resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
November, 2008, Vol. 08, Issue 11
The Progression of Cervical Stenosis Toward Cervical Spondylotic Myelopathy (CSM), Part 3
By Dale G. Alexander, LMT, MA, PhD
Since beginning to describe the progressions of chronic dysfunctions last year, I propose that my research and intuitive extrapolations have tripped over many of the default settings of the human aging process.1 My instincts suggest that there are more progressions than what has occurred to me. Six appear to be clear.
I have already proposed and described how gallbladder difficulties may underlie many of the gastrointestinal difficulties and their somatic expressions that accompany aging.2 Included in part 2 of that series, the connection between the progression of gallbladder dysfunction and the emergence of type 2 or non-insulin-dependent diabetes mellitus was noted. In this present series, I am describing and postulating how many motor-coordination and chronic sensory complaints are likely to be associated with cervical stenosis progressing toward cervical spondylotic myelopathy (CSM).3
The other four proposed progressions include: osteoporosis, atherosclerosis (deposition of fatty materials in arterial walls), desiccation and dehydration, and senility (the cognitive decline associated with dementia and Alzheimer's). I plan to explore these in future articles, so I invite you to consider what other progressions may exist and either let me know or write about them yourself. Please send me a copy. Let's combine our profession's capacity for astute observation, our willingness to listen to our clients and, our collective common sense to make a lasting contribution to humanity.
One of the most reliable indicators that one or more progressions may be occurring is that a client presents with one or more chronic somatic complaints without a recent precipitating event. My clinical experience has repeatedly shown that for a large majority of clients, chronic difficulties are the "canary in the coal mine" of underlying degenerative progressions. These fly under the radar of medical testing because they take decades to undermine physiologic function until reaching a tipping point of degradation and clinically detectable expression. Understanding such progressions will add to our collective ability to assist clients to make more informed medical and lifestyle choices.
All of these subtle progressions contributing to declining capacity, function and pain have two common denominators: the body's capacity for delivering nutritious oxygenated blood and the length of time it takes for the return of venous and lymphatic fluids to deliver the raw materials so that the lungs and heart can make new blood. As massage therapists, facilitating the movement of bodily fluids is at the core of our training. We are uniquely oriented to assist our clients to maintain the quality of their lives as they age.
Returning to the progression of cervical myelopathy, let's begin with my own cervical MRI from the previous article. The process of having an MRI is fairly simple and painless, especially one that allows you to sit or stand. Reading the radiologist's report however, was more of an emotional experience than I had anticipated. Even though I have reviewed thousands of medical reports, to read one that described what is going on inside of my own neck was sobering yet very educational. Early detection translates into an increased field of choices for us all.
My report described C4-5, C5-6, and C6-7 as having moderate to severe disc compression with posterior bulging of the discs, one of which is impinging upon the left side of the thecal sac (the meninges). It also noted left-sided and right-sided foraminal narrowings (where the spinal nerves exit) between each of these vertebrae. The report certainly helped me to understand how and why my upper extremity pain and numbness could express itself on either side or bilaterally and why my left lower extremity has been more symptomatic over many years. There was no evidence of frank spinal cord compression, only the stenosis or pinching of the left-sided thecal sac at C4-5.
In a discussion with my personal physician, he noted that he has seen many such MRI reports that reflected more significant stenosis along with frank spinal cord compression, but without accompanying symptomatic pain or numbness; instead, the patient's motor coordination was generally more the presenting problem. I also requested that a retired radiologist take a look at the films to confirm what the report stated. His response was, "What are you going to do, Dale? You're 55; it's not bad enough for surgery." My response was a declaration that I was going to attend to the integration of my soul and personality, seek out excellent bodywork, refrain from working with my neck in extension and arms over my head, as I do trimming the tropical trees and plants in our yard, and seek out nutritional sources to quell the activation of the inflammatory process. "That makes sense," he concluded. He also noted that more information would have been obtained had the MRI been done with my neck in extension as this would more directly activate the cervical ligaments. So, do pass this on to any clients who might seek out such information for themselves.
When I subsequently asked an orthopedic physician who is a client and has had surgery for CSM himself for his opinion of my MRI results, he advised me that what he saw did warrant surgery. I didn't want to hear that. This is what our clients are very often faced with - real dilemmas with differing medical opinions. I took to heart my personal physician's distillation of the human condition from his many years of medical experience: "Clots and inflammation are what disable us leading to our eventual deaths." Thus, based on his advice, the course of action I am pursuing is to contain the inflammatory process through the use of prescription-strength omega-3 salmon oil, baby aspirin and over-the-counter anti-inflammatory medication at the first sign of an escalation, and regulating more judiciously the number of hours I work each day in my clinic. This approach has reduced my daily upper extremity pain and numbness dramatically.
I am pleased that I followed my instincts in seeking out more information. I consistently offer this caveat to clients: "If you don't look, you don't know." Medical tests have their place and they are not always conclusive. However, with additional information we all have more perspective from which to make a choice.
Based on my research thus far, my current guidelines for encouraging clients to explore a surgical option for CSM include the following somatic profiles (individually or in combination): unrelenting upper extremity/neck pain or numbness, atrophy of the deltoid muscle group or muscular hand wasting (usually associated with the muscles of the thumb or the central portion of the palm), the development of an ataxic gait pattern (a clumsy and jerky walking style), and an escalating frequency of urinary or bowel urgency or episodes of incontinence. This last symptom is the one that slides under the radar for many.
It is important to consider that more than one degenerative progression may simultaneously co-exist in the same body. This was the case for both of the clients with CSM for whom I was unable to stem the tide of its progression. One was a male client who has been chronically overweight for years and I suspect has gallbladder dysfunction and/or progressed into a pre-diabetic state. For the other, a female client, her osteoporosis had insidiously accelerated despite her best efforts to track it with periodic bone density tests.
Researching this progression has been a humbling and rewarding personal and professional experience. Humbling to experience the "zone of limits" that my genetics and trauma history may be signaling in my own aging process. Rewarding in the vast appreciation for how well our bodies do adapt overall and in the realization that the progression of CSM is truly a broad symptomatic continuum that affects some more than others, both functionally and clinically across a wide spectrum of somatic expressions.
In my next installment of this column, I will touch on the issue of gender and CSM, and finish up by discussing my studies of CSM.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.