Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
February, 2012, Vol. 12, Issue 02
Positional Release Self Care for Soreness and Other Pains
By Leon Chaitow, ND, DO
If your patients are anything like mine, they will report to you that there is commonly a degree of discomfort, soreness or stiffness a day or so following manual treatment no matter how gentle or appropriate that treatment might have been.As a result, I offer advice regarding home care of such problems, and I tend to repeat a mantra to most patients who have received treatment for musculoskeletal problems as they depart. I ask them to largely ignore any soreness they might feel the next day. I tell them that it is perfectly normal for there to be an adaptive reaction/response to treatment for a day or so of their knee, neck, or whatever focal point of distress brought them to see me and that it will probably not be until around 48 hours later that they will know whether today's treatment was helpful.
And of course, if your patient happens to have a chronically painful problem, it's highly likely that a degree of sensitization will have occurred, making their responses and reactions to treatment far less predictable and potentially excessive. For more on that subject please see my May 2011 article, "Understanding Central Sensitization"
How common are short-term adverse effects following manual therapy? Bronfort et al (2010), conducted a major review of the effectiveness of manual therapies and it also looked at negative effects: "Adverse events associated with manual treatment can be classified into two categories: 1) benign, minor or non-serious and 2) serious. Generally, those that are benign are transient, mild to moderate in intensity, have little effect on activities, and are short lasting. Most commonly, these involve pain or discomfort to the musculoskeletal system. Less commonly, nausea, dizziness or tiredness are reported."
Carnes et al (2010), also conducted a detailed review of the evidence relating to the safety and side-effects following use of manual therapy modalities and concluded that: "Nearly half of patients after manual therapy experience adverse events that are short-lived and minor; most will occur within 24 hours and resolve within 72 hours. The risk of major adverse events is very low, lower than that from taking medication."
Even in relation to muscle energy technique (MET), one of my favorite modalities because of its extreme versatile efficacy, gentleness and safety, there are commonly minor degrees of discomfort for a day or two following treatment, even when appropriately applied. Greenman (2003) has explained some of the processes leading to post-MET-treatment discomfort: "All muscle contractions influence surrounding fascia, connective tissue ground substance and interstitial fluids, and alter muscle physiology by reflex mechanisms. Fascial length and tone is altered by muscle contraction... The patient's muscle effort requires energy and the metabolic process of muscle contraction results in carbon dioxide, lactic acid and other metabolic waste products that must be transported and metabolized. It is for this reason that the patient will frequently experience some increase in muscle soreness within the first 12 to 36 hours following MET treatment. Muscle energy procedures provide safety for the patient since the activating force is intrinsic and the dosage can easily be controlled by the patient, but it must be remembered that this comes at a price. It is easy for the inexperienced practitioner to overdo these procedures and in essence to overdose the patient."
In other words, when correctly applied, MET will commonly lead to mild discomfort for several days, BUT, when incorrectly applied (contractions too strong, stretching too vigorous, etc.) more severe reactions may result and without the bonus of benefits that correct usage might offer! For more on muscle energy techniques, you can visit my web site, www.leonchaitow.com/muscle.htm.
Are there strategies that you might be able to teach patients to manage this adaptive stage? What else might you offer your patients as self-care for minor reactions to treatment? Depending on the specifics of the individual's problems, a number of options are available, ranging from simple hydrotherapy (hot and cold compresses, ice massage) to relaxation methods, self-stretching (if appropriate) and from my perspective the most potent self-care we can teach patients in pain is self-applied positional release.
Derived from osteopathy, Positional Release Technique (PRT), or that version of it known as Strain-Counterstrain (SCS), can relieve pain by relaxing tight (shortened) tissues and improving local circulation. Unlike massage and stretching, PRT is safe to apply even on damaged or inflamed tissues. If painfully shortened (hypertonic) soft tissues can be gently placed into a position in which they are made even shorter, pain is usually temporarily removed. If that "position of ease" is maintained for a minute or so, the tight, tense muscle (and often trigger points housed there) are likely to release and relax, sometimes permanently, but at least for a while with pain diminishing subsequently.
Try the following exercise, self-treatment of tense suboccipital muscles, and consider teaching it to patients as an example of this remarkable method of self-care. This is adapted from Chapter 5 of my book, Positional Release Techniques.
Patient instructions for suboccipital self-treatment using SCS:
General Guidelines For SCS Self-Care Of Pain Anywhere Else
If a painful point/local area is on the front of the body, bend forward to relieve it; the further it is to one side, the more you should slowly turn toward that side. If the point is on the back of your body, bend slightly backward until the pain reduces a little, then turn away from the side where you feel the pain, and "fine-tune" to release the discomfort. If the point is on a limb, try to shorten the relevant muscles (don't stretch them) by slowly moving the area to find the position in which the pain is most reduced. When there are many areas of pain it is often best to start with those nearer the head and nearer the middle of the body, using this extremely noninvasive and effective form of treatment.
Click here for more information about Leon Chaitow, ND, DO.
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