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The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
July, 2013, Vol. 13, Issue 07
Using My Massage Therapy Skills to Help Save a Career
By Debbie Roberts, LMT
I always like to bring you a real case and a real story. I know you, too, will someday probably have that same type of client that needs your help with treatment. This time, I am helping an oral surgeon save his career by saving his hands.When this doctor presented in my office seeking help, he had been looking at surgery on his hands as his only option to save his career. It took him 10 years to complete his degree and 10 years of practicing to almost lose everything he had worked so hard for.
While working with him, it became clear to me that a massage therapist looking to specialize and gain a reputation as the one to seek out for hand dysfunction could have a forever busy practice. Just go to YouTube and look at what small instruments and awkward positions that this profession does on a daily basis. Now, think how many other professions use similar intricate tools. Those professionals need a therapist that can take a no nonsense approach to helping them save the career they have spent so much time and money on to achieve.
Working with hands or feet is very challenging for the massage therapist in terms of how it affects your hands. The work has to be very meticulous and that can be very wearing to your own hands. So I have tried to offer suggestions of how to do treatment in a manner to get the job done and have less wear on you.
He presented with aching hands all the time, he was beginning to lose grip strength, his fingers had become stiff feeling and it was affecting his ability to close his hand, he had bilateral thumb pain and bilateral numbness and tingling in the ring and little finger. He had more thumb pain on the right, but said this was due to the fact that three months ago he was playing with his son and his finger had been abruptly pulled backwards. He also complained of right shoulder pain.
The first thing we want to do is assess or take a screen of the patient. A screen helps you rule out, should they be in your office or do they need other higher medical care. Just a reminder to stay within your scope of practice, a screen is not to be used as diagnoses, it is to be used as a tool to understand movement quality. You are looking at how healthy or dysfunctional is the individual's joint movement. This helps you determine the complex of muscles and fascia to be treated. When taking a screen, you will want to look above and below the joint being questioned. From the screen, you can develop an organized logical approach to treatment and suggestions of home care.
Screen Number One
Rule out cervical involvement by looking at the quality of cervical motion and asking the question throughout the screen: is there pain or no pain? In this case, he has presented with ulnar nerve involvement. Also ask if they feel any referral pain when going through the range of motion. Cervical flexion: they should be able to touch their chin to chest 45 degrees. Cervical extension: 45 degrees with mouth closed. Cervical side bending 20-40 (watch to see if the shoulder rises indicating how tight the trapezius muscle can be). Cervical rotation 70-90 degrees without pain. See reference.
Specific to this case because he had shoulder pain, I also went through all of the shoulder range of motion tests and he had a positive impingement sign. He also had a very stiff neck. We are addressing all of his concerns from the screen, but for this article I have kept the focus on the hand and forearm.
Screen Number Two
Assess their wrist and elbow range of motion. Wrist flexion: 80 degrees. Wrist extension: 70 degrees. Ulnar Deviation: 45 degrees. Radial Deviation 20 degrees. Supination 90 degrees. Pronation 90 degrees. Elbow extension 0 degrees and Elbow flexion 145. See reference.
Screen Number Three
Muscle test wrist flexion, extension, pronation and supination. Muscle test elbow extension and flexion. Muscle test all the ranges of each digit including the thumb. Each finger may flex, extend, abduct and adduct and also circumduct. See reference.
The reason I listed all of the muscles indicates your need to be extremely specific. You want to look at an anatomy book and to the best of your ability treat each and every muscle you see. If you treat fractional inches at a time from the finger tips to the elbow joint, and then from the elbow to the shoulder, slowly along the bone, you won't miss anything. But if you always do an effleurage type of stroke you will miss something. Therapy should be about being specific, not generalized. The hand should not only feel better, but should also have better function. Recheck your range of motion and muscle tests to show the client how much improvement your treatment has made. I mentioned above all the tools I used besides my hands and every few minutes during the session I will trade out and use those tools so I save my own career.
Treatment Tip: I generally follow the thought of contrast first, myofascial second, specific work next, then PNF stretching and repeat. So far, 25 years and still going strong!
So, how is this client doing today? He is doing great and I continue to see him once a week. He has since been able to go back to more intricate work because his body isn't fighting him with pain anymore.
Fun Ring Finger Trivia
Before medical science discovered how the circulatory system functioned, people believed that a vein of blood ran directly from the third finger on the left hand to the heart. Because of the hand-heart connection, they chose the descriptive name vena amoris, Latin name meaning, literally vein of love. Based upon this name, their contemporaries, purported experts in the field of matrimonial etiquette, wrote that it would only be fitting that the wedding ring be worn on this finger.
Click here for more information about Debbie Roberts, LMT.
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