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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.
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.
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.
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.
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.
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.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
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?
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).
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.
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.
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.
Code Connection: 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.
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.
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.
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.
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.
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.
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.
April, 2009, Vol. 09, Issue 04
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In this issue we will discuss a common, frustrating, but not particularly threatening condition – acne rosacea. Sometimes called “adult acne,” this idiopathic condition is usually benign but it has some complications that are worth noting. Imagine being a fair-skinned man in your 50s. You have noticed that over time, much of your face now appears to have become permanently reddened—like a sunburn that never fades. You outgrew adolescent acne 30 years ago, but now you see bumps and pimples over your cheeks and on your chin. Occasionally they sting or itch. Your nose has become enlarged and the skin has become thick and bumpy. Tiny red lines appear on your face: these are especially noticeable when you drink hot beverages or eat spicy foods. Worst of all, some friends and acquaintances assume that your skin is a sign of chronic alcohol abuse: you find yourself constantly defending yourself against that prejudgment. These are the signs and symptoms of acne rosacea.
What is acne rosacea?
Acne rosacea is a skin condition that affects mostly middle-aged, fair-skinned adults. It is most common among 30 to 60-year-olds. Although it is diagnosed in women slightly more often than in men, men tend to have it in a more severe form. Rosacea is very common; estimations suggest that about 14 million Americans may have it, although not always so severely that treatment is required.
Despite being common, acne rosacea remains mysterious. It runs in cycles of flare and remission, but does not appear to be auto-immune in nature. It can lead to the appearance of pustules that clear up with antibiotic use, but it is not a specific bacterial infection that can be cultured and identified. Some research points to two microbial infestations, but research on these factors remains inconsistent and inconclusive. Because the cause or causes of this condition remain elusive, its treatment is limited to addressing symptoms only. Acne rosacea is considered to be a manageable, but not curable, condition.
Symptoms of Acne Rosacea
Acne rosacea typically affects the skin of the face, focusing especially on the cheeks, forehead, and chin—often the places that acne vulgaris (“common” acne associated with the changes in testosterone secretion that occur during puberty) appears. Many people find that their skin becomes reddened and bumpy or even pimply, and may stay that way for weeks and months. Then, for no known reason, symptoms resolve and the skin goes back to normal for an undetermined period of time. Other people find that the changes are permanent and progressive. Acne rosacea usually spares the skin around the eyes, but one version can affect the conjunctiva and even lead to the risk of corneal damage.
Causes of Acne Rosacea
Causes of acne rosacea are mainly unknown. One of the frustrating things about this condition is that triggers may vary widely for people, and that the tissue changes seen in skin biopsies of people with this condition are inconsistent. Some of the features that occur often include:
Types of Acne Rosacea
In 2004, a committee of specialists convened to compare notes and create some clear guidelines for subtypes of acne rosacea in an effort to create more awareness and to strategize the best treatment options for each type. The types of rosacea that they identified are:
This idiopathic disorder has no permanent cure, and so is treated palliatively. Patients are taught to recognize their specific triggers, and to avoid them when possible. Acne medication like Accutane is often prescribed. If mites are suspected, patients may be counseled to try the same skin cream recommended for scabies infestation. Photodynamic therapy (combining oral medication with careful doses of UV radiation) works for some patients. Laser surgery or dermabrasion may help the appearance of the skin and mask telangiectasias. Plastic surgery may be considered for a person with advanced rhinophyma. None of these interventions are considered to be a permanent solution for acne rosacea, however.
What about massage?
Specific massage promotes local blood flow as the skin warms and capillaries dilate in the area being addressed. For most clients this is a benefit, but for clients with acne rosacea facial massage could be a trigger for uncomfortable flushing and redness. As long as no infection is present, lymph drainage modaliies may help decrease fluid retention and any local edema. Therapists must be careful about using a lubricant that doesn’t irritate the skin or lead to a hyper-reaction.
Massage is unlikely to make any direct or specific changes to acne rosacea, but the chance to receive educated, non-judgmental touch may be an important positive factor in the life of someone who lives with this common and frustrating condition.
Well readers, do you have questions about medical issues that are presented in your contact with clients? Let me know – what’s on your table? Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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