resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
December, 2009, Vol. 9, Issue 12
By Elaine Stillerman, LMT
It was supposed to be a Sunday like any other Sunday: get up, go to the gym, do the shopping and chores, and enjoy the rest of the day with my son. Except on this June morning, I couldn't get out of bed.I put one foot down and the pain shot down from my knee to my toes. It was the same with the other leg. And both arms: pain, stiffness, swelling, and fire from elbows to fingers. All the connective tissues and articulations were inflamed. I recently had some dental work and thought that I was having an allergic reaction to the inlay. But that wasn't it at all.
My doctor suspected acute onset rheumatoid arthritis (RA), which blood tests later confirmed. For someone who has been practicing yoga since my teen years (let's not count how long ago that is) and works out regularly, this felt so wrong. The doctor prescribed heavy doses of prednisone which put out the fire and helped ease the stiffness, but this nasty drug has awful side effects and cannot be used long term.
RA & the Immune System
Generally affecting people 20-50 years of age, the cause of rheumatoid arthritis is unknown although there are a number of viable theories. RA is considered to be, by Western standards, an autoimmune disease. In RA patients, the immune system seems to attack body cells that are mistaken to be invader cells. Elevated levels of white blood cells are present within the synovial membranes that line the body's joints. This results in swelling, pain, and limited mobility. Over time, joints can become deformed and rheumatoid nodules, or small lumps, may grow under the skin at pressure points.
In more serious cases, RA can also affect other body parts such as tear ducts, salivary glands, the lining of the heart, the lungs, and sometimes blood vessels. Women are two to three times more likely to get rheumatoid arthritis than men and the rates for women are increasing. After nearly four decades of steady decline, the tide has turned and the numbers are rising. From 1985 to 1994, 36.4 per 100,000 women suffered from this debilitating condition. In 1995 to 2004, that number rose to 54 per 100,000 women. The incidence for men, however, stayed the same. And no one can explain why.
At the turn of the 20th century, rheumatoid-like conditions (i.e. ankylosing spondylitis) were considered to be venereal diseases. A few short years later, urinary infections were deemed to be the cause. By the time steroids transformed treatment, these causes were largely debunked.
"Immunological crossreactivity" is currently the leading theory of RA. This view reinforces the autoimmune nature of the disease. Infectious agents are considered to be the major environmental factors involved in the inflammatory process. The production of tumor necrosis factor (TNF), a pro-inflammatory cytokine, seems to have a major part in the inflammatory response. But the actual triggering mechanism is still unknown.
Other possible causes include hormonal factors which may explain the heightened risk factors for women. Reduced childbearing and breastfeeding (which seem to be contradictory) are associated with elevated prolactin levels.
In addition, there may be a genetic component to RA, abnormal bowel permeability, environmental and lifestyle factors, food allergies, and microorganisms all which lead to a multidimensional disease where any combination of factors may be culpable.
Treatment: Western vs. Eastern Thought
So how does Western medicine treat this painful, debilitating disease? Since the cause is unknown, standard medical therapy works by treating the symptoms - often times successfully. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are often well tolerated and inexpensive.
If these drugs are not effective, corticosteroids are prescribed, with prednisone the most frequently prescribed oral corticosteroid. This drug is very effective in the short term in reducing the inflammatory response, but long-term use generally causes more harmful side effects than benefits. Long-term use suppresses the natural production of the corticosteroids by the adrenal glands, and sudden withdrawal of the drugs may lead to collapse, coma and death. Other side effects, over a protracted period of time, may include: depression and other mental/emotional disturbances (this occurs in 57 percent of patients being treated with high doses of prednisone over a long period of time); high blood pressure; diabetes; peptic ulcers; acne; excessive facial hair in women; insomnia; muscle cramps and weakness; thinning and weakening of the skin; osteoporosis; and increased susceptibility to the formation of blood clots.
Disease-modifying anti-rheumatic drugs (DMARDs), such as hydroxychloroquine, gold therapy penicillamine, etc., are used to slow joint erosion, but their effectiveness is still unproven. One drug that has proven to be effective in delaying joint damage and reducing the inflammation is methotrexate, a drug commonly prescribed for breast cancer and severe psoriasis. This drug works by inhibiting the body's ability to use folic acid which is required for cell production (which is why it is used in instances of cancer.). In RA, the dosage is much lower than for cancer patients, but the side effects still may include gastrointestinal ulceration and bleeding; mouth and throat ulcers; hair loss; bone marrow suppression; liver, lung, and kidney damage; increased rate of infections; and higher risk for developing cancer.
Dietary considerations are strongly implicated in cases of RA. Some doctors posit that certain diets might even cause RA. It is interesting to note that the incidence of RA is practically non-existent in cultures and societies that eat a more "primitive" diet while it is found at a high rate in societies that eat a Western diet. A diet rich in whole foods, grains, vegetables and fiber and low in refined foods, sugar, and meat provides the best protection against developing RA. A vegetarian diet showed a substantial reduction in inflammation in many patients tested.
Another interesting factor in the development of RA is altered gastrointestinal gut flora. This is linked not only to RA, but other autoimmune diseases as well. Improper digestion is also suspect. Many patients with RA are deficient in digestive factors such as HCl and pancreatic enzymes resulting in incomplete digestion.
The Eastern interpretation of rheumatoid arthritis is quite different than the allopathic point of view. Arthritis is considered to be a "bi-syndrome" (pronounced "bee") which is a disorder resulting from blocked energy channels, the sluggishness of qi and blood circulation after wind, cold, dampness or heat. The symptoms of bi-syndrome are pain, numbness and heaviness of muscles, tendons and joints, joint swelling, hotness, and limited range of motion.
The wind-dampness-heat type of bi-syndrome is differentiated from the wind-cold-dampness type by its joint redness, swelling, hotness, and pain. An acupuncturist can determine the type of bi-syndrome it is and either disperse the wind and cold, dredge the meridians, and eliminate the dampness, or warm the meridians, disperse the wind and cold, and eliminate the dampness.
Chinese herbs may also be prescribed to support the related organs, nourish the blood and connective tissues, and eliminate the inflammation.
Massage & RA
Massage is never performed in cases of acute inflammatory RA, but can be very effective once the inflammation is controlled. A study by Field, Hernandez-Reif, Seligman, et al (1997) with children with mild to moderate juvenile RA showed that after the parents massaged their children 15 minutes a day for 30 days and a control group practiced relaxation therapy, the massaged group reported less stress and anxiety, less pain, and improved motor activities.
After including regular acupuncture, chiropractic care, dietary restrictions, herbal remedies, and stretching as part of my treatment along with proper medication, I am back on track. Perhaps not as agile and fluid as I once was (who is?), but I've got it under control. And I hope that this episode was my only one...one can hope.
Author note: I want to say a special "thank you" to Kellie White, senior editor, and Kelly Milford, editor, Elsevier Publishing, for their help in researching this article.
Click here for previous articles by Elaine Stillerman, LMT.
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