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.
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.
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.
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.
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.
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.
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.
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...
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.
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.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
December, 2009, Vol. 9, Issue 12
By Elaine Stillerman, LMT
It was supposed to be a Sunday like any other Sunday: get up, go to the gym, do the shopping and chores, and enjoy the rest of the day with my son. Except on this June morning, I couldn't get out of bed.I put one foot down and the pain shot down from my knee to my toes. It was the same with the other leg. And both arms: pain, stiffness, swelling, and fire from elbows to fingers. All the connective tissues and articulations were inflamed. I recently had some dental work and thought that I was having an allergic reaction to the inlay. But that wasn't it at all.
My doctor suspected acute onset rheumatoid arthritis (RA), which blood tests later confirmed. For someone who has been practicing yoga since my teen years (let's not count how long ago that is) and works out regularly, this felt so wrong. The doctor prescribed heavy doses of prednisone which put out the fire and helped ease the stiffness, but this nasty drug has awful side effects and cannot be used long term.
RA & the Immune System
Generally affecting people 20-50 years of age, the cause of rheumatoid arthritis is unknown although there are a number of viable theories. RA is considered to be, by Western standards, an autoimmune disease. In RA patients, the immune system seems to attack body cells that are mistaken to be invader cells. Elevated levels of white blood cells are present within the synovial membranes that line the body's joints. This results in swelling, pain, and limited mobility. Over time, joints can become deformed and rheumatoid nodules, or small lumps, may grow under the skin at pressure points.
In more serious cases, RA can also affect other body parts such as tear ducts, salivary glands, the lining of the heart, the lungs, and sometimes blood vessels. Women are two to three times more likely to get rheumatoid arthritis than men and the rates for women are increasing. After nearly four decades of steady decline, the tide has turned and the numbers are rising. From 1985 to 1994, 36.4 per 100,000 women suffered from this debilitating condition. In 1995 to 2004, that number rose to 54 per 100,000 women. The incidence for men, however, stayed the same. And no one can explain why.
At the turn of the 20th century, rheumatoid-like conditions (i.e. ankylosing spondylitis) were considered to be venereal diseases. A few short years later, urinary infections were deemed to be the cause. By the time steroids transformed treatment, these causes were largely debunked.
"Immunological crossreactivity" is currently the leading theory of RA. This view reinforces the autoimmune nature of the disease. Infectious agents are considered to be the major environmental factors involved in the inflammatory process. The production of tumor necrosis factor (TNF), a pro-inflammatory cytokine, seems to have a major part in the inflammatory response. But the actual triggering mechanism is still unknown.
Other possible causes include hormonal factors which may explain the heightened risk factors for women. Reduced childbearing and breastfeeding (which seem to be contradictory) are associated with elevated prolactin levels.
In addition, there may be a genetic component to RA, abnormal bowel permeability, environmental and lifestyle factors, food allergies, and microorganisms all which lead to a multidimensional disease where any combination of factors may be culpable.
Treatment: Western vs. Eastern Thought
So how does Western medicine treat this painful, debilitating disease? Since the cause is unknown, standard medical therapy works by treating the symptoms - often times successfully. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are often well tolerated and inexpensive.
If these drugs are not effective, corticosteroids are prescribed, with prednisone the most frequently prescribed oral corticosteroid. This drug is very effective in the short term in reducing the inflammatory response, but long-term use generally causes more harmful side effects than benefits. Long-term use suppresses the natural production of the corticosteroids by the adrenal glands, and sudden withdrawal of the drugs may lead to collapse, coma and death. Other side effects, over a protracted period of time, may include: depression and other mental/emotional disturbances (this occurs in 57 percent of patients being treated with high doses of prednisone over a long period of time); high blood pressure; diabetes; peptic ulcers; acne; excessive facial hair in women; insomnia; muscle cramps and weakness; thinning and weakening of the skin; osteoporosis; and increased susceptibility to the formation of blood clots.
Disease-modifying anti-rheumatic drugs (DMARDs), such as hydroxychloroquine, gold therapy penicillamine, etc., are used to slow joint erosion, but their effectiveness is still unproven. One drug that has proven to be effective in delaying joint damage and reducing the inflammation is methotrexate, a drug commonly prescribed for breast cancer and severe psoriasis. This drug works by inhibiting the body's ability to use folic acid which is required for cell production (which is why it is used in instances of cancer.). In RA, the dosage is much lower than for cancer patients, but the side effects still may include gastrointestinal ulceration and bleeding; mouth and throat ulcers; hair loss; bone marrow suppression; liver, lung, and kidney damage; increased rate of infections; and higher risk for developing cancer.
Dietary considerations are strongly implicated in cases of RA. Some doctors posit that certain diets might even cause RA. It is interesting to note that the incidence of RA is practically non-existent in cultures and societies that eat a more "primitive" diet while it is found at a high rate in societies that eat a Western diet. A diet rich in whole foods, grains, vegetables and fiber and low in refined foods, sugar, and meat provides the best protection against developing RA. A vegetarian diet showed a substantial reduction in inflammation in many patients tested.
Another interesting factor in the development of RA is altered gastrointestinal gut flora. This is linked not only to RA, but other autoimmune diseases as well. Improper digestion is also suspect. Many patients with RA are deficient in digestive factors such as HCl and pancreatic enzymes resulting in incomplete digestion.
The Eastern interpretation of rheumatoid arthritis is quite different than the allopathic point of view. Arthritis is considered to be a "bi-syndrome" (pronounced "bee") which is a disorder resulting from blocked energy channels, the sluggishness of qi and blood circulation after wind, cold, dampness or heat. The symptoms of bi-syndrome are pain, numbness and heaviness of muscles, tendons and joints, joint swelling, hotness, and limited range of motion.
The wind-dampness-heat type of bi-syndrome is differentiated from the wind-cold-dampness type by its joint redness, swelling, hotness, and pain. An acupuncturist can determine the type of bi-syndrome it is and either disperse the wind and cold, dredge the meridians, and eliminate the dampness, or warm the meridians, disperse the wind and cold, and eliminate the dampness.
Chinese herbs may also be prescribed to support the related organs, nourish the blood and connective tissues, and eliminate the inflammation.
Massage & RA
Massage is never performed in cases of acute inflammatory RA, but can be very effective once the inflammation is controlled. A study by Field, Hernandez-Reif, Seligman, et al (1997) with children with mild to moderate juvenile RA showed that after the parents massaged their children 15 minutes a day for 30 days and a control group practiced relaxation therapy, the massaged group reported less stress and anxiety, less pain, and improved motor activities.
After including regular acupuncture, chiropractic care, dietary restrictions, herbal remedies, and stretching as part of my treatment along with proper medication, I am back on track. Perhaps not as agile and fluid as I once was (who is?), but I've got it under control. And I hope that this episode was my only one...one can hope.
Author note: I want to say a special "thank you" to Kellie White, senior editor, and Kelly Milford, editor, Elsevier Publishing, for their help in researching this article.
Click here for previous articles by Elaine Stillerman, LMT.
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