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Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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%.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
December, 2009, Vol. 9, Issue 12
Heating Up Your Practice Safely, Part 1
By Dixie Wall, Contributing Editor
Over the last decade, many bodyworkers have begun using stones, not to replace human touch but as an additional relaxing and leveraging technique. Traditionally used by Egyptians, Shamans and American Indians, stones have a long history of therapeutic use and spiritual healing.Today, incorporating stones in one's practice offers this ancient tool, to not only relax clients but also give our hands a rest. Hot stones are a form of thermal and magnetic therapy, requiring a unique trust between the client and practitioner. A respect for the trust bestowed in us by our clients need to be developed by a safe and meticulous protocol to perform this primal technique.
After attending a hot stone seminar this summer, I was immediately reminded how splendid hot stone massage is, not only for the client but also for the therapist. Throughout my years of practice, I was always hesitant to use any type of tool, I never cared for the way the tools felt on my skin, either giving or receiving. Yet with rocks, especially smooth and warm ones, the feeling is different. There is an instant primal connection to a real rock from the ocean or a riverbed, which is relaxing to the spirit and nurturing to the soul.
Hot stone massage is usually done with basalt lava stones, which contain high levels of calcium, magnesium and iron. These minerals can facilitate balance within our energy centers or chakras, and they can move stagnation within our channels and meridians. Many therapists use cold stones as well. These may be smaller marble stones or quartzite crystals. Cold stones are commonly used on the face.
Stones and heat are both very powerful. When not treated with respect and vigilance, they can actually injure the client. Other types of heat therapy to keep in mind include hydroculator wet packs, water bottles, herbal compress bags and infra-red heat lamps.
Last fall, I published a three-part series on malpractice and liability claims. Many of these claims frequently involve burns from hot stones, cupping and hydroculator packs.
And while we are well aware of all the benefits of hot stones and other heat therapies. Over the winter months, we will discuss several treatment procedures, contraindications and cautions of which we should be aware as we provide therapeutic heat, especially hot stones to our clients. This month, we will discuss treatment procedures, skin typing and informed consent.
It is of utmost importance to have set procedures. We must follow a methodical, yet simple, protocol in our treatment rooms to ensure the safety of ourselves and our clients. Sloppy procedures and little or no training are the number one causes of burns in the treatment room. Why do client's get burned? Usually because stones are too hot.
According to Michael Schroeder, vice president of the American Massage Council, "The most common problem with hot stones is the method therapists are using to cool down the stones. If they are too hot, therapists often use cold water to cool them down, but this only cools the external layer of the rock.
"After placing them on a client, the superficial layer of the stone quickly becomes hot again, sometimes burning the client. The therapist doesn't realize they have only temporarily cooled the external layer. This means if the stones are too hot, the only way to cool them down is time. We can put them on a washcloth next to the heater, turn down the temperature and wait for them to cool."
Additionally, always test stones on your own forearm before placing them on the client. Our own hands may not be a safe temperature gauge because they are less sensitive to heat than the rest of our bodies.
Never give a hot stone massage using silicon gloves. If you use a glove rather than tongs or a skimmer to remove the stones out of the water, never put them straight onto client. If the palm of your hand cannot hold the stone, most likely the client will not tolerate the heat. Again, test the temperature on your own forearm first.
Always use a temperature gauge in the water while heating up the stones. Warm stones (90 F - 110 F) are used for those with sensitivity to heat or for large stones that are going to compress the body without a sheet or towel. Hot stones (110 F - 125 F) are used for active massage. Temperatures will vary according to client, always test your equipment, set the heater at low without a cover and go from there.
It's better to start on tougher (yang) areas first (back and lateral portions of the body), then work toward medial and anterior portion (yin).
In general, "stones do not care for bones". We should avoid all bony clefts and spinal processes. No stones should be placed on the eyes if the client wears contact lenses.
Fitzpatrick Classification Scale
Another tool we can use to keep our clients and ourselves protected is becoming familiar with skin typing. The Fitzpatrick Classification Scale (developed in 1975 by Thomas Fitzpatrick, a Harvard Medical School dermatologist) classifies a person's complexion and tolerance of sunlight. The scale is used by several different health practitioners to determine how their patients will respond to heat therapies.
We can educate our clients by including a skin typing chart in our initial examination documents or by incorporating it into our informed consent documents.
Another important facet of a long-term successful practice using heat therapies is always having the client sign an informed consent document, specifically for hot stone therapy, before receiving treatment. This document may explain benefits and risks of hot stones therapy, contraindications and cautions, and explain the skin-typing procedures.
By enlightening our clients through a professional intake procedure, we further establish a foundation of love and trust that facilitates their healing.
In the chilly months ahead, heat therapies may be suitable to offer your clients as a seasonal special or a holiday gift. When incorporated into practice with a healthy respect and awareness, we can securely integrate these healing modalities into our current practices. In the coming months, we will discuss contraindicated diseases, conditions and medications for heat therapies.
I would love to hear your experiences or comments. Please feel free to contact me at .
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