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.
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.
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.
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.
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.
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.
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.
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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
March, 2005, Vol. 05, Issue 03
By Ruth Werner, LMP, NCTMB
Author's note: There is a movement in the health sciences away from using the possessive form of a disease name. This makes some sense, since it's not really Parkinson's disease; it's the disease of those who live with it.Sometimes this change takes the form of turning a descriptive term into a noun (e.g., from Parkinson's to parkinsonism) and sometimes the apostrophe simply disappears (e.g., Alzheimer disease). Since my column "What's on Your Table" always strives to stay on the cutting edge of both grammar and science, I will do my best to incorporate this new adjustment to the language.
The consensus is clear: Parkinson's disease, also called parkinsonism, is the issue on the table for today. Parkinsonism is a fairly common progressive degenerative central nervous system (CNS) disorder that leads to dysfunction at the motor centers in the basal ganglia. It affects about one in 1,000 people in the U.S., and the majority of people with parkinsonism are mature. It is unusual to see diagnoses in persons under 50 years of age - Michael J. Fox is a famous exception to this rule.
Etiology: What happens? Understanding the etiology of this disorder is a little like playing "The House that Jack Built" because the sequence of events is so specific and predictable.
So the sequence goes like this: A voluntary impulse to stand on one foot begins in the cerebral cortex. It is sent through the basal ganglia where, because adequate dopamine is supplied by substantia nigra cells, this impulse travels to the prime movers and antagonists of the lower extremity and postural muscles in order to bend the knee (go ahead, try it).
Parkinsonism occurs when the cells in the substantia nigra unexpectedly and prematurely die. Consequently, dopamine is in short supply in the basal ganglia; it becomes difficult to initiate voluntary movement (this is called bradykinesia - the person often reports feeling "rooted to the floor"), and/or the balance between prime movers and antagonists is disrupted, leading to rigidity or tremor. Several other symptoms may develop as well; they will be discussed shortly.
Causes: Most of the time, it is unclear exactly why the substantia nigra cells die off. Genetics and environmental exposure (or the combination of both) are often thought to be contributing factors. Excessive exposure to carbon monoxide, heavy metals, pesticides or agricultural chemicals is sometimes suspected. Repeated head trauma causes a variation called pugilistic parkinsonism; this is the case with former boxer Muhammad Ali. Most cases of parkinsonism, however, are considered to be idiopathic (of unknown origin).
Signs and Symptoms: Parkinsonism presents very differently in different people, but most primary symptoms have to do with movement problems. A short list of primary and secondary symptoms includes the following:
Treatment: Chemical imbalances in the CNS are often difficult to treat because the blood-brain barrier (a layer of cells that wrap around blood vessels in the brain) blocks the introduction of many substances into this precious environment. Some drugs must be administered in high amounts to overcome this obstacle.
Treatment for parkinsonism often begins with a dopamine precursor, or dopamine agonists. These substances essentially try to replace what the damaged substantia nigra cells should be producing; however, remember that dopamine in the basal ganglia helps create coordinated movement, but too much dopamine in the frontal lobe can cause hallucinations - a significant side-effect! Furthermore, most patients eventually develop tolerance to these drugs, and they lose their efficacy.
Other drugs work to change dopamine metabolism and other brain activity, but at this time no permanent solution or cure for parkinsonism exists. Other options include surgery to affect the globus pallidus or thalamus (this helps to control very extreme tremor), deep-brain stimulation, and eventually the possibility of stem cell implantation with the goal of re-growing the damaged substantia nigra cells.
Massage? Parkinson's patients experience progressive stiffness and rigidity of voluntary muscles. Rigidity is safe for massage, especially when sensation is present, but it is important to remember that this comes about because of a CNS dysfunction, and won't be completely resolved, even with the most brilliantly applied bodywork.
Several different modalities have been quantifiably researched in the context of parkinsonism, including Trager, Alexander Technique and Swedish massage with specific muscle exercises. All modalities report improvement in function, from the reduction of rigidity and improvement of sleep, to the reduction of tremor and increase of daily activity stamina.
It is important to work in cooperation with a client's primary physician, because massage may impact the need for antidepressants and other medication. Be aware, however, that clients with Parkinson's disease do not have the freedom of movement that most other people do, and they may have great difficulty in getting on and off tables safely. Some massage therapists address this by working with these clients on chairs or floor mats.
On a final note, I'd like to recognize two people for their contributions to my preparation of this article. One is a reader named David Ponsonby, who has done an enormous amount of research on this topic and generously shared his information - this article barely scratches the surface of what he has collected on this topic. David has allowed me to put interested readers in touch with him for more information.
The other person is a massage therapist named Jan Mueller who, years ago, published a fascinating and lovely article on working with clients who have Parkinson's disease in the Massage Therapy Journal [Winter 1996, (35): 1]. I made mention of her wonderful work at a class I taught in Kentucky one time, and it turned out by chance that she was one of the participants! Thanks, Jan, for your pioneering work.
And now, loyal readers, a familiar plea: What will it be for next time? At the moment I'm on a progressive degenerative CNS disorder roll, and could easily continue with amyotrophic lateral sclerosis (a.k.a., Lou Gehrig's disease). If you have experience with clients who live with this disease, I invite you to share your wisdom with the rest of our readership. If you have other ideas about what you'd like to read about, let me know that, too. Please let me know: What's on your table?
Many thanks and many blessings,
Ruth Werner, LMP, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.