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The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Massage Combats PTSD
Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops in response to a traumatic event. The event often includes physical and/or psychological harm to an individual or a loved one. Triggers of PTSD include violent personal assaults, natural or man-made disasters, accidents, or military combat. Post-traumatic stress is the inability to dissociate the trauma from the past and live without fear of the future. Evidence demonstrates that massage therapy eases suffering caused by this disorder and assists in the recovery process.
Trauma and PTSD
After the September 11th terrorist attacks on the United States, the perspective of the world changed forever. Since, the Indian Ocean tsunami, the Chilean and Kasuri earthquakes, hurricane Katrina, countless wars and famine, PTSD has risen to unprecedented levels. According to the National Center for PTSD, 7.7 million in the United States have suffered from PTSD.
Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq, according to a major RAND study.1 Most of the 1.64 million will return home from war without problems and readjust successfully. However, 18.5 percent of all returning service members meet criteria for either PTSD or depression.1
Symptoms include: flashbacks and/or nightmares, avoidance/numbing, a feeling of estrangement from others, hyperarousal/hypervigilance, and a feeling of constantly being in danger. Other common symptoms include: sleep disturbance, physical pain, irritability, depression, suicidal thoughts, and no longer feeling at home in one's body.2
However common the disorder, stigma may hinder individuals from receiving treatment. In 2008, it was reported that only half of military service members who have returned from Iraq with PTSD or major depression have sought treatment.1 Stigma includes factors such as being concerned that one will be viewed or treated differently by peers or military leaders if they are receiving mental health treatment. Other barriers to receiving care include not being able to get time off work, lack of information about where to find help and not having adequate transportation to get to the location where care is available. Stigma and barriers seem to affect both genders, especially males, who are not as likely to pursue professional help as females.3
Sgt. Travis Runnels, Combat Veteran of the 1st Infantry Division, U.S. Army, (himself a sufferer of PTSD) said, “Team strength is emphasized within the units and nobody wants to feel like the loose link. Sometimes a cry for help is confused with being weak, instead of taken for the serious disorder it is. Understand that PTSD needs proper medical treatment and sometimes intervention.” Runnels found that massage and alternative medicine were a real compliment to his conventional treatment. However, for a long time he had a hard time with doctors touching him, let alone someone that he was not comfortable with. Ultimately, at the right time with the correct counseling resources, he was able to control his reactions and unwind enough to the point where he was able to receive massage. “Massage helped me to learn to relax, let my guard down, and begin to feel safe and comfortable within my body and mind,” said Runnels.
Traditional treatment includes pharmacology and psychotherapies, cognitive behavioral programs, exposure therapies, and eye movement desensitization and reprocessing (EMDR). Cognitive behavioral treatments include: psychoeducation, anxiety management, exposure and cognitive restructuring. According to the National Center of PTSD,4 specific cognitive behavioral therapies including prolonged exposure, cognitive processing therapy and EMDR are best used as initial treatments of PTSD. Group and family therapies along with alternative methods continue to be studied.4
Treatment is provided by TRICARE Prime, a health care plan for active duty military personnel, the Veterans Administration and the U.S. Department of Defense (DoD). Since 1998, the DoD has required soldiers to complete a pre-and post-deployment health assessment, and more recently has mandated a post-deployment health reassessment to be completed six months after the service member returns home.5
Based on the combined screening, clinicians identified 20.3 percent of active duty and 42.4 percent of reserve soldiers as requiring mental health treatment, according to a 2007 study.6 Mental health treatment by the Veterans Administration is helping those with PTSD; 49-59 percent of those who had PTSD symptoms identified after the first assessment, report improvements six months later.6 However, those who didn't initiate treatment at that time, tend to get worse. Several community health programs are also becoming more readily available, one being a DE-STRESS program (Delivery of Self-Training and Education for Stressful Situations), that utilizes an interactive Web site to complete an eight-week program designed to help manage and treat PTSD.5
A revolutionary change in the treatment of PTSD has begun with a holistic approach at the Fort Bliss Restoration and Resilience Center in Texas.7 The program, created by clinical psychologist John Fortunato, was launched in the summer of 2007 after a long struggle for funding. His six- to nine-month program includes a rigorous 35-hour treatment week that combines group and individual therapies that include alternative therapies such as: massage, reiki, qigong, tai qi, meditation, yoga, acupuncture, chiropractic, exercise, games, hot-stone therapy treatments and "rehearsal therapy", which includes telling your most painful memories over and over until they lose their power.
Fortunato uses acupuncture in the treatment of anxiety, panic and tension-induced pain. Reiki treatments are used to assist in treating hyperarousal symptoms. According to Fortunato, "In order to stay alive, their bodies have been hyperaroused for so long, that they come back and cannot turn it off. Their body doesn't even remember how to relax again, and because of that they don't sleep and are irritable. ... The massage has helped soldiers sleep."
And the holistic healing approach for soldiers is paying off: 12 of the 37 soldiers have returned to their units and only two have ended up having to take medical discharges from the army.
According to a 2005 study,8 positive changes have been shown in biochemistry following massage therapy including reduced cortisol and increased serotonin and dopamine. By decreasing the clients' cortisol levels with bodywork, a client can reduce the constant feelings of hyperarousal and danger. By increasing serotonin and dopamine in the brain, an ease of suffering and anxiety is felt.8
A study on sexual abuse victims suffering from PTSD conducted by Cynthia Price, concluded victims of PTSD showed a significant decrease in physiological and physical symptoms, after massage and body-oriented therapy (in addition to psychotherapy).9
Alternative medicine, massage and bodywork, along with traditional methods, can help victims of PTSD in the recovery process. With PTSD numbers on the rise, and more troops coming home every day, there are plenty of sufferers in need. In the hands of a well-intentioned therapist, massage for clients with PTSD acknowledges and helps to restore the most basic human needs of safety, trust, control, self-worth and intimacy. When these needs are satisfied in the context of a healthy therapeutic relationship, an individual may not only succeed but re-learn or discover for the first time how to thrive.2
For a comprehensive list of PTSD resources go to: http://ptsdcombat.blogspot.com/2007/01/need-transition-help-free-resources.html.