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.
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.
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:
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.
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.
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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?
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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."
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."
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.
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.
March, 2008, Vol. 08, Issue 03
Easing Migraine Pain
By John Upledger, DO, OMM and Lisa Upledger, DC, CST-D, FIAMA
Gone are the days when migraines were considered a psychological disorder reflecting poor coping skills, low stress threshold, clinical depression or a borderline personality disorder. According to the National Migraine Association, migraine disease is now a recognized neurological condition affecting more than 30 million Americans.
In many cases, CranioSacral Therapy is one of the most effective tools you can offer a client suffering from migraine pain. This light-touch modality helps release restrictions in the meningeal membranes around the brain and spinal cord, increasing the healthy flow of cerebrospinal fluid and allowing the central nervous system (CNS) to resume its optimal levels of performance.
Cerebrospinal fluid within the craniosacral system acts as a shock absorber for the brain. It delivers nutrients to the nerves, brain and spinal-cord tissue, and washes away waste products created by various metabolic processes. You can see how critical it is to have a strong, functional craniosacral system.
In addition, research has shown that meningeal membranes and perivascular fascia are the only pain-sensitive tissues in the brain. Therefore, any abnormal meningeal tension can cause pain, as can any pressure on the blood vessels that run through the meninges. That means when you release restrictions in the meningeal membranes, you also take pressure off the blood vessels.
Pressure on the brain stem from surrounding fascia also can cause sensory neurons to relay their messages to higher brain centers, which may correlate with another theory about migraines: that brain stem pain receptors actually cause the migraine pain.
Cortical Spreading Depression
Historically, the migraine has largely been defined as a vascular disorder in which an event triggers vasoconstriction followed by vasodilation, inflammation and headache. Now, it's believed that the vasoconstriction/dilation is the result of a phenomenon called cortical spreading depression.
Cortical spreading depression is a slow, spreading wave of strong, sustained neuronal firing that generates a transient, intense spike of activity as it progresses into the tissue. The spike increases innervation to blood vessels, which strengthens regional blood flow. This is followed by reduced neuronal activity associated with a vasoconstriction that produces a transient ischemia and a drop in cerebrospinal fluid flow. This neuronal suppression can last for minutes and cause a neurochemical imbalance.
The auras and prodromes (a premonition that the headache is coming) often associated with migraines are likely caused by the vasoconstriction leading up to the rebound and vasodilation. The actual pain of the migraine occurs when there is a rebound of abnormal vasodilation of the intracranial arteries, and an activation of the sensory pain fibers around the blood vessels and meninges.
If a client sustains an impact that distorts or otherwise compromises the pain-sensitive meningeal membranes, this also can increase pressure on the brain and central nervous system, potentially causing cortical spreading depression and triggering a chain reaction leading to migraines.
Migraines generally occur in several phases. The first phase is called the prodrome - a forewarning that indicates an alteration in the central nervous system. A highly individual experience, the prodrome may be accompanied by changes in mood or energy levels; a sudden feeling of depression, euphoria or fatigue; or cravings for chocolate or other foods. There also may be an alteration in sensory processing, muscle tone, nasal congestion, fluid retention, cognitive impairment or facial pressure.
In approximately 15 percent of migraine cases, there is an aura phase that generally lasts no more than an hour. While symptoms vary, the most common ones are visual effects such as flashing lights and partial or blurred vision. Other symptoms can include olfactory and auditory hallucinations, tingling or numbness in the face and extremities, confusion, partial paralysis and more. It is widely believed that the aura is caused by the cortical spreading depression. With vasoconstriction resulting in decreased blood flow, the brain will certainly do strange things.
Next comes the mild phase of the migraine - when the pain begins. If the migraine is terminated at this stage, the pain may feel like a tension headache. If the migraine progresses it generally leads to mild pain, sometimes accompanied by nausea and the beginning of throbbing pain.
If not aborted in the mild phase, the migraine will develop into moderate to severe throbbing pain with nausea and sensory sensitivity. At this point the blood vessels are dilated. Any movement or activity increases the blood flow, which causes more dilation, pain and throbbing. This is when many people prefer to lie perfectly still in a dark, quiet room.
A migraine may dissipate over anywhere from four hours to three days, after which a post-headache phase could last another few days. During this time the person may feel exhausted, irritated, sore and unable to concentrate and tolerate certain foods.
A Light-Touch Solution
CranioSacral Therapy helps prevent and end migraine headaches primarily by releasing tensions throughout the meningeal membranes of the craniosacral system. Removing these tissue restrictions takes pressure off the nervous system and allows cerebrospinal fluid to drain correctly, preventing the buildup of pressure. CranioSacral Therapy helps release both primary and secondary dysfunctions of the peripheral body, dural tube, cranium and sacrum. The goal is to correct and balance all craniosacral system dysfunctions and the areas to which they might lead. Removing these meningeal and dural tube restrictions can effectively help release and prevent the pain of migraines.
Click here for previous articles by John Upledger, DO, OMM.
Dr. Lisa Upledger is vice president of The Upledger Institute and an examiner for the institute’s CST certification program. She graduated from Palmer College of Chiropractic in 1981.
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