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Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
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!
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
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.
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.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
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.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
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.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
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.
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.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
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.
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.
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.
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.
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."
October, 2008, Vol. 08, Issue 10
The Iterative Process: A CranioSacral Approach to Health and the Human Body
By Eric Moya, MS/MFCT, LMT, CST-D; guest author for John Upledger, DO, OMM
Have you ever had a client ask, "How many sessions will it take for my pain to go away?" or "Why am I feeling pain in this part of my body when the problem is somewhere else?" At some point, you probably have had your clients ask these questions.With these issues in mind, I'd like to illustrate a couple of important factors about health and the human body from a CranioSacral Therapy (CST) perspective.
To better understand CST, consider the seemingly simple process of tuning a guitar. Whenever you put on a new set of strings, you have to tune the guitar many times over days before the strings hold their tune. Why? Because when you tune one string up to pitch, it stretches out and goes flat, so you have to retune it. Eventually, the string will stretch out completely and be able to hold its pitch. But then, with tension on the strings, the guitar itself actually changes. The neck may be stiff, but when you load it with asymmetrical tension in the form of strings, it bows a bit and throws the strings out of tune. That means you need to go back and tune the whole thing all over again.
As you can tell, it's impossible to tune a guitar perfectly the first time around. Instead you have to retune it over and over again, continually moving closer to the end goal of having a perfectly tuned instrument. It's simply a process of making minute changes until you reach your desired solution. This kind of problem - one in which it's impossible to find the solution through direct or linear means - is called an "iterative" problem. Iterate means to repeat. It's also the root for the word reiterate, which also means to repeat. (Isn't it strange that we have two words that both mean "to repeat"?)
In mathematics, an iterative problem is one in which you can't arrive at the solution using linear means. Instead, you must continually adjust the data, getting closer and closer to the solution until it's finally revealed. Structural health is also an iterative problem. With our vast interconnections of anatomy from the perspective of muscles, bones, fascia, lymphatic system and more, it becomes increasingly difficult to look at the body as a collection of parts. It's actually an integrated ecosystem in which any minuscule change affects the entire system.
Looking at fascial anatomy alone, there are innumerable ways in which a pull on one part of the fascia can affect other parts of the body. Practically, this means your client can have right-shoulder pain while the source of the problem is far removed from the shoulder. Although it would be important to work the shoulder girdle in your session, if you don't locate the original source of the shoulder pain, it's bound to recur.
Initially, this situation becomes a defeating conundrum for many manual therapists. Trying to intellectually figure out such problems is a staggering task. Fortunately there's an easier way, and it comes from the lineage of Andrew Taylor Still (the "Father of Osteopathy"), William Garner Sutherland (the "Father of Cranial Osteopathy") and John E. Upledger (the "Father of CranioSacral Therapy"). Their philosophies deviated from the standard allopathic approach of looking at the body in terms of problem and solution. Instead, they each viewed the body as an interconnected web that is continually trying to heal itself.
In CranioSacral Therapy, we cultivate techniques based on following the body. Because the body is continually trying to self-correct, even hidden problems become accessible when you know how to follow the body's cues and let them show you where to work. In CST, we align ourselves with the body's attempt to heal itself naturally. This involves working the entire body using a range of techniques based on tissue, energy, emotion and cognition.
Back to iterative processes. Let's say a client comes to see me with right-shoulder pain. I don't need to know whether the shoulder pain is a result of one or two restrictions or a whole lifetime of accumulated tensions. As a CranioSacral therapist, my job is simple. I follow the tissues into their restrictions and help them release using whatever techniques are at my disposal. With each release, the whole ecosystem of the body adjusts slightly. And with each change we get closer to a pain-free shoulder until we finally reach the solution - just like tuning a guitar.
So whenever clients ask me how many sessions it will take to "fix" their problems, or if they wonder why I'm working on areas that don't seem to hurt, I help them appreciate how complex and interconnected their bodies are. Then I help them recognize the shifts that have already taken place.
Once they realize they're getting better, even in ways they didn't realize were connected with their problems, they usually become intrigued and excited about their process. And why not? Feeling better is a magnificent thing.
Click here for previous articles by John Upledger, DO, OMM.
Eric Moya is a licensed mental health counselor, an Upledger-certified CranioSacral Therapy instructor and president/founder of The Ripple Effect: Center for Mind and Body Therapy in Albuquerque, N.M. Currently he is acting dean of integral education at the Esalen Institute in Big Sur, Calif.
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