resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
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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