resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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).
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).
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.
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.
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.
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.
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.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
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.
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%.
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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