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Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
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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