaged and then overworked after their infection. This may mean using or adapting tools like braces, crutches or canes. Massage certainly can help in this area to de-stress overworked areas and to support and refresh muscles that are newly being pressed into service. Massage won't eradicate the problems behind PPS, but by focusing on taking the workload off the weakest muscles and supporting the strongest ones, bodywork can be part of a helpful coping strategy for our population of polio survivors.
I've had some interest expressed in exploring polymyositis: an autoimmune disease that affects muscle function. If you have experience working with clients who have this condition, be sure to share. Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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