resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
July, 2010, Vol. 10, Issue 07
Osteoporosis: Another Insidiously Silent Progression
By Dale G. Alexander, LMT, MA, PhD
At the age of 83, my mother died on July 25, 2009, five days after fracturing her left hip. Her silent progression of osteoporosis had shown itself many years before, but I failed to fully comprehend its true implications.This series is dedicated to the memory of Shirley M. Lloyd. Her life has provided me with many significant lessons and has served as a case study for me to write about the subject.
To my sensibilities, our role as massage therapists is to educate our clients and to refer them for medical testing when their physical histories or chronic somatic problems indicate it. It is my intention to offer our profession the perspective and information that would have helped me to be a more effective health advocate. And, to further explore how normal age-related bone loss may progress into what is called osteopenia (bone thinning) and then into osteoporosis (porous bone). This progression is considered silent because we do not feel the weakening of our skeleton.1
After six months of research into this subject, I am unable to offer any definitive answers. Yet, there are markers of the progression for us as massage therapists to consider. There exists a broad continuum of opinion of how to prevent, treat, and/or how one might stabilize or reverse this progression.
As we age, our ability to absorb nutrients becomes less efficient, the bone remodeling process (breaking down old bone and building new bone) slows down. Other health-related difficulties, associated medical procedures and lifestyle choices can influence the speed of this progression. The reasons for these changes are many and certainly include genetic predisposition.
In fact, one of the questions to ask clients over age 50 and especially those dealing with chronic somatic difficulties is whether their parents experienced any bone fractures and whether their posture became stooped forward and lost height as they aged. The postural decline was true of my mother's mother. Also, it is important to inquire with your clients as to whether they have had any bone fractures.
Fractures are the most severe complication to the progression of osteoporosis. Then, for some, as was the case for my mother's hip fracture, it heralds the beginning of a slide toward the end of their life. According to the National Osteoporosis Foundation (NOF): "Hip fractures result in 10 to 20 percent excess mortality within one year. Approximately 20 percent of hip fracture patients require long-term nursing care, and only 40 percent regain their pre-fracture level of independence."2
The most common osteoporosis related fractures tend to occur at the wrists, within the thoracic or lumbar vertebrae (commonly referred to as compression fractures) or, as fractures of the pelvis and/or the femoral neck. Other fracture sites are of the ribs, the ankle and the foot. These are especially correlated if the fractures occur after the age of 50 and the intensity of the trauma seems unlikely to have induced a broken bone.1
My mother's trauma history is as follows: At age 71, she fractured her wrist and left foot in a fall; at 79, she fractured her left ankle and foot in another fall; at 81, she experienced a T7/8 compression fracture while bending over; and finally, at 83, she experienced an inter-trochanteric fracture (the base of the femoral neck) in a lateral fall to her left side.
I assure you that you are currently working with clients over the age of 50 and some even younger who are affected by this insidiously silent progression of osteoporosis. According to NOF, more than 10 million Americans have osteoporosis (about 2 million men and 8 million women) and an additional 33.6 million have low bone density of the hip.
As the demographics of our aging population increases, there will be more who come to you with this as an underlying difficulty in their somatic profile. "The Surgeon General estimates that the number of hip fractures and their associated costs could double or triple by the year 2040."2
Very often clients come to us seeking to relieve their pain and to improve their function, yet have little or no understanding of how these somatic complaints may reflect the subtle physiological degradation of their skeleton or, other degenerative progressions.
It is with some humility and humor that I share that Shirley only tolerated my more holistic orientation to preventative care. She was a fiercely independent person who, like many in her generation, did mostly what her physician(s) told her to do. She had taken the hormonal replacement therapy during her post-menopausal years until that was officially deemed risky, then was given Fosomax after her bone mineral density (BMD) test showed that her bone density was declining. Not unlike many who have taken such medications, she developed esophageal and gastritis difficulties for which proton pump inhibitors were prescribed. The functioning of the osteoblasts (the cells in the bone remodeling process which build new bone) depend on the proton pumps to do their job.3
Gillian Sanson, author of The Myth of Osteoporosis,4 states that most individuals who do experience osteoporotic-related fractures do not die of this as a primary cause if they are otherwise healthy. Shirley's health was compromised at the time of her death. Her gall bladder was removed in her early 40s which resulted in severe scar tissue formation. She had been diagnosed with COPD in 1999 and with cirrhosis of the liver in 2004. These and other health challenges, the medications to manage them and surgeries are considered to be secondary causes, which accelerate the progression of osteoporosis.1
The three most common lifestyle factors associated with the progression of bone loss are lack of exercise, smoking, and drinking alcohol. Yes, Shirley did smoke cigarettes and did drink alcohol for most of her adult life. (Food, or the lack of, and its possible contribution will be addressed in a future article.)
In short, Shirley's stooped posture, thinness, additional health problems and being a female reflect a poster-child picture of someone at risk for a severe osteoporotic related fracture.
Encourage your clients who show indications of bone loss, as discussed, to request their physician to do a complete review of their medical history. Next, we will discuss the bone remodeling process and will touch on the sea of controversy surrounding what we may do to prevent the onset of osteoporosis.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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