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Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
March, 2008, Vol. 08, Issue 03
Easing Migraine Pain
By John Upledger, DO, OMM and Lisa Upledger, DC, CST-D, FIAMA
Gone are the days when migraines were considered a psychological disorder reflecting poor coping skills, low stress threshold, clinical depression or a borderline personality disorder. According to the National Migraine Association, migraine disease is now a recognized neurological condition affecting more than 30 million Americans.
In many cases, CranioSacral Therapy is one of the most effective tools you can offer a client suffering from migraine pain. This light-touch modality helps release restrictions in the meningeal membranes around the brain and spinal cord, increasing the healthy flow of cerebrospinal fluid and allowing the central nervous system (CNS) to resume its optimal levels of performance.
Cerebrospinal fluid within the craniosacral system acts as a shock absorber for the brain. It delivers nutrients to the nerves, brain and spinal-cord tissue, and washes away waste products created by various metabolic processes. You can see how critical it is to have a strong, functional craniosacral system.
In addition, research has shown that meningeal membranes and perivascular fascia are the only pain-sensitive tissues in the brain. Therefore, any abnormal meningeal tension can cause pain, as can any pressure on the blood vessels that run through the meninges. That means when you release restrictions in the meningeal membranes, you also take pressure off the blood vessels.
Pressure on the brain stem from surrounding fascia also can cause sensory neurons to relay their messages to higher brain centers, which may correlate with another theory about migraines: that brain stem pain receptors actually cause the migraine pain.
Cortical Spreading Depression
Historically, the migraine has largely been defined as a vascular disorder in which an event triggers vasoconstriction followed by vasodilation, inflammation and headache. Now, it's believed that the vasoconstriction/dilation is the result of a phenomenon called cortical spreading depression.
Cortical spreading depression is a slow, spreading wave of strong, sustained neuronal firing that generates a transient, intense spike of activity as it progresses into the tissue. The spike increases innervation to blood vessels, which strengthens regional blood flow. This is followed by reduced neuronal activity associated with a vasoconstriction that produces a transient ischemia and a drop in cerebrospinal fluid flow. This neuronal suppression can last for minutes and cause a neurochemical imbalance.
The auras and prodromes (a premonition that the headache is coming) often associated with migraines are likely caused by the vasoconstriction leading up to the rebound and vasodilation. The actual pain of the migraine occurs when there is a rebound of abnormal vasodilation of the intracranial arteries, and an activation of the sensory pain fibers around the blood vessels and meninges.
If a client sustains an impact that distorts or otherwise compromises the pain-sensitive meningeal membranes, this also can increase pressure on the brain and central nervous system, potentially causing cortical spreading depression and triggering a chain reaction leading to migraines.
Migraines generally occur in several phases. The first phase is called the prodrome - a forewarning that indicates an alteration in the central nervous system. A highly individual experience, the prodrome may be accompanied by changes in mood or energy levels; a sudden feeling of depression, euphoria or fatigue; or cravings for chocolate or other foods. There also may be an alteration in sensory processing, muscle tone, nasal congestion, fluid retention, cognitive impairment or facial pressure.
In approximately 15 percent of migraine cases, there is an aura phase that generally lasts no more than an hour. While symptoms vary, the most common ones are visual effects such as flashing lights and partial or blurred vision. Other symptoms can include olfactory and auditory hallucinations, tingling or numbness in the face and extremities, confusion, partial paralysis and more. It is widely believed that the aura is caused by the cortical spreading depression. With vasoconstriction resulting in decreased blood flow, the brain will certainly do strange things.
Next comes the mild phase of the migraine - when the pain begins. If the migraine is terminated at this stage, the pain may feel like a tension headache. If the migraine progresses it generally leads to mild pain, sometimes accompanied by nausea and the beginning of throbbing pain.
If not aborted in the mild phase, the migraine will develop into moderate to severe throbbing pain with nausea and sensory sensitivity. At this point the blood vessels are dilated. Any movement or activity increases the blood flow, which causes more dilation, pain and throbbing. This is when many people prefer to lie perfectly still in a dark, quiet room.
A migraine may dissipate over anywhere from four hours to three days, after which a post-headache phase could last another few days. During this time the person may feel exhausted, irritated, sore and unable to concentrate and tolerate certain foods.
A Light-Touch Solution
CranioSacral Therapy helps prevent and end migraine headaches primarily by releasing tensions throughout the meningeal membranes of the craniosacral system. Removing these tissue restrictions takes pressure off the nervous system and allows cerebrospinal fluid to drain correctly, preventing the buildup of pressure. CranioSacral Therapy helps release both primary and secondary dysfunctions of the peripheral body, dural tube, cranium and sacrum. The goal is to correct and balance all craniosacral system dysfunctions and the areas to which they might lead. Removing these meningeal and dural tube restrictions can effectively help release and prevent the pain of migraines.
Click here for previous articles by John Upledger, DO, OMM.
Dr. Lisa Upledger is vice president of The Upledger Institute and an examiner for the institute’s CST certification program. She graduated from Palmer College of Chiropractic in 1981.
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