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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
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.
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).
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.
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.
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.
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?'
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.
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.
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.
April, 2010, Vol. 10, Issue 04
Pain Caused By Low Back Ligaments
By Ben Benjamin, PhD
Q: An injured sacrotuberous ligament can cause pain down the back of the leg. True or false?
A: True. This is its referred pain pattern. The sacrotuberous ligament is a thin, fan-shaped structure that runs obliquely downward from the posterior-superior and posterior-inferior iliac lines and the lateral margins of the sacrum and coccyx, inserting on the ischial tuberosity of the pelvis (the bone you sit on). (Figure 1)
Each structure in the low back has a specific referred pain pattern associated with it (Figure 2). For example, the sacroiliac ligaments generally refer pain straight across the lowest portion of the back. The ilio-lumbar ligament refers pain on one side of the low back across the top of the ilium, the lateral hip, and the groin area. The sacrotuberous ligament has a distinctive pattern. It refers pain down the central portion of the back thigh, and if more severe, down the central portion of the calf into the heel. This injury is frequently confused with a hamstring injury when the pain is felt only in the lower buttock and down the back of the thigh.
There are a few easy steps to check whether this type of pain is originating in the hamstring or in the sacrotuberous ligament. First, have the person bend forward with the knees straight. Note the pattern of pain. Pain down the back of the thigh can be caused by either structure, but only the sacrotuberous ligament refers pain into the calf.
Now, have the client lie down and hold the knee at a 90° angle. Ask them to pull the heel toward the buttock as hard as they can while you resist with equal force (Figure 3). If this test is painful in the hamstring region, you know there is a hamstring injury, because resisted tests place stress on muscles and tendons, not on ligaments.
If you suspect an injury to the sacrotuberous ligament, a final step in assessment is direct palpation. Injury to this structure usually occurs at the lateral margins of the sacrum, rather than the attachment to the ischial tuberosity. You can access the ligament with the client lying prone, but it is more easily accessible with a client in a side-lying position with the knees drawn up.
Click here for more information about Ben Benjamin, PhD.
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