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What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
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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