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Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
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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