resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
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.
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.
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.
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.
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.
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.
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.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
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.
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.
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.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
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.
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.
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 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.
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.
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.
October, 2009, Vol. 9, Issue 10
Red, White and Black Reaction
By Leon Chaitow, ND, DO
In the current edition of my book, Palpation & Assessment Skills, there are 12 "special topic" sections, where subjects that don't quite fit into the regular chapters, have been placed. The special topic I want to bring to your attention is the so-called "red and white" reaction - the name of which has been expanded to "red, white and black" reaction. Mysterious? Not really - but it's a catchy name for a simple but useful assessment method that dates back well over 100 years. The name refers to superficial responses that take the form of red, white and sometimes blue-black lines following skin-friction, applied by a finger or probe, usually running down each side of the spine.
In the early days of osteopathy in the 19th century, the assessment method was already in use. Carl McConnell, one of the original osteopathic pioneers wrote this in 1899: "I begin at the first dorsal and examine the spinal column down to the sacrum by placing my middle fingers over the spinous processes and standing directly in back of the patient, draw the flat surfaces of these two fingers over the spinous processes from the upper dorsal to the sacrum in such a manner that the spines of the vertebrae pass tightly between the two fingers; thus leaving a red streak where the cutaneous vessels press upon the spines of the vertebrae. In this manner slight deviations of the vertebrae laterally can be told with the greatest accuracy by observing the red line. When a vertebra or section of vertebrae are too posterior, a heavy red streak is noticed and when a vertebra or section of vertebrae are too anterior, the streak is not so noticeable."6
Much more recently, another osteopathic physician, Marshall Hoag, discussed the same phenomenon: "With firm but moderate pressure the pads of the fingers are repeatedly rubbed over the surface of the skin, preferably with extensive longitudinal strokes along the paraspinal area. The blunt end of an instrument or of a pen may be used to apply friction, since the purpose is simply to detect color change, but care must be taken to avoid abrading the skin. The appearance of less intense and rapidly fading color in certain areas as compared with the general reaction is ascribed to increased vasoconstriction in that area, indicating a disturbance in autonomic reflex activity."3
On the same theme, Upledger and Vredevoogd wrote: "Skin texture changes produced by a facilitated segment [localised areas of hyper-irritability in the soft tissues involving neural sensitisation to long-term stress] are palpable as you lightly drag your fingers over the nearby paravertebral area of the back. I usually do skin drag evaluation moving from the top of the neck to the sacral area in one motion. Where your fingertips drag on the skin you will probably find a facilitated segment. After several repetitions, with increased force, the affected area will appear redder than nearby areas. This is the 'red reflex.' Muscles and connective tissues at this level will:
De Jarnette, the chiropractor who developed the sacrooccipital technique (SOT), wrote extensively on the subject of the red reaction, suggesting some complex interpretations.2 He used such assessments as part of a process of evaluating the particular category of patient he was treating. In one variation he describes the process as follows: "Making a firm pressure, draw fingers down the spine, with a fairly slow motion. You should be able to count to 15 while drawing the fingers from the seventh cervical to the coccyx, by counting steadily. With a good light on the back, the results should show a line which becomes red, some portions brighter and some very faintly colored. Now watch the lines fade. The area which shows the whitest is marked as the major [lesion] for this is the most anaemic spinal muscle area. It will be paler than any portion of skin on the patient's body."
Eminent physiologist Irvin Korr described how this red reflex corresponded well with areas of lowered electrical resistance, which themselves correspond accurately to regions of lowered pain threshold and areas of cutaneous and deep tenderness (termed "segmentally related sympatheticotonia").5 He cautioned: "You must not look for perfect correspondence between the skin resistance (or the red reflex) and the distribution of deeper pathologic disturbance, because an area of skin which is segmentally related to a particular muscle does not necessarily overlie that muscle. With the latissimus dorsi, for example, the myofascial disturbance might be over the hip but the reflex manifestations would be in much higher dermatomes because this muscle has its innervation from the cervical part of the cord."
By use of a mechanical instrument that quantified the pressure applied at a constant speed, followed by measurement of the duration of the redness resulting from the action of the frictional stimulator on the skin, Korr could detect areas of intense vasoconstriction which corresponded well with dysfunction elicited by manual examination.
But was the opportunity to feel the tissues being ignored during all these strokes? Marsh Morrison discussed this: "Run your fingers longitudinally down alongside the dorsal and lumbar vertebrae (anywhere from the spinous processes extending laterally up to two inches [5 cm]) and stop at any spot of tissue which seems 'harder' or different from normal tissue. These thickened areas, stringy ligaments, bunched muscle bands, all represent indurated tissue; they are usually protective and indicate irritation and dysfunction. Once these indurated areas are palpated press down and almost always they will be sensitive, indicating a need for treatment."7
Osteopathic researchers Cox, et al., wrote: "'Red reflex' cutaneous stimulation was applied digitally in both paraspinal areas [T4 and T9-11] simultaneously briskly stroking the skin in a caudad direction. Patients were divided arbitrarily into three groups.
Hruby, et al. describe the thinking regarding this phenomenon. "Perform the red reflex test by firmly, but with light pressure, stroking two fingers on the skin over the paraspinal tissues in a cephalad to a caudad direction. The stroked areas briefly become erythematous and almost immediately return to their usual color. If the skin remains erythematous longer than a few seconds, it may indicate an acute somatic dysfunction in the area. As the dysfunction acquires chronic tissue changes, the tissues blanch rapidly after stroking and are dry and cool to palpation."4
Newman-Turner described the research of osteopath/naturopath, Keith Lamont, who first described the "black line" phenomenon: "It is a common observation of osteopaths...that pressure on either side of the spine with a hemispherical probe of approximately 0.5 cm diameter, will, in some patients, elicit a dark blue or black line. Local engorgement of the capillary bed with de-oxygenated venous blood causes the appearance of the line which slowly fades as the circulation returns."8
I hope these glimpses onto different interpretations of the red reflex will stimulate you to explore the concepts described, remembering that what you feel and see is not the basis for a diagnosis; only an indication of dysfunction that may be local or reflex, chronic or acute, or significant or not.
Click here for more information about Leon Chaitow, ND, DO.
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