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New Knee, New Pain (Part 2)
The patient presented to the chiropractic clinic with symptoms of genu varum and pain on the medial aspect of the tibiofemoral joint.
We Get Letters & E-Mail
Let's Restore Integrity to Health Care – Starting With Us; MDs Offer More – So Can We.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Increased Breast Cancer Risk: Another Implication of High Cholesterol
In addition to being a known risk factor for heart and cardiovascular disease, recent studies have highlighted the link between high cholesterol and increased risk of breast cancer. Breast cancer is the second most common malignancy in women after skin cancer.
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
Climbing the Ladder of Opportunity (Part 1)
President Obama spoke of building "ladders of opportunity" in his State of the Union and Inauguration addresses.
An Introduction to Evidence-Based Clinical Practice - Again
One of your patients is in for treatment and catches you off guard by asking you a question about a news article she recently read. It seems that a new intervention for back pain was found to reduce the rate of serious side effects by 50 percent.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
News in Brief
Parker Announces Executive Director of Parker Professional; Athletic TIPS Program Getting Financial Support; ANJC Award Recipients Named.
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
Putting Public Health Into Action: Thinking Globally, Acting Locally
The Chiropractic Health Care section of the American Public Health Association (APHA) met at the 141st APHA Annual Meeting and Exposition in Boston late last year, and it was another triumph for chiropractic and its public health advocates.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
The Importance of Staying Focused
Our world is so full of over stimulation and constant information. We live in a fast paced, ever-changing society. If you seek you will receive.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
The Many Faces of Cervical Compression
When evaluating the neck, there are any number of orthopedic tests to be considered.
Why Stretching Doesn't Work
Like most chiropractors, a good part of my day is spent working with sedentary office workers who spend eight to 12 hours a day glued to a desk chair in front of a computer.
Betraying Patients and the Profession
Imagine flying from New York to Paris on a jumbo 747. Your thoughts are on your vacation and experiencing the City of Lights. Midway over the Atlantic Ocean, you overhear the flight attendants talking in muffled voices.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Look, Listen and Learn to Code
Study of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) coding system can leave a doctor of chiropractic a bit confused. The description of the five new-patient and five established-patient examination codes takes up several pages in most coding books. The degree of detail and charts used to describe the codes can be overwhelming.
Ask and You May Receive
A friend of my mother has had a problem with her ears for almost 20 years. Whenever the wind blows, it sends shooting pain through her jaw. She has seen any number of medical specialists over that time, but with no relief.
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
March, 2010, Vol. 10, Issue 03
By Elaine Stillerman, LMT
The encouraging news about uterine fibroid tumors is that they are almost always benign, especially for women in their 30s and 40s. However, they can cause a multitude of discomforts, including heavy menstrual bleeding (menorrhagia), painful menstruation (dysmenorrhea), backaches, and/or abdominal or pelvic bloating and heaviness.If the fibroids grow large enough to protrude into the pelvic cavity, other pelvic organs may be involved, resulting in urinary frequency and urgency, or constipation. Most fibroids, however, are asymptomatic and many women don't know they have them until they cause a problem or a gynecological exam detects them.
Uterine fibroids are solid, noncancerous tumors made of fibrous and smooth muscle tissues. The preeminence of fibrous tissue gives these tumors their name. Their etiology is unknown, but they seem to be estrogen-dependent because they don't develop before a woman gets her first period and they decrease in size and occurrence after menopause, when estrogen levels are low. Oral contraceptives that contain estrogen compounds, and pregnancy can stimulate the growth of these tumors. (I have seen pregnant women who looked as if they were carrying twins when, in fact, one mass was a fibroid.) There also might be a predisposition based upon genetics.
The sizes of fibroids vary from microscopic to ones that takes up the entire abdominal cavity. Fibroids affect nearly 20 percent of women over the age of 20 and approximately 40 percent of women 35 to 45 years of age. In the United States, Asian-American and African-American women are two to five times more likely than Caucasian women to have them.
There are several different types of uterine fibroid tumors based upon their location within the pelvis:
The diagnosis of fibroids usually is made when the provider palpates a mass during a routine gynecological exam. An ultrasound confirms the diagnosis and determines the type of fibroid.
When a client with a confirmed fibroid comes for a massage, it is important to avoid massaging the abdomen with any deep strokes. If any type of pressure causes pain, the abdominal massage should be stopped. Client positioning also is determined by comfort level. If prone positioning is uncomfortable, position her side-lying with a pillow under her neck and others placed between her knees.
Women have many options to treat uterine fibroids. The most extreme is a hysterectomy to remove the uterus. Only about 10 percent to 20 percent of fibroids require surgery. While it is certainly an effective way to remove the fibroids that have been causing pain, it puts women into an immediate surgical menopause if the ovaries also are removed and, like any surgical procedure, has many risks. An incision is made in the lower abdomen, although it can sometimes be performed vaginally. Recovery from this major surgery can take as long as six weeks.
A less invasive treatment is a procedure known as myomectomy. During this surgery, which may be done as an outpatient procedure depending on the number, size and location of the fibroids, the uterus is left intact. If an abdominal incision is made, the recovery takes as long as a hysterectomy. It may be performed using a laparoscope - lighted surgical tubes inserted near the navel - or through the vagina with a hysteroscope.
Rather than going under the knife, some women opt for embolization of the fibroids. This nonsurgical procedure cuts off the blood supply to the fibroids, which effectively shrinks them, although they don't necessarily disappear. A catheter is inserted through the patient's femoral artery and gently moved to each affected uterine artery. Tiny pellets are inserted through the catheter which blocks the blood supply. A woman must remain in the hospital for a day or two and is able to resume normal activities within the week. Embolization studies have found an 85 percent to 95 percent reduction in fibroid symptoms, while not actually eliminating them.
Prior to undergoing any type of surgery or medical procedure, women might opt for acupuncture, with or without herbal remedies, to treat their fibroids. The first mention of uterine fibroids in traditional Chinese medicine was in the Ling Shu (ca. 100 BC), which described them as "stony tumors." Chinese medicine categorizes fibroid tumors as zheng xia, or "masses in the uterus with a feeling of pain, swelling or fullness, and with bleeding in severe cases." TCM recognizes three patterns of uterine fibroids and treats them accordingly: qi stagnation and blood stasis; yin deficiency and empty-fire blazing; and liver qi stagnation and spleen deficiency. Once the appropriate pattern has been determined, acupuncture and specific herbs are provided. TCM is very effective in reducing or eliminating many types of uterine fibroids, especially if they are caught early.
Pharmaceutical drugs also can be taken to reduce the size of these fibroids and control the bleeding they often cause. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken alone or with the addition of progesterone. A synthetic form of gonadotropin-releasing hormone (Lupron) controls the supply of estrogen and progesterone, which causes the fibroids to decrease in size. However, its use is limited because long-term use contributes to osteoporosis and once a woman stops taking Lupron, the fibroids grow back. It is more effective when used prior to a myomectomy to shrink the tumors and make the surgery easier.
A cutting-edge procedure (which is not necessarily covered by insurance) is an MRI-guided ultrasound. High-intensity ultrasound is directed at the fibroids, heating them and breaking down their outer walls. The procedure takes a few hours and the patient has to remain in a prone position in an MRI machine with her head outside of the machine and her abdomen submerged in a pool of water. Risk factors include burns and nerve damage, and the effects of this intensive ultrasound on future pregnancies have not been determined.
Uterine fibroids are not life-threatening growths, but the symptoms they cause can have a major impact on a woman's quality of life. Thankfully, there are many options available today, and women can make their decisions based upon their own needs.
Click here for previous articles by Elaine Stillerman, LMT.
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