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It's About the Word
The new patient was already a fan of chiropractic. "I liked the guy a lot," he said of the previous DC he had consulted. "But he is on the other side of town, and I just can't get there after work. So he sent me to you, since you're his buddy."
We Get Letters & E-Mail
The "Great Opportunity" for Chiropractic: Expanded Scope of Practice; The SOAP Note: An Effective Tool for Documentation; Treating Patients Goes Beyond Following Established Protocol.
Weaving Eastern & Western Medicine Together: Q&A with Beijing's Dr. Kezhen Zhang
Dr. Kezhen Zhang M.D., is currently the founder and president of Beijing Taijitang Traditional Chinese Medicine Hospital.
The Physiology of Anger
Most of us recognize and have felt anger at some point in our lives. Anger can be seen as a natural response to some kind of pain, whether emotional or physical.
A Medication Primer for Alternative Health Care Practitioners (Part 2)
Morphine is arguably the greatest drug of all time, at least in the sense that it is so powerful in relieving pain.
Dry Needling is Acupuncture: But What of Education? What of Public Safety?
One of my patients told me recently, that their physical therapist used a "dry needle" and that it wasn't acupuncture. Apparently, physical therapists (PT) are taught to tell their patients that "only acupuncturists practice acupuncture."
Becoming a Concussion Expert in Your Community: What You Need to Know (Part 2)
What makes an individual an expert in concussions? Obtaining education about concussions and treating concussed patients are two factors that lead to expertise.
Chiropractic Care for Veterans: Serving Those Who Served (Pt. 2)
To what extent do you think the role of chiropractors in the VA can serve as a model for greater chiropractic integration elsewhere in the American health care system? That's a very important question.
News in Brief
In Remembrance: A Moment of Silence for Robin McKenzie (1931-2013); DC Re-Elected to Co-Chair AMA Code Review Board; WFC Celebrates 25 Years.
Keeping Up With Western Medicine Advancements: The Amazing World of Imaging Studies
When patients with neuromuscular problems come to you for treatment there is usually a lot you can do for them to improve their mobility or reduce their pain, whether it is a middle age woman with a frozen shoulder.
Beauty is Averageness
After seeing Kim Kardashian's face all over the Internet -and my inbox- following her posting on getting facial acupuncture, I recalled the work of Michael Cunningham who was at the University of Louisville when I was doing my doctoral work.
Obesity is a Shen Problem
The expressions "obese" and "obesity" are not pejorative terms. They are scientific terms, determined solely by the Body Mass Index scale, which combines a person's height and weight in a mathematical formula. A number of 30 and above denotes "obesity."
Study: Acupuncture for Acute Low Back Pain More Effective Than Drugs
New research by Korean doctors of Oriental Medicine suggested that an acupuncture method could reduce acute lower back pain faster and more effectively than conventional drug injections.
Protein and Weight Loss
Recently I was asked by the staff at Dynamic Chiropractic to referee some of their water-cooler discussions regarding nutrition. Topping their list was this one about protein and weight loss: "Why is protein important for weight loss and how much should I eat?"
If you visit the website of the JAMA and search on the word chiropractic, more than 200 results appear. If you sort that list chronologically and look at the oldest entry, you will find "Medical News" that includes the following.
Three Essential Herbal Products For Your First-Aid Kit
There are three Chinese patent medicines that belong in everyone's first aid kit. All three are for topical application, and all three provide extraordinary benefits unavailable from any domestic over-the-counter.
Healing the Qi: The Boston Marathon Bombing
On Monday, April 15 2013, locals and visitors from around the globe gathered for the world's largest marathon in the city of Boston. With 23,000 participating in the race and many more on the sidelines, the marathon represents a Boston institution.
Lateral Femoral Cutaneous Nerve Entrapments
The lateral femoral cutaneous nerve arises from the 2nd and 3rd lumbar nerves. It is formed in the psoas muscle and emerges from its lateral border to cross the iliacus muscle and exit the pelvis.
10 Life Lessons That Will Change the Way You Practice
"What would you do if you knew you couldn't fail?" I have posed this question for years to groups I've spoken to across the country and around the world.
Maintaining Professional Boundaries in a Facebook World: Social Media Guidelines for DCs
A few months ago, I received an unexpected message on my Facebook account: "Hi Doc, do you remember me? I'm so happy to find you here on Facebook. It's been years since I have seen you and I'm glad to reconnect with you.
Pre-Conception Wellness: What Do Your Patients Need to Know?
Deciding to have a baby is one of the most important decisions a woman will ever make. But how many women are really prepared for a healthy pregnancy?
The Monkey on Your Back
Many practitioners run their clinic without any extra help—at least initially. I've always been pretty good at multi-tasking. Having nine kids taught me how to wear multiple hats and juggle a lot of responsibilities. Running a clinic is similar.
A Solution for the Primary Care Crisis?
A white paper generated by the ACCAHC Primary Care Project and UCLA Center for Health Policy Research Senior Research Scientist, Michael Goldstein, PhD, addresses a clear oversight noted in recent workforce analyses designed to assess the nation's primary care needs.
Extraordinary Vessels and Emotional Healing
In addition to the 12 primary Organ-related meridians in the body, there are other energy circulation channels that have been mapped out by Traditional Chinese Medicine. Probably the most significant of these are called the Eight Extraordinary (or Extra) Vessels.
Treating Rib Joints to Protect Thoracic Stability
It is an exciting world that awaits us when we go to work every day. We deal with all types of people who present with varying health conditions we can (hopefully) help alleviate.
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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