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Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
March, 2008, Vol. 08, Issue 03
Medial Wrist Pain
By Ben Benjamin, PhD
Question: If passive radial deviation causes pain on the medial side of the wrist, what structure is likely to be injured?
Answer: The ulnar collateral ligament of the wrist.
The wrist joint is located at the junction where the bones at the base of the hand meet the two long forearm bones, the radius and the ulna. The small bones of the wrist are uniquely shaped and fit together like a jigsaw puzzle in two rows of four bones each. The row closest to the fingertips is called the distal row; the row nearest to the forearm is called the proximal row. These bones are joined to one another and to the radius and ulna by an intricate network of ligaments. The ligaments provide stability while allowing movement among the individual wrist bones and between the wrist and arm bones.
The ulnar collateral ligament of the wrist, also known as the internal lateral ligament, is a fibrous band of tissue located at the medial side of the wrist. (Be careful not to confuse it with the ulnar collateral ligament of the elbow, an entirely separate structure.) This ligament attaches at the styloid process of the distal ulna and inserts primarily on the triquetrum bone, with some fibers running to the pisiform and hamate bones. It functions to protect the wrist joint by limiting radial deviation (i.e., the side-bending movement of the wrist toward the thumb).
To assess the wrist for damage to the ulnar collateral ligament, grasp the forearm a few inches above the wrist with one hand and grip the medial part of the hand with the other. Stretch the ulnar side of the wrist by moving the hand laterally toward the thumb side, while stabilizing the arm with your other hand. Be sure the client's hand is relaxed. Note whether this produces discomfort at the medial side of the wrist. If it does, the ulnar collateral ligament is likely to be injured. (It is also possible for pain in this region to be caused by a fracture of the triquetrum bone or the styloid process of the ulna, so be sure your client sees a physician to rule out those conditions.)
Although injuries to the ulnar collateral ligament may occur throughout the ligament, they most commonly occur at the attachments - and primarily at the origin. To locate the ligament origin, place your thumb or index finger against the styloid process at the distal edge of the ulna. To locate the distal attachment, move distally to the attachments at the triquetrum and the pisiform bones.
The most common cause of ulnar collateral ligament injury is sudden or repeated trauma. Sudden trauma to the wrist often occurs when we try to protect ourselves by extending our hands to break a fall. Jobs or activities that require using the wrist in repetitive actions for many hours each day (long hours working on a computer, for example) make this area vulnerable to injury. Injuries also can result from performing the repetitive motions involved in playing an instrument without adequate rest and recovery.
Ulnar collateral ligament injury is common in karate students who practice hitting objects with the medial surface of the hand. It is also a frequent problem in massage therapists, drummers, carpenters, construction workers, house painters and athletes who use their wrists in stressful positions.
Click here for more information about Ben Benjamin, PhD.
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