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Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
June, 2013, Vol. 13, Issue 06
Key Nutrients for Maintaining Musculoskeletal Health
By Christopher Oswald, DC, CNS
As a chiropractor, I fully appreciate the amazing potential of manual therapy. Whether that therapy is a chiropractic adjustment, therapeutic massage, or some of the many other effective body work options; people generally have a wonderful response.From time to time though, we all run into an individual who doesn’t respond to our therapy as we would expect. This can be very frustrating as you are providing something to them that you know should be making a big difference, but for some odd reason they just don’t respond and they may think that massage or body work is just not the right option.
In my clinical experience, I have come to realize is that these "non-responders" are the people who need the most help, but the problem is that their body is so malnourished, there is no support for the underlying biochemistry to respond to the exact therapy they need. When their bodies are supported with appropriate nutritional supplementation, the newfound results are, at times, amazing. Think about this for your own health as well.
Nutritional support for musculoskeletal health may target many physiologic functions due to the multifactorial nature of pain, inflammation and tissue abnormality underlying musculoskeletal conditions. Sometimes, optimal support focuses on addressing a unique factor involved in someone’s disease, such as chronic inflammation underpinning rheumatoid arthritis or providing targeted nutrition for joints affected by arthritis. For this article, I will be focusing on a more general approach to musculoskeletal health support that can be beneficial to the majority of your massage clients.
One of the first concepts to consider is generalized support of the tissues. Within my practice, I have noticed that without base nutrition people cannot respond to the more specific therapies. Through the proper application of a high quality multi-vitamin mineral complex, it can be nearly assured that your client will be receiving the proper base nutrition to have an appropriate response to any manual therapies you perform.
Fish oil is another general recommendation that will benefit most of your clients. While research has shown a myriad of positive health benefits, there have also been some fairly specific benefits to overall musculoskeletal health. In regards to fish oils being beneficial for musculoskeletal health, many people understand that they promote an anti-inflammatory effect within the body, but do you really know why and how effective they can be? A study in the Journal of Nutritional Biochemistry from 2010, discusses the endocannabinoid signaling system and its role in musculoskeletal health and osteopenia. This system is activated and suppressed by the balance between omega-6 and omega-3 fatty acids. The standard American diet (SAD) today is extraordinarily high in harmful omega-6 fatty acids and is almost devoid of the healthy omega-3 fatty acids (which are primarily found in fish oil, but can also be found in cod liver oil, krill oil, flax and others). This system has been found to be more active under the presence of high levels of arachidonic acid (omega-6), which will ultimately result in muscle atrophy and osteopenia. The researchers found that when omega-3 and omega-6 fatty acids are balanced, this problem is corrected and healthy muscle development and bone modeling occurs.
Vitamin D supports many functions throughout our bodies, but has some significant effects on musculoskeletal health. People with adequate vitamin D status seem to benefit from a protective effect against muscle weakness and bone fractures. There are a variety of additional nutrients that support the health of the musculoskeletal system. Two which I have come to use quite regularly in practice are bromelain (from pineapple) and proteolytic enzymes, which both have a systemic effect. When used away from food (30 minutes prior to eating or 90 minutes after), the systemic effect is one that helps to break down the exudates that our cells release following any type of injury or insult. Some studies suggest that use can reduce swelling, pain and inflammation. The mechanisms that have been proposed to support this activity include a reduction in PG-E2 production and through the modulation of adhesion molecules and supporting appropriate cytokine balance.
Vitamin C is another nutrient that can be very beneficial in the support of soft tissues throughout the body. This is essential for the adequate formation of collagen and L-carnitine. Collagen is a major component of all of our connective tissues and therefore is an essential component to maintain to ensure the integrity of our musculoskeletal systems. Carnitine is also very essential as it plays a key role in the transport of fatty acids into our mitochondria. Without this nutrient our body would have a very difficult time utilizing our fat stores to produce energy to initiate muscle contraction. Research has found that vitamin C can help to decrease muscle soreness after exercise and speed up our muscles recovery to full strength.
When you successfully combine nutrition and manual therapies (such as massage therapy), the results for your clients can be absolutely amazing. Remember to stay within the limits of your scope of practice for your specific state. Suggest a client might need to see their medical provider or a chiropractor who can counsel them on proper nutrition. Nourishing the bodies of the people that you work with will provide them the extra advantage of having adequate levels of the proper nutrients to ensure an appropriate response to the therapy that you have been providing them.
Christopher Oswald, DC, CNS, is currently in clinical practice in both Wisconsin and Minnesota, as well as a 2007 graduate of Northwestern Health Sciences University. Upon graduating, he started a private practice with a focus on using a functional medicine to approach tissue health, adrenal health, GI health, weight loss, and optimizing sports performance. Along the way Dr. Oswald has learned how to effectively address many of the underlying concerns with chronic health problems with a combination of chiropractic care, lifestyle changes, and specific nutritional protocols. He can be reached at
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