Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
March, 2008, Vol. 08, Issue 03
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
This month, we continue our survey of neurological issues with a topic that has generated a lot of questions from concerned bodyworkers - peripheral neuropathy (PN). This rather ambiguous umbrella term refers to virtually any damage to nerve tissue outside the central nervous system. While we often associate PN with symptoms in the feet, it can likewise affect cranial nerves - in particular the vagus nerve - with serious or even life-threatening consequences.
Types of Peripheral Neuropathy
PN often is classified by what types of peripheral nerves have been affected. You may remember that peripheral nerves (which include spinal and cranial nerves) have some fibers dedicated to the somatic nervous system (having to do with conscious processing of sensory input and voluntary muscle activity) and others dedicated to the autonomic nervous system (mostly motor fibers that control heart rate, blood pressure, digestion and other involuntary functions). PN can affect any of these fibers. In other words, it can be primarily sensory, it can affect voluntary motor control, it can affect autonomic function, or any combination of the three. Furthermore, PN may be described by the tissue that is damaged: the neurons themselves, which is called an axonal injury, or the myelin surrounding the neurons in the peripheral nervous system.
PN often is classified according to its cause. Here is a short list of some possibilities:
Injury and infection also can cause peripheral nerve damage. Examples include carpal tunnel syndrome, thoracic outlet syndrome, Bell's palsy, HIV, herpes simplex and shingles. In these cases, however, symptoms are usually unilateral rather than symmetric. This is a diagnostic clue to the cause of the pain.
Signs and Symptoms of Peripheral Neuropathy
The signs and symptoms associated with PN vary according to the cause of the problem and which types of neurons have been affected. Obviously, sensory neuron damage leads to changes in sensation. This may reflect as tingling, shooting or burning pain, or numbness. Often people with PN describe a feeling of "stockings" or "gloves" with symptoms that begin bilaterally at the extremities and work proximally up the limbs.
Motor neuron damage leads to poor coordination and specific muscle weakness, which can lead to local atrophy as muscle fibers degenerate in the absence of stimulation. Perhaps the most alarming and dangerous symptoms of PN occur when cranial nerves, especially the vagus nerve, are affected. Autonomic symptoms can vary from occasional dizziness to changes in respiration and blood pressure. Reduced sweating with resulting hyperthermia may occur, gastric motility and digestion may be impaired, and bowel and bladder control may be lost.
Treatment options for PN are determined by the cause and severity of symptoms. Peripheral neurons have the amazing capacity to regenerate, so if the irritation is stopped and blood flow is returned, the nerve tissue may regain function. The prognosis is most hopeful when damage only affects the myelin sheath rather than the neuron tissue itself.
Analgesics (painkillers), antiseizure medications, lidocaine patches and antidepressants sometimes are prescribed to mitigate the symptoms of PN. These work with pain management, but don't target rebuilding the myelin sheath or damaged nerve tissue, for which exercise and good nutrition are generally the best options.
When we have a client who reports unexplained alternating periods of numbness and sharp shooting pains in the feet, the first thing we need to recommend is that they see a doctor. While we obviously don't want to exacerbate pain, in many ways numbness is a more serious symptom in terms of bodywork, because it prevents our client from telling us when our pressure is too intense.
Many people find relief with the gentle circulatory stimulus massage gives to limbs that are tingling and painful. Clients who have been diagnosed with PN may benefit from massage as long as sensation is intact and as long as cautions concerning their underlying disease or injury process are understood and respected. These are situations during which we definitely want to be in communication with a client's health care team, and it is important to avoid any radical changes in external environment - going from a hot soak to a cold plunge, for instance.
For Next Time
We could look at some of the neurological disorders that this discussion brought up (Bell's palsy, anyone?) or we could examine a poorly understood autoimmune condition, polymyalgia. Please let me know: What's on your table? 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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