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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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
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.
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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