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.
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.
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:
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).
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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.
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.
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.
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.
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?
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.
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."
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.
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.
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.
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.
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.
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."
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.
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.
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?
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
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.
February, 2006, Vol. 06, Issue 02
Exploring the Therapeutic Value of CranioSacral Therapy
By John Upledger, DO, OMM
Throughout the course of human history, great discoveries frequently have met with resistance before acceptance. Today, we take for granted that the world is round. Yet people in the 15th century not only believed the world was flat, but that anyone who sailed beyond its limits would vanish off the edge of the earth.
The exploration of the human body has proven no different.While no one questions the value of the cardiovascular and respiratory rhythms in modern medicine, there was a time when their very existence was debated worldwide. Even now, medical approaches to these systems are as varied as medical practitioners themselves.
For more than 30 years, I have been a proponent of using the rhythm of a different body system to evaluate and improve health and well-being. I have dedicated my life to teaching the therapeutic value of the craniosacral system to health care professionals worldwide, physicians and nonphysicians alike. How can many different types of practitioners benefit from understanding one physiological system? And what evidence supports the value of therapy focused on this system? Please allow me to explain.
While the craniosacral system has only been scientifically defined within the last three decades, it has existed since the beginning of time as we know it in every human being and animal possessing a brain and spinal cord. Forming in the womb and functioning until death, it extends from the bones of the skull, face and mouth (the cranium) through a system of fluid hydraulics and membranes to the lower end of the spine (the sacrum). Because the craniosacral system surrounds and protects the brain and spinal cord, restrictions in its membranes can directly affect all aspects of central nervous system performance, from motor function to emotions. Fortunately, such problems can be detected and corrected by a skilled therapist using simple methods of palpation.
The History of CranioSacral Therapy
The roots of CranioSacral Therapy date back to the early 1900s, when William Sutherland, DO, was struck by the unusual idea that the bones of the skull were structured to allow for movement. For more than 20 years, he explored this concept, performing makeshift experiments on himself with helmet-like devices designed to impose variable pressures on different parts of his head. His wife then recorded personality changes he displayed in response to different pressure applications.
In the early 1930s, Sutherland published the first article about his work in the Minnesota Osteopathic Journal under a pseudonym. Based on his experiments, he developed a system of examination and treatment for the bones of the skull that today is known as cranial osteopathy. With some patient success, Sutherland organized a small group of osteopaths who studied cranial work with him. Because so little was known about how it worked, and the results at times seemed miraculous, his system acquired an understandably esoteric reputation.
Personally, I knew very little of this history when I observed the rhythmic movement of the craniosacral system firsthand in 1970. I was assisting a surgery on a man named Delbert and had only one job to do: hold the membrane that surrounds the spinal cord still while the surgeon removed a calcium deposit from its surface. As simple as it sounds, I couldn't do it. The membrane kept pulsing at a rate of about eight beats per minute, which didn't correspond to his breathing or heart rate, both of which were being monitored. Delbert made it through surgery, and I discovered that the pulsing motion I witnessed was new to all of the doctors there, not just me. We didn't know it at the time, but what we were seeing was the rhythm of cerebrospinal fluid pumping through the craniosacral system. The system itself hadn't even been named yet.
A few years later, I attended a workshop on cranial osteopathy developed by Dr. Sutherland. The course focused primarily on the bones of the skull and the fact that they weren't fused as doctors had been taught in medical schools, where anatomy was studied using embalmed and calcified cadavers. Instead, Sutherland's material demonstrated that skull bones continue to move throughout life. While this phenomenon has since been widely documented (see references for examples), widespread acceptance has typically been a slower evolution.
So here we were at the seminar, all palpating the motion of the bones, when people started asking about this rhythm they were feeling. That's when I realized I had seen the driving force behind these pulsations during Delbert's surgery. I put that episode together with what I was feeling now with my own hands. They seemed linked, yet no one knew how. That lack of information enticed me to continue developing my palpation skills and experiment with different methods of connecting with the rhythm of the craniosacral system. Yet instead of focusing on the skull bones as Sutherland and other cranial osteopaths had, I was continually drawn to work with the membranes of the system itself.
News of my work spread, and in 1975 the Osteopathic College of Michigan State University invited me to lead the world's first task force to study and verify (or debunk) the mobility of cranial sutures and bones. It was an exhilarating time. For the next five years, I led a team of anatomists, physiologists, biophysicists and bioengineers, all testing the potential for performing therapy on the craniosacral system.
Together we conducted research, much of it published, that formed the basis for the modality I went on to develop and name CranioSacral Therapy. Yet we continued to take a different approach than the osteopaths who came before us. Again, instead of focusing on the bones of the cranium, we were working with the fluids and membranes of the system within the skull and spinal canal. By blazing this new path, we finally were able to explain the function of the craniosacral system. We then went on to demonstrate how it could be used to assess and relieve numerous health problems involving the brain and spinal cord.
How CranioSacral Therapy Is Performed
CranioSacral Therapy is a gentle, noninvasive approach to whole-body health. Generally using about 5 grams of pressure (roughly the weight of a nickel), the practitioner evaluates the craniosacral system by testing for the ease of motion and rhythm of cerebrospinal fluid. Simple manual techniques are then used to release restrictions in fasciae, membranes and any other tissues that influence the craniosacral system.
Experienced clinicians are able to feel the craniosacral motion anywhere on an individual's fully-clothed body. Valuable information can quickly be gained by palpating the rhythm for rate, amplitude, symmetry and quality. Lack of symmetry, for instance, can help localize a pathological problem that might relate to musculoskeletal dysfunctions, inflammatory responses, adhesions, trauma, surgical scars, vascular accidents and many other conditions. As the asymmetry is eliminated and normal symmetrical craniosacral motion is restored, the problem is often resolved or in the process of being resolved.
Consider, too, that fascia is a slightly mobile sheath of connective tissue that runs continuously from head to toe, surrounding every somatic and visceral structure in the body. This fascial system is in constant motion, corresponding to the craniosacral rhythm by both direct connections and common osseous anchorings. With this in mind, it's easy to see how loss of tissue mobility in one area can be used to trace the location of the disease process that caused the original lack of mobility.
Ultimately, CranioSacral Therapy focuses on solving physiological problems at their source by using the individual's inherent self-corrective mechanisms. It has been shown over and over again, in thousands of cases, that it enhances general health, reduces accumulated stress, strengthens central nervous system function and improves resistance to disease.
I encourage you to continue to explore this therapy's potential for improving health, well-being and quality of life. Let your proof be in your results. And if you're faced with skepticism for your efforts, take heart. You might well be ahead of your time.
Click here for previous articles by John Upledger, DO, OMM.
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