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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).
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.
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.
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.
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).
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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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%.
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.
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.
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.
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.
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.
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.
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.
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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