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Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
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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