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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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
October, 2008, Vol. 08, Issue 10
Complex Regional Pain Syndrome
By Whitney Lowe, LMT
Pain resulting from nerve entrapment syndromes is a common reason for clients to seek the care of a massage practitioner. However, there are numerous neurological disorders that, at first glance, might appear to be nerve entrapment but are an entirely different pathological condition. Complex regional pain syndrome (CRPS) falls into that category.
A brief review of fundamental neuroanatomy is helpful to properly understand what occurs in CRPS. The autonomic nervous system has efferent fibers that control activity in various smooth muscles, glands and cardiac muscle. Within the autonomic system there are two divisions, the sympathetic and parasympathetic. The primary function of the sympathetic branch is to stimulate activity, while signals from the parasympathetic branch serve to inhibit activity. Of these two, the sympathetic branch is more involved in CRPS.
The sympathetic nervous system has a vital role in protective reflexes as the body responds to stress. It is in high gear during the "fight or flight" response. However, excess sympathetic system activity can generate and maintain pain states in different regions of the body. It is this excess sympathetic activity that causes the symptoms of CRPS. While there still is not a complete understanding of how excess sympathetic branch activity causes these pain conditions, it appears there is some spillover of noxious input from the sympathetic efferents into various nociceptors, especially in the extremities.
The term complex regional pain syndrome has only recently been added to the medical lexicon. It includes two separate conditions that have similar symptoms, but are different in cause. The two conditions were formerly called reflex sympathetic dystrophy (now called CRPS 1) and causalgia (now called CRPS 2).5 The primary difference between them is how they occur. In CRPS 1, symptoms commonly occur as a result of some traumatic incident, but there is no evidence of specific nerve damage. In CRPS 2, there also is some event that initiated excess sympathetic activity, but this condition also involves identifiable damage to the nerve. Most of the symptoms of CRPS 1 and 2 are similar and are listed below:
Symptoms of CRPS
Distinguishing CRPS from other neurological disorders is aided by detailed evaluation of several clinical features in addition to those listed above. The condition can affect either the upper or lower extremity, but is more common in the upper extremity, and the pain usually is aggravated with moving the affected limb. Various myofascial dysfunctions also might accompany the extremity pain.1 Women are affected more often than men by approximately a three-to-one ratio.2 Some degree of depression or psychological dysfunction is common with CRPS. However, it is unclear if this psychological dysfunction is a causative factor or a result of the condition, because depression and similar psychological manifestations are common in severe and chronic pain conditions.4
Treatment for CRPS varies widely, but physical therapy is a primary component of most treatment protocols. The goal of most physical therapy treatments is to desensitize the area and restore normal function of the affected extremity. Massage might play a fundamental role in this process. Because myofascial dysfunction often is a part of the array of symptoms, addressing the myofascial component might interrupt the cycle of pain and dysfunction. In many cases, if the myofascial pain condition was properly addressed, the whole syndrome may resolve.3 Massage is also likely to be helpful because it is effective at decreasing overall sympathetic system activity.
If you have a client demonstrating signs and symptoms that indicate the possibility of CRPS, it is important to have them properly evaluated by a physician. There are a number of other treatment strategies such as nerve blocks and medications that are effective in addressing the problem, and it might be important to start these treatments as early in the rehabilitation process as possible.
CRPS can be a debilitating condition. Because it occurs more often in the upper extremity, it might be easy to dismiss many of the symptoms as arising from a peripheral compression neuropathy such as carpal tunnel syndrome. However, awareness of the variety of symptoms associated with CRPS allows the practitioner to look at a bigger picture and catch this condition early on, if present, so it can be most effectively treated.
Click here for more information about Whitney Lowe, LMT.
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