A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
2018 Gallup-Palmer Report: Key Findings
The fourth annual Gallup – Palmer College report is out; here are some of the key findings excerpted directly from the executive summary regarding Americans' experiences with chiropractic care relative to the management of neck and back pain:
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
January, 2006, Vol. 06, Issue 01
The Potential Impact of Orthodontia on Whole-Body Health
By John Upledger, DO, OMM
While the craniosacral system is comprised of the membranes and fluid that surround the brain and spinal cord, its numerous osseous relations can impact the body in far-reaching ways. For instance, I was a professor of biomechanics at Michigan State University in 1976, when I first witnessed the effects of orthodontia on the spinal alignment of the vertebral bones.
The patient was a 16-year-old girl who had begun to develop scoliosis about two years earlier.Her father, an English professor at the university, told me her orthopedic surgeon wanted to implant corrective rods for the scoliosis, which had been measured at 38 degrees in the thoracic curve. At his request, I began to see his daughter weekly.
Over a period of six weeks, we were able to reduce the curve to 18 degrees using a combination of CranioSacral Therapy, Myofascial Release, osteopathic spinal manipulation and Therapeutic Imagery. At that point, I continued to try to help improve her condition. After four or five unsuccessful attempts, however, I realized that each time I balanced her occipital bone it was off balance the following week.
Clearly, I had not located the underlying cause of the occipital bone problem. The occipital bone had to be relieved of its abnormal transverse tilt and its restriction to motion, which were both compromising craniosacral system function. The sphenoid bone remained transversely tilted in the opposite direction from the occiput.
Ultimately, I discovered the hard palate was preventing the sphenoid bone from maintaining the corrections. Could it be that the orthodontic braces the patient had been wearing for about three years were contributing to her scoliosis? The answer proved to be "yes." At my request, the orthodontist removed the braces from the patient's mouth. Subsequently, her scoliotic curve was able to correct to less than five degrees and there was no recurrence of scoliosis over the next five years. I continued to see her every six months or so until she married and left home.
Please allow me to explain the biomechanics of how such an event could occur in a 16-year-old girl. The paired maxillary bones are influenced via the pterygoid wings of the sphenoid bone with which they articulate bilaterally. The maxillary bones move in concert with the sphenoid bone via these articulations. Actually, the distance between the second upper molars on each side fluctuates about two millimeters at a rate of 8-12 cycles per minute in accordance with the craniosacral rhythm. The sphenoid bone is one of the prime movers of the craniosacral system. When the bone's mobility is restricted, the craniosacral system tries very hard to compensate for the dysfunction, but it's seldom fully successful.
When an orthodontic appliance is put on the upper teeth and it crosses the midline between the two anteromedially located incisors, the motion of the maxillary bones induced by the sphenoid bone is inhibited and sometimes totally restricted. When they are first applied, the braces also might entrap one of the maxilla in an external position and the other in an internal position. In CranioSacral Therapy, the motions of the maxillae in response to the sphenoid bone are called internal and external rotations, because the maxillae appear to rotate about individual axes generally directed in anterior-posterior directions.
The distance across the hard palate is measured using the biting surfaces of the second molars as reference points. The usual mean distance variation between these teeth in response to internal and external rotations of the maxillae is two millimeters. In the case of my scoliosis patient, the braces locked the left maxilla in external rotation while locking the right maxilla in internal rotation. The abnormal positional locking of the maxillae caused the sphenoid bone to eventually yield to these abnormal forces after attempting to correct the problem and then adapt to it. Having ultimately failed in these attempts, the sphenoid was forced into a transversely oriented tilt, with its left side tilted in a superior direction and its right side in an inferior direction.
Next, the occiput had to compensate for the sphenoid tilt. In order to do this, the occiput had to tilt in the opposite direction, right side superior and left side inferior. This occipital tilt placed an increased traction on the right side of the dural tube as it ran through the sinal/vertebral canal. It also allowed less tension or increased slack on the left side of the dural tube.
We have found over and over again that the sacrum mimics the occiput unless there is a significant restriction of the dural tube somewhere between the occiput and the sacrum. In the case of our patient, the sacrum was mimicking the occiput. The right upper pole of the sacrum was higher; the left was abnormally lower. Hence, the sacral base, which is the upper transverse boundary of the sacrum, presented a tilted foundation for the spinal column to rest upon. Because of this un-level sacral base with the right side high and the left side low, the 5th lumbar vertebra had to angle off to the left, creating a "leaning-tower" dynamic. In order to correct this, the remaining lumbar vertebrae formed a scoliotic curve so the thoracolumbar junction crossed the midline center of gravity.
Now we had the upper lumbar coming diagonally across the midline center of gravity from the left, thus sending the lower thoracic vertebra off diagonally to the right. This curve needed to come back to the midline center of gravity at about the cervico-thoracic juncture in order to maintain body balance. The compensatory lumbar and thoracic spinal curves form the classic "S" curve of scoliosis. In the neck, we also might have a compensatory curve that involves most of the cervical spinal vertebrae. Clearly, the balance for the neck is skewed as the upper thoracic vertebral column comes to the midline center of gravity.
Sometimes this whole compensation in the neck occurs from a sharp displacement of the two lower cervical vertebrae atop the 1st thoracic vertebrae. This acute compensation at the lower cervical vertebrae often is painful and frequently results in brachialgia or dysfunction of the arms and hands, all due to nerve-root compression. It seems reasonable to me that the powerful nerve reflexes that strive to keep the eyes horizontal with the horizon might require this compensation at the cervicothoracic junction.
This is but one example of how orthodontia can affect the craniosacral-neuromusculoskeletal relationship to impact the whole body. To learn more, read "Surviving Orthodontics: A Bodyworker's Exploration into Orthodontics and CranioSacral Therapy," by Nancy Burke, CMT, CST. You can find it at www.upledger.com/news/9803.htm.
Click here for previous articles by John Upledger, DO, OMM.
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