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News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
November, 2009, Vol. 9, Issue 11
The Silent Progression of Kidney Infections and Stone Formation
By Dale G. Alexander, LMT, MA, PhD
There is a strong possibility that the chronic or semi-acute somatic complaints of your clients may have a deeper origin than biomechanical strain. In fact, their somatic difficulties may be associated with the progressing development of kidney stones or infections.
Kidney stones (also called nephrolithiasis or urolithiasis) affect about 12 percent of men and 5 percent of women by the time they are 70 years old.1 Another reference states: "One in seven men and one in 15 women will be diagnosed with kidney stones during their lifetime. On a typical day, more than 1,300 of them will end up in emergency rooms."2 In a calendar year that potentially means 474,500 people will seek emergency medical help for their kidney stones.
According to Jean-Pierre Barral, the developer of Visceral Manipulation, kidney dysfunctions are implicated in most lower back and lower extremity chronic somatic complaints, especially those that involve the groin, knees, ankles and feet.3 The next time a client comes to you complaining of chronic pain in the low back, groin, knee or foot, without a recent direct trauma to these structures, ask them the following questions: Have you or anyone in your family ever had a kidney stone or a kidney infection? Do you have a history of urinary tract or bladder infections? Have you or other members of your family been diagnosed with diabetes? Do you have high blood pressure? Have you recently been experiencing any urinary urgency, high frequency of urination, pain or burning while urinating? Have you noticed a pinkish tinge to your urine?1
A positive response to any of these questions, especially the last two, suggests that encouraging your clients to see their physician is in their best interest. Let's appreciate the amazing capacity of the human kidneys. According to the NIH: "Every day, a person's kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, which flows to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination."4
The important question for us as massage therapists is, how many of our present clients are progressing toward developing kidney stones? It has been estimated that it can take up to 10 years for kidney stones to form.5 Consider that low back or lower extremity dysfunction and pain may be the "voice" of one's kidneys; or the hand being raised and waving for attention. Through increased awareness, we may be able to help our clients acknowledge these signals and take appropriate action.
Silent Kidney Dysfunction
According to the Mayo Clinic Web site, "Kidney infection (pyelonephritis) is a specific type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels up into your kidneys.6 Another resource suggests that such infections may also result from the encroachment of not only bacteria but also fungi and viruses. The invasion may come from the bloodstream as well as the bladder. Kidney infections seem to occur most often in adult females who are otherwise healthy. Urinary tract infections are uncommon in males until old age, when bladder catheterization and other urinary procedures are more commonly performed.7
Similar to the intense pain of renal colic when passing a kidney stone, an acute kidney infection with its attendant fever and chills, abdominal and back pain, urinary urgency and blood in the urine will generally send an individual to the emergency room rather than to your office.
However, chronic kidney infections, which may lead to chronic kidney disease, is reflected in a gradual loss of the kidneys' ability to filter blood, usually due to high blood pressure or diabetes. When kidney function is seriously impaired, dangerous levels of fluid and waste can quickly accumulate. In the early stages of chronic kidney disease, an individual may have few signs or symptoms. Many people with chronic kidney disease don't realize they have a problem until their kidney function has decreased to less than 25 percent of normal.2 Obstruction of the flow of urine by stones, an enlarged prostate, strictures (narrowings) or cancers may also contribute to chronic kidney disease.7 Kidney pain is quite tricky because it can radiate to many different parts of the body. The pain may radiate from the organ itself but often appears as back pain.8
According to John Rothchild, MD, a kidney specialist, "The kidney has no pain receptors except in the capsule. Things that provoke kidney pain are in response to its capsule being stretched or in response to its inflammation."9 This is why kidney diseases are considered "silent." However, this doesn't mean that the degradation of the kidneys' ability to filter our blood doesn't have an effect on physiological homeostasis.
Alerting Your Client
It is my clinical speculation that the origin of kidney-related lower back and lower extremity dysfunctions probably stems from a combination of two factors: venous and lymphatic congestion as the kidneys filter blood more slowly, and through the neural network of viscero-somatic reflexes within the autonomic nervous system. This is our bodies' evolutionary genius for survival in action. On the downside, this may be how kidney stones and chronic kidney disease may seem to sneak up on us and suddenly emerge. These, among other progressions, rob our clients of their quality of life.10
Our opportunity as massage therapists is to alert our clients to the possibility that their chronic somatic complaints may be related to these dysfunctions and encourage them to seek out medical testing to rule out these progressions as possible contributors to their chronic ailments. Encourage clients to ask for blood tests specific to kidney function, and a urinalysis and a urine culture test.
An emerging theory of the Inside-Out Paradigm suggests that when the biomechanical expressions of organ or spinal-cord dysfunction are normalized such that a client's chronic somatic complaints reduce, the body will show a more classic presentation that can be medically recognized. The number of bodywork sessions needed to facilitate the expression of these dysfunctions varies wildly between a few sessions and a number of years, but the theme continues to repeat itself with chronic conditions.
Clients want their answers to be explainable in musculoskeletal terms. One intention of the Inside-Out Paradigm is to bring to our collective awareness the possibilities of progressions that have little or no direct voice. The progressions of kidney stone formation and kidney infections may play a role in your clients' chronic lower back and lower extremity problems. Early detection and prevention is the only way to stay ahead of these "silent" progressions.
I wish to express my gratitude to Jean-Pierre Barral for assisting me to see more clearly how the human body works.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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