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Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
July, 2008, Vol. 08, Issue 07
Ligaments vs. Discs
By Ben Benjamin, PhD
Q. How do you tell the difference between a disc and a ligament injury?
A. Disc and ligament injuries present differently in the following areas: nerve-specific weakness, asymmetrical limitation of movement, distal reference of pain, one-sided pain and reflex changes.
The answer to this question is complex. It's a physician's role to accurately diagnose which type of injury is present. The more knowledge you have, the better - but it's not necessary to be able to make such a diagnosis. Below are some areas you should be cognizant of when someone comes in with neck or low back pain.
Different movements of the arm and hand are controlled by different nerves. For example, resisted extension is enervated by the C7 nerve, resisted flexion primarily by the C6 nerve and resisted medial rotation by the C5 nerve. Therefore, if a nerve root is compressed by a protruding disc at the C7 level, the triceps will be weakened. If the C6 nerve is compressed by a disc, the biceps will be weakened, and so forth. If there is only a ligament injury, the muscles will not be weakened.
Distal reference means pain is referred peripherally. For instance, the pain from a nerve compression in the neck usually is felt in the lower arm and hand. With a ligament injury, the pain usually is felt more proximally, which in the case described, would mean the pain is located near the neck in the shoulder, upper arm or upper back.
Asymmetrical limitation means the person can move in one direction but not in the opposite direction. For example, the person can rotate the neck to the right, but is very limited in rotating the neck to the left; or the person can bend forward at the waist easily, but can't bend back. When a disc is affected, the pain does not switch from the right to the left; it stays on one side. In cases of ligament injury, it's common for the pain to switch from one side to the other. Pain also will come and go with a ligament injury, but not with a disc injury.
Reflexes in the arm or leg diminish with disc injuries but do not with ligament injuries. Similarly, disc and ligament injuries cause different types of numbness and disturbances in sensation.
As with most diagnoses, a practitioner needs to know the complete range of a patient's symptoms in order to make sound conclusions about their injury and appropriate treatment. In the case of disc and ligament injuries, it is easy to mistake one for the other in the absence of the appropriate knowledge. For more information, see www.benbenjamin.com, Neck and Low Back Series.
Click here for more information about Ben Benjamin, PhD.
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