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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
March, 2002, Vol. 02, Issue 03
The Expanding Role of Cerebrospinal Fluid in Health and Disease
By John Upledger, DO, OMM
In 1971, I first witnessed the rhythmical activity of cerebrospinal fluid (CSF) as its hydraulic forces affected the patch of dura mater I was watching. At the time, I had no inkling of the incredible journey that was in store for me.
That small section of dura mater was only about 1-1/2 inches long and 2 inches wide.We had exposed it to remove a dime-sized calcium plaque from the outer surface of the dura. The operative site was the posterior aspect of the mid-cervical region of the patient.
My assignment was to hold the dura very still with a pair of forceps while the neurosurgeon delicately removed the calcium plaque without incising the dural membrane. In spite of my efforts, the exposed dural membrane repeatedly protruded and receded at about 10 cycles per minute.
That particular rhythm was a surprise to everyone in the operating room. It didn't synchronize with the anesthetist's breathing apparatus or the cardiac monitor. The only thing I could think of that could create this force was the pumping of CSF inside the dura mater.
The subject of CSF was quite contentious at the time. When I was in osteopathic college in the early '60s, CSF was considered mainly a shock absorber for the brain during swift starting and stopping movements. There was also some debate about whether CSF was a transport system delivering nutrients and removing waste, but no one was certain. Some cranial osteopaths even made vague references to CSF following nerve fibers to every cell of the body to deliver "mystical" energy.
Despite all these theories, scientific knowledge at that time stated firmly that CSF did not penetrate the brain's surface or leave the compartment formed by the dura mater. The fluid did appear to follow nerve roots peripherally from the brain and spinal cord, but only as far as the dura mater provided a sheath for the roots. This, it was thought, was to bathe the nerve roots and the surface of the brain.
Controversy even existed over whether the fluid in the subdural space should be considered CSF. There was evidence to support the concept that the arachnoid membrane was impermeable to CSF and, therefore, the fluid outside the arachnoid membrane, but inside the dura mater was not CSF, even though they were biochemically identical. This, of course, raised yet another question: Should a fluid be named by its biochemical characteristics, or by the compartment in which it resides?
It was against this backdrop that I observed the pumping activity of CSF in 1971. And it was in this environment that I went on to develop CranioSacral Therapy.
My initial focus with CranioSacral Therapy was to mobilize the meningeal membranes that related to the entire central nervous system and the proximal aspects of its major nerve roots. I used the bones that attach to these membranes, either directly or indirectly, to manipulate the meningeal membranes and release any mobility restrictions.
I found CranioSacral Therapy also released restrictions in membrane mobility and in the sutures between bones of the skull vault by effectively using the hydraulic forces provided by the pumping of CSF. The therapist simply drew those forces into restricted areas by gently inhibiting the areas of maximum (compensatory) compliance to the rhythmical rises of hydraulic forces. By continuing this gentle manual pressure, the fluctuating hydraulic forces helped release those restrictions naturally.
My colleagues and I were fascinated by the wide variety of patient improvements we witnessed using these new techniques and theories. Most positive responses came in cases of pain that were attributable to meningeal restrictions, in cases of painful sutural restrictions, and with learning disabilities that could be related to specific dysfunctions in this craniosacral system.
Yet what was truly difficult to explain were the positive results seen with diseases like Parkinson's, multiple sclerosis, chronic fatigue syndrome, and acute and chronic infections, including resistant staphylococcus and cytomegalovirus.
Indeed, there were many positive results from CranioSacral Therapy in areas that seemed untouchable based on concepts held about CSF at that time. Even now, as scientific research continues to uncover the secrets of CSF, we see more and more how CranioSacral Therapy helps in so many surprising ways.
Several research projects over the past few years have demonstrated that, contrary to previously held ideas, CSF is the interstitial fluid of the brain and spinal cord. That means it permeates the spaces between all the nervous and glial cells of the brain and spinal cord. In this way it carries nutrients; removes metabolic byproducts, waste and toxic molecules; strongly influences pH (acidity); and is now thought to influence the electromagnetic environment of the neurons and other cells of the central nervous system. (Author's note: For a complete overview of these research projects, see Science News, January 1999.]
In The New York Academy of Science Annals, Volume 854, an article entitled "Towards the Prolongation of a Healthy Life Span" reported that CSF contains low-molecular-weight chelating agents that remove metal atoms from the interstitial spaces of the brain and spinal cord, and from the neuronal and glial cell membranes. According to the article, CSF also protects against oxidation and toxic accumulations of nonmetallic toxins.
This is especially enlightening in cases of recent studies that have shown both Parkinson's and Alzheimer's diseases may be induced by toxic build-ups of heavy metals - within the basal ganglia in the case of Parkinson's, and in the cortical and subcortical regions in the case of Alzheimer's disease. Enhancing CSF circulation may well help prevent these two diseases, along with many other types of senility and deterioration problems.
In my own clinical practice, I've been able to break fevers, alleviate chronic viral infections, prevent flu... the list goes on and on. All these results suggest an enhancement of immune function, which is exactly what I believe CranioSacral Therapy does. It moves CSF and every other body fluid, especially the interstitial fluids. By whatever name, the fluids between cells must move in order to deliver molecules that not only nurture cells but also transport messages and patrol for antigens - all vital to strong immune function.
Physicians at Stanford University have also discovered that the exchange of CSF slows with age. While there is a complete turnover of CSF about four or five times a day in healthy middle-aged people, in the elderly that rate may be cut in half. In fact, the Stanford folks became so convinced that CSF turnover is important that they've placed shunts in a sample of nine patients with reduced turnover. They want to see whether the drainage of stagnant CSF enhances production and reduces certain substances in the CSF - and hence the central nervous system - that are believed to contribute to brain deterioration and Alzheimer's disease.
I firmly believe CranioSacral Therapy can help maintain or regain the normal daily turnover of fluids, with all of its attendant health benefits.
Click here for previous articles by John Upledger, DO, OMM.
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