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Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
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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