resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
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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