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Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
April, 2012, Vol. 12, Issue 04
Treatment Decisions for Peripheral Neuropathy
By Rita Woods, LMT
First, the physiology and chain of events involved in a glucose-related neuropathy, as with diabetes, is more clearly understood than in some other neuropathies. This makes it easy to see how and why the protocol can be effective. Second, we know from experience that chemotherapy-induced peripheral neuropathy responds well to the massage protocol and is used today in some oncology massage clinics. Both of these conditions require that the underlying cause be eliminated for complete recovery. The glucose levels must be stable to prevent further damage and the chemotherapy must be completed or changed to achieve optimal results. Our work is to return the tissue back to normal (as much as is possible) through increased circulation and the condition will improve or go away. Peripheral neuropathies (PN) come with a variety of causes and in some cases, the cause is not known. Let's take a look at some of them.
About 30% of all PNs are a direct result of diabetes. Another 30% are considered idiopathic, meaning the cause is unknown. The rest fall into several groups and are either acquired (most of them are) or inherited. Presently, there are more than 100 known causes of peripheral neuropathy. The Mayo Clinic provides this list of known causes:
What I found missing from this list was that some medications are known to cause PN in some patients. In particular are the statins – cholesterol lowering drugs. This prompts me to remind you to get a complete medical history that includes a list of medication. Drugs are easy to look up online in order to identify possible side effects. (Please review two articles on this subject, "Chasing the Pain" from the October 2010 and February 2011 issues of Massage Today). To see how this happens, let's remember that a nerve is surrounded by a myelin sheath. Myelin is an insulating layer that forms around nerves and is made up of protein and fatty substances including cholesterol. The purpose of the myelin sheath is to allow impulses to transmit quickly and efficiently along the nerve cells. If myelin is damaged, for whatever reason, the impulses slow down or send imperfect signals that can be interrupted as pain. Stain drugs are developed to reduce cholesterol and in some patients, it prevents the myelin sheath from repairing itself. This reduces its ability to protect the nerve resulting in pain, tingling and numbness of the nerves. This can also affect nerves to internal organs. Do you see how our ability to help that client may be limited because the neuropathy is caused by nerve damage and is not the result of blocked or impaired circulation?
The neuropathies caused by physical trauma or pressure on nerves is really our area of expertise and an area in which can have a positive impact on the client. Repetitive stress often leads to entrapment neuropathies, a special category of compression injury. Cumulative damage can result from repetitive, forceful, awkward activities that require flexing of any group of joints for prolonged periods. The resulting irritation may cause ligaments, tendons and muscles to become inflamed and swollen, constricting the narrow passageways through which some nerves pass. Carpal tunnel syndrome is a good example of this kind of neuropathy. Remember to think it through. If the underlying cause falls within our scope of practice, then you may be able to have a positive outcome. If not, give what supportive care you can but be careful not to give false hope to the client. Help them to understand their condition and develop a treatment plan that you will both be happy with.
Click here for previous articles by Rita Woods, LMT.
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