Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Breath: The Movement of Oxygen and Energy
I remember with surprising clarity the first time a patient started crying during an acupuncture treatment I was giving. This is now quite a long time ago, back in 1999, when I was a student.
How One Little Symbol (#) Gets You More Patients
Are you struggling to get more fans or followers for your acupuncture practice? Or are looking for ways to simply connect with your patients? Or do you just want to know how to keep them engaged (comments, retweeting, liking and sharing)?
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
The Source-Luo Point Combination
The luo collaterals are part of the acupuncture channel system presented in the Su Wen and the Ling Shu (The Nei Jing). The function and clinical application of the luo mai are primarily presented in chapter 10 of the Ling Shu, however, they are also found in others chapters in the Su Wen and the Ling Shu.
Use Technology to Gain New Patients and Improve Efficiency
From the smartphone in your pocket to your microwave oven, advancements in technology have made almost every aspect of our lives easier.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
The Nectar of Plants: Essential Oils and Chinese Medicine
Essential oils are a very hot topic these days, especially with the likes of the Ebola virus and the resurgence of measles lurking in our awareness, but when I first became interested in Chinese medicine, essential oils weren't on the radar screen for acupuncturists.
What Does Success Mean to You?
Recently, I was asked to speak to young, budding businesswomen about running a successful business — and at first I thought, "Me? You want me to speak to others about success?!"
TMF 2015 Scholarships
The Trudy McAlister Foundation (TMF), a nonprofit organization established to support students who are on track to make contributions either to clinical practice and/or to the understanding of the role of Traditional Oriental Medicine, has announced the 2015 scholarship recipients.
Marijuana, Apathy and Chinese Medicine, Part 2
A talented young woman presented herself with emotional mood swings, which included being nervous, anxious and jittery.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients, in May 2014, researchers showed that drinking the equivalent of 2 to 4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Acupuncture in the U.K. Today: A Personal View
When asked to write a short piece on the current state of the U.K. acupuncture profession, my first response was to say it has all been relatively quiet.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
The Modern Acupuncturist
You studied ancient Chinese medicine, but I'll bet you don't practice it! Contrary to popular belief, our medicine has evolved A LOT over the years. Let's take a brief walk through history and discover the differences between ancient and modern acupuncturists.
Calculating Billable Units
I recently learned of an office that was audited based on the number of acupuncture sessions performed in one day. Is there a maximum number of sessions that can be performed in one day?
The Year to Make Things Happen
It is hard to believe that the Year of the Ram – 2015 is half over. Time seems to be moving especially fast. This is the year for things to happen for the acupuncture profession.
Acupuncture and the Pulse
In 1991, I attended a martial arts workshop hosted coincidentally by Sung Baek, a martial artist and the head of his lineage as a Korean trained acupuncturist. I was enamored by the details Sung could attain from the pulse, as told to me by some of his apprentices.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
February, 2012, Vol. 12, Issue 02
Dealing with Fibromyalgia
By Stuart Taws
It is estimated that between two to four percent of the population are now suffering from fibromyalgia, including Irritable Bowel Syndrome and TMJ. Perhaps our massage school education did not include how to successfully deal with fibromyalgia.Massage therapists often express a lack of confidence, some fear and anxiety along with the lack of a clear program for how to go forward and help their clients diagnosed with fibromyalgia.
In 1990, the American College of Rheumatology (ACR) established the definition of chronic widespread pain and the 11 of 18 tender point test to diagnose this "mystery illness." Interestingly, for most people, these points are naturally a little tender. This protocol has proved to be somewhat of a tragedy. A male MD "prodding" a female in pain looking for tender points then announcing that she has fibromyalgia has a negative downside. Once a medical practitioner determines that you have a certain condition and names it, then you get to keep it. You become like Alice in Wonderland going down the "Rabbit Hole" of a series of elaborate and sophisticated medical tests. The results confirm your symptoms and perhaps your worst fears, but along with the diagnosis there is no forward looking answer to your pain free recovery. Please note: the ACR 11-18 tender point protocol was for study criteria only and was never meant to be used as a diagnostic tool.
After decades of research, there is still no satisfactory answer by the medical profession for chronic pain syndromes. You receive prescriptions for painkillers, sleeping medication and anti-depressants. These deal with symptoms, not the cause of the condition.
When you're in pain for many years, you change physiologically. In one study by the University of California, they found that persistent stress shortened the length of the telomeres in the DNA. If stress can affect your very DNA, imagine what it can do to your sensitive molecules. Stress changes you at a molecular level. When you are in pain, life changes and you change. All the happiness of life has been put into the mortar and pestle of life, crushed like chaff and blown into the wind of despair. Sleep is continually disturbed so the REM phase, where all emotional stresses of the day are processed keeping mental health and stability, is rarely achieved.
In 1997, F. Wolf (University of Minnesota) published an article looking at some of the data collected in population-based studies. He found "that the number of tender points an individual has is highly correlated with the number of measures of distress. High threshold tender points are a sedimentation rate for distress."
In the mechanism of pain, it is observed that after injury the nervous system can delay it's response to that injury by a day, week or a month. When a person is diagnosed with cancer, the oncologist often asks what happened in their lives two years previously. When you ask a similar question of your fibromyagia clients, surprisingly I have found there was a serious illness or a vehicle accident, death in the family or a bitter divorce and custody battle over the children, all within the last two years. As the manifestation of pain is delayed, the connection is not made and falls into the mystery illness category.
"Information regarding pain is immediately transmitted from the injured tissue to the cerebral cortex," according to Dr. Linda Sorkin. Notice that pain quickly becomes a matter of the higher centers. She continues, "The peptides and injury products activate the pain fibers, sensitize and excite the nociceptors. There 'silent nociceptors' that signal well after tissue damage and that inhibition of this activity diminishes the perception of pain. There are spinal cord sensory cells, that when activated by injury refers pain to portions of the body that share these neurons, or cell cross talk. These fibers release glutamate and peptides from their central terminals and this biochemical cascade magnifies and enhances the response, becomes triggered into a long lasting spinal sensitization and the resulting hyper sensitization to pain even spills over into un-injured tissue."
This biomechanical cascade throughout the body over a period of developing hyper-sensitivity means you can have sites of pain all over where there is no injury. This understanding is vital. Similar to many MD's, some massage therapists fall into the trap of being judgmental, supposing their clients are somewhat neurotic and using an imaginary pain as a secondary benefit in life. You must always believe everything they tell you. "When they tell you the pain is real, it is real," said Dr. Daniel Clauw, Professor of Rheumatology and the director of the University of Michigan Chronic Pain and Fatigue Research Center, is the country's leading expert on Fibromyalgia and the author of many studies. "In people without pain, these structures encode pain sensations normally. In people with fibromyalgia, the neural activity is increased."
"It is time for us to move past the rhetoric about whether these conditions are real, and take these patients seriously as we endeavor to learn more about the causes and most effective treatments for these disorders," said Richard Harris, a Research Investigator.
These studies indicate that fibromyalgia patients have abnormalities within their central brain structures. Clauw states, "this is a diffuse, central problem with pain processing, a problem with the way people are processing pain or sensory information." Pain, he says, "is a miscommunication between the brain and the spine. It's as though someone has increased their volume control center, turning the volume up."
How do we use this information? The brain, spinal cord and the CNS are described as listening systems. The new neuro-sciences when referring to the brain and CNS use the expression plasticity. They are not fixed but are plastic; the input from the extremities can be changed. We do this by giving the listening systems new information and changing the direction of the input back into the higher centers. This remodels how the brain and CNS modify how they process pain.
The handmaidens of chronic pain syndromes are fear, anxiety and underlying anger. Pain in itself is harmless.
It is how the brain and CNS process and respond to perceived injury insult that cause the alarm. There is not the software to do an MRI, CAT scan, PET scan and X-Ray of the sensitive nervous system. The sensitive nervous system has gone off like a fire alarm, every fire department in the region has been mobilized, lights flashing, loud sirens piercing the night, and guess what, there is no fire! I tell the client that rightly or wrongly their "silent alarm has been tripped" and their brain and CNS believes they are under attack. They only response the body has to protect them is the inflammation response with the end result of pain.
Now here comes the tricky part, especially for a male therapist talking to women in pain. I compliment them on being so sensitive, as the truly caring and compassionate souls of this world often end up in pain. I try to change the context of the pain from not being some sort of divine punishment, but rather an unfortunate random reaction to a very stressful world. If your intention is good and kind, that shines through. When you carefully and gently suggest there is nothing physically wrong with them, rather they have a lovely kind friend deep inside trying so hard to help them, maybe too hard, they seem to accept that. Not only are you the only one that has patiently listened to them, but you also are the only one that is actually going to gently touch them for an hour, a rarity in the medical profession.
Listen to your client; but you must have a specific program in mind. If this is done seamlessly, moving back to the original site of pain briefly, there is not the time for the client to work out what you are doing, so there is a certain amount of distraction. I really like a side lying position with the client at the very end of the table. This is not working on soft tissue only; my intention is to dramatically change the input into the CNS. If you get the nervous system on your side first, then any therapy you use will be infinitely more successful.
Remember, during all this time you are talking to the sensitive nervous systems, re-assuring these delicate systems they are safe and secure and to desist in their protective mode. That is what getting the nervous system on your side first means. This is the most important part of any treatment.
Stuart Taws is a Sports Rehabilitation Therapist originally from England, now living in California. Stuart is the developer of Soft Tissue Release - the Taws Technique. For 20 years he has been teaching through Massage Schools and Weekend Workshops. For more information, visit www.softtissuerelease.com or
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