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Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
May, 2016, Vol. 16, Issue 05
Massage Therapy and Trigeminal Neuralgia
By Linda LePelley, RN, NMT
Trigeminal Neuralgia (TN) is a chronic condition that causes severe, excruciating facial pain. It usually occurs when the myelin sheath of the trigeminal nerve has been worn away, sometimes due to a blood vessel causing compression to the nerve, or if the patient has Multiple Sclerosis, a disease which attacks the myelin sheath.Sometimes TN can be brought on by an arteriovenous malformation or a tumor. Trauma, dental work, and strokes affecting the nerve can also trigger TN. The trigeminal nerve consists of three branches, which service the face and up into the scalp. Any branch, and more than one, can be affected. Occasionally, it can occur bilaterally.
When diagnosed, TN is classified as one of two types, which The National Institute of Neurological Disorders and Stroke describes as follows: The typical or "classic" form of the disorder (called "Type 1" or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, in volleys lasting as long as two hours. The "atypical" form of the disorder (called "Type 2" or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.
I have seen a handful of patients over the years with TN. The first one came into an emergency room where I was doing my clinical rotation. I will never forget what she cried, "Please, knock me out, or kill me, but I can't bear this pain!" She was medicated and sent home. I've often wondered about her. The ER doctor called her a "Frequent Flyer," but once he left the room, the nurse on duty reminded me that the patient's pain is whatever they say it is. I refused to work on the first client who asked if I could help TN, referring her to a neurologist. Several years ago a long-time client with MS told me her TN, which had been in remission for a long time was back, and she wanted me to work. I told her she needed to see a neurologist, to which she replied, "My neurologist is the one who sent me to see you, so don't be a chicken!" I used a very cautious approach, fearing that massage would trigger an attack. Her jaws were almost rigid bilaterally, so I focused on relaxing and softening the tissues using gentle massage and heated eye pillows over the face. It was entirely successful. In the following years that I worked on her, she had no more complaints of TN.
It is one thing to read and learn about a condition and quite another to experience it firsthand. I had begun to experience some very short but severe episodes of pain in my upper jaw. It felt as if I were being struck with an electrical shock that would paralyze me with pain for just a second, and then be gone. I decided to have some dental work done, thinking that whatever was hurting would get cleared up at the same time. The attacks of pain became more frequent, lasting up to twenty mind-bending minutes, and the area involved expanded from my TMJ up into my eye and the side of my head. While in the dentist chair one day, I was struck with an episode. I told my dentist I would rather die than feel this pain again, which brought to mind the patient in the ER all those years ago. Before he even began explaining it to me, I realized that I was experiencing TN. I chose to treat it the same way I do headaches, heat and massage until all of the painful, tight and hardened tissues are soft and malleable. For myself, it worked completely. I haven't had an attack in about two years.
Since this experience, I have sought clients with TN, offering treatment in exchange for allowing me to experience working on them. The results I've had are excellent, with complete pain relief for three clients. However, because they either did not have an actual diagnosis of TN, there were other conditions going on, as well as other treatments being used, a reliable case study could not be produced. I live and work in a small town, but hopefully, the right client with the right diagnosis will become available to study in the near future.
TN is serious in that the pain is debilitating. According to the NIH, the incidence of new cases is about 12 per 100,000 people a year, and is more frequently found in women. Current treatment for TN begins with anticonvulsant medications, and tricyclic antidepressants are prescribed for pain relief. TN is not believed to be related to depression or psychological factors, but analgesics are generally ineffective.
TN is a progressive condition, and if medications lose their effect over time, there are more invasive treatments available for pain relief. These include injections and several different types of surgery, all which involve the risk of unpleasant side effects. The NIH handout for TN states, "Some individuals manage trigeminal neuralgia using complementary techniques, usually in combination with drug treatment." Although they list low-impact exercise, yoga, and visualization among other approaches, there is no mention massage therapy. In my limited experience, massage therapy for TN has relieved everyone who has attempted it. From what I understand of this condition, it progresses over time. As the tissues become more compressed, the pain becomes more intense. If heat and massage can soften, mobilize, and relieve pain elsewhere in the body as it does, it can certainly relieve at least some of those cases of TN. It only makes sense to try therapeutic massage before administering drugs or performing surgeries.
Click here for previous articles by Linda LePelley, RN, NMT.
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