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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
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.
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.
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.
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.
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.
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.
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.
December, 2015, Vol. 15, Issue 12
TDR to Facilitate Venipuncture
By Linda LePelley, RN, NMT
A few years ago, a client who had been receiving intravenous medications regularly complained that she was dreading her next scheduled infusion. She stated that it was bad enough having to sit there for over an hour and a half, but they routinely needed to stick her several times before accessing a vein, and it hurt. It hurt a lot.
Ever believing that massage can alleviate most pain, I offered to work on her antecubital areas, with the hope and expectation that reducing the overall density of the involved tissues could alleviate the pain from multiple sticks. I performed the treatment based on the principles of Tissue Density Restoration (TDR) massage (See "The Seven Principles of TDR Massage," Massage Today, July, 2015.)
Before treatment, the density of the tissues of the antecubital area were elevated, rated at G2 (See "The Tissue Density Grading Scale: A Communication Tool," Massage Today, March, 2014) with slight ridging palpable. After heating the areas and applying the massage, the grade was reduced to G1, with no ridges present. I wasn't disappointed, my client later reported that the entire procedure was painless and I was happily surprised to learn that not only was her nurse able to insert the cannula on the first attempt, but the infusion was completed in 45 minutes.
Since this experience, the occasion to suggest massage to family and clients before routine, expected venipuncture has arisen several times. In each case, whether I administered the treatment or the client did it for themselves, the results have been all positive with no complaints. While these are only a few events, they seem to be repeatable, and are worthy of further investigation. It would not only reduce the pain and anxiety for those being punctured, but if the treatment results in an increase in the rate of infusion, there could also be an increase in the number of patients a facility can treat per day as well. Please note this is not intended for persons who have indwelling ports such as used for dialysis, PICC lines, and the like.
TDR Massage is very effective, but the time required to achieve results can become tedious, so when teaching clients to do this massage for themselves, suggest they do it while watching a show or visiting with a friend, to prevent their becoming bored. Once both ante-cubital areas have been massaged to a tension-free and malleable state, a monthly maintenance routine should be established. Warming the tissues and giving them a brief massage to ascertain that there are no ridges or increase of density will prevent future difficulty with venipuncture.
My Perspective on Pain
TDR Massage is focused entirely on the real and existing state of the tissues that are in pain. In nursing school, I was taught that pain is whatever the one who is experiencing it says it is. At the time, I thought this meant that we should treat everyone's pain, even those who were just imagining it. In the years since then, I have consistently and repeatedly found that tissues which are in a state of pain are associated with a palpable elevation in their density, referred to as Elevated Tissue Density (ETD). I've found and relieved painfully dense tissues in many dozens of people who were thought by other care providers to be imagining or faking their pain. By focusing on restoring the density to a softened and malleable state, the ETD as well as the pain is resolved.
When discussing pain and massage, it is important that the terms being used are understood by all of the communicants involved. When I say that I can feel another person's pain, I am not expressing my emotional or empathetic response to their distress. I am saying that with my hands, I can palpate, measure, document, and treat an actual and real state or condition that exists within the musculoskeletal tissues. Anyone who wishes to do so can also learn to palpate and distinguish tissue that is in pain from that which is not. This kind of "feeling" is in no way an energetic or intuitive sense, it is an actuality. I make no claim of any special gift, only that I pay attention to small details and question everything. Pain is real, and it is palpable, not only by the person who has it, but also by anyone else with an educated touch.
Click here for more information about Linda LePelley, RN, NMT.
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