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News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
February, 2012, Vol. 12, Issue 02
A Massage Protocol for Peripheral Neuropathy
By Rita Woods, LMT
My last article in the October 2011 issue focused on diabetic peripheral neuropathy and I want to stress the importance of reviewing that information before proceeding on to this protocol. This protocol is only successful when you have full client participation and when you understand the clinical significance and importance of this potentially devastating condition.
Under treating or failing to engage the client in their own treatment can render this protocol useless. This is a protocol that requires 100% participation and commitment from the therapist and client.
While my focus has been on diabetic peripheral neuropathy, is important to note that this protocol also works for chemotherapy-induced peripheral neuropathy (CIPN). Some chemotherapy agents cause peripheral neuropathy that is so disturbing and painful to the patient that they consider stopping their chemotherapy treatment. Because that is not a viable option, oncologists will sometimes adapt the chemotherapy treatment in hopes of lessening or preventing the neuropathy.
Let's revisit some pathophysiology of peripheral neuropathy as stated in my first article, "distal circulation is compromised and the blood vessels themselves become occluded beginning with the small capillaries. Unable to supply the surrounding tissue and nerves with nutrients and oxygen the resulting oxidative debt ... causes nerves to malfunction sending signals to the brain of pain, tingling, burning and numbness." And now let's recall one of the chief benefits of massage: increased circulation.
This peripheral neuropathy massage protocol can be painful to the client so care must be taken to work to the client's tolerance in each session. That being said, however, it's important to bear in mind that the ultimate goal is to gradually increase pressure so that eventually you are working tissue "to the bone." Naturally, this is a process. It may be that in the first few sessions all you can do is touch their feet. Remember, you're looking at a long-term relationship with the client so don't rush as the process can take months, depending on the severity of the neuropathy and the cooperation of your client.
Daily, detailed self-care is essential in order to improve or reverse the tissue damaged caused by peripheral neuropathy. The suggested client homework is as follows: Spend 15 minutes each day on each foot. Lightly massage both feet as deeply as you can without causing pain.
Perform full range of motion exercises at your ankles. A fun way to do this is to "write out" the alphabet using your ankle joints and toes. Grasp each toe at the tip in massage and squeeze as deeply as you can without causing pain. Work the entire toe from the tip to the base on both feet.
Deeply stroke the skin of both feet moving in an upward direction toward your knee. Next squeeze and massage all of the tissue of your feet starting between the toes, include the front and back surfaces of your feet. Squeeze, press and massage the entire foot as deeply as you can without causing pain.
Stroke the skin of both feet from your toes to your knees once again moving in the direction towards the knees. Massage the calves then repeat the range of motion exercises at your ankles.
Whenever possible, throughout the day, take off your shoes and rub your feet on the floor, bend and wiggle your toes, roll a tennis ball under the sole of your bare feet, perform your range of motion exercises and massage her feet deeply.
Sixty-minute massage therapy sessions should be performed by a massage therapist once a week for the duration of the symptoms along with the client "homework" outlined above. Remember that infrequent, non-detailed therapy is ineffective and the main goal is consistent, daily, deep work.
For therapists who are also reflexologists, this protocol can be a nice addition to your service. For anyone interested in learning a detailed reflexology protocol that lends itself well to this peripheral neuropathy work, contact me about for more information. You'll find that combining these two therapies is a formula for success.
Editor's Note: For additional information, see Step-By-Step Massage Therapy Protocols for Common Conditions by Charlotte Michael Versagi with contributions by Rita D. Woods. Published by Lippincott Williams & Wilkins, 2011. To find this book and more on medical protocols, visit www.darienlourde.com.
Click here for more information about Rita Woods, LMT.
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