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Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
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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