The Opioid Crisis Hits Home: An Acupuncturist's Inside Perspective of Addiction Treatment
My husband and I have four grown children, but we still sleep with a phone next to our night stand just in case they need us. But nothing could have prepared us for a 1 a.m.
Power of the Talk: A Simple Way to Attract New Patients
One of the most effective ways to bring patients in predictably, especially if you enjoy teaching, is by doing talks. Talks can also bring in another stream of income beyond just seeing more patients one on one.
Who's the "Father of Corrective Traction" in Chiropractic?
History teaches that a Presbyterian minister, Samuel Weed, coined the name for the profession of chiropractic from the Greek cheir for "hand" and praktos for "done."
How to Reduce Metabolic Endotoxemia
Approximately 50 percent of the Western population suffers from a condition known as metabolic endotoxemia (ME). The condition is characterized by increased serum endotoxin concentration during the first five hours of the post-prandial period.
The Medicine of Peace in a Land of Conflict
We often read about violence, despair, and political stalemate between Israelis and Palestinians. It's easy to feel overwhelmed and pessimistic. And yet there are Israelis and Palestinians working together to transform conflict into cooperation.
Weight Watchers Goes Wellness
Goodbye Weight Watchers, hello "WW." The company has changed its name to reflect its new WW brand not only on its website, but also on every aspect of its public expression, including every studio.
ACA, ICA at Odds Over H.R. 7157
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.
Winter Joint Health: Looking at Seasonal Influences
One of the most common clinical issues I see during the winter season is joint / muscle pain. These issues often appear due to the activities of winter sports or may appear due to seasonal influences on old chronic injuries.
An East & West Perspective on Sleep
You, your patients, and people all over the world are sleeping less. In 1979 a team led by American psychiatrist Daniel Kripke did a large-scale study of over a million people, which indicated that most people slept between 7-8 hours.
Dehydration ... A Commonly Overlooked Etiology
Water covers 71 percent of the earth's surface. It's found in every living organism and is considered the "universal solvent," yet we take it for granted as the foundation for optimal health.
Historic Farm Bill Provisions Legalize Hemp ... and CBD?
Until recently, hemp was classified as a Schedule 1 drug per the federal Controlled Substances Act, putting it in the same class as marijuana (and heroin, by the way).
Electromagnetic Hypersensitivity and the Science of EMFs
Movement of planet Earth's molten iron core generates a weak static geomagnetic field that varies in strength over millennia but currently ranges from 0.25 to 0.65 gauss. This is the native field in which all life has evolved.
3 Tips to Get New Patients After a Talk
One of the most effective ways to bring in new patients predictably, especially when an acupuncturist enjoys teaching, is by doing talks. It can also bring in another stream of income, beyond just seeing more patients one-on-one.
Differentiating Qi Under the Needle (Part 2)
While classic sages have said a lot on this topic, I will share my own experience with the sensations under the needle with you. You, in turn, will also need to gain your own understanding of them through daily clinical observation, thinking, and practice.
Neuroscience 101: Understanding Opioid Addiction and How Chiropractic Can Help
Opioids now account for nearly two-thirds of all overdose-related deaths in the U.S. This insidious bane is no respecter of gender, age, race or ethnicity, with nearly all categories experiencing increases.
Case Study: Forefoot Pain
Patient presents with a history of forefoot pain. Discomfort has become worse in the past six months. He has difficulty completing his four-hour shifts as a part-time hairdresser.
Pain in the Butt (Pt. 1)
Many of my patients (and probably many of yours) come in with pain and/or tenderness in the buttock region. First, I assess where the painful and/or tender spots are located and what these points represent.
Flying Into the Year of the Pig: Making Way for the Impossible
The first of the new year has passed, and some of our New Year's resolutions may have already come and gone. Fortunately, we will celebrate the Chinese New Year this month, and will welcome in the Year of the Pig.
Quickie Seminar Adjustments Have No Place in Chiropractic
Recently, I observed chiropractors treating each other in the vendor area at the annual meeting of a chiropractic association. "Quickie" chiropractic adjustments and other hands-on procedures were administered without appropriate history taking, physical examination, diagnosis or informed consent.
The Role of TCM When Treating Mental Illnesses
Mental illness is common in the U.S., nearly 20 percent of adults live with a mental illness which vary in degree of severity—ranging from mild to moderate, to severe. It is not exaggerated to say that mental illness is an epidemic.
Simple Screening Tests for Stroke and Other Brain Lesions
The drift test, arm rolling and finger rolling are three useful assessments in the identification of upper motor neuron dysfunction.
Top Social Media Do's & Don'ts for Chiropractors
For years, health care practitioners have avoided embarking on the social media highway, primarily due to patient HIPAA privacy issues and the time needed to give the process due diligence.
Outcomes for Any Occasion
Outcome assessment tools (OATs) are a necessary part of documentation and patient care. They are used to show patient progress and help practitioners show changes as a result of their treatment interventions.
Quick Sacroiliac Assessment: Treating Different Types of Pain
The lower back is a generator for a number of types of pain. The lower back involves several different articulations – the lumbar spine with vertebral bodies, discs, and facets – the sacroiliac joints – and the lumbosacral junction.
Know Your Clinical Flags: 5 Different Colors to Consider
In health care, the term red flag is used to describe signs and symptoms that can indicate the presence of serious health conditions. These conditions generally carry an increased likelihood for serious complications, disability or even death.
October, 2008, Vol. 08, Issue 10
Complex Regional Pain Syndrome
By Whitney Lowe, LMT
Pain resulting from nerve entrapment syndromes is a common reason for clients to seek the care of a massage practitioner. However, there are numerous neurological disorders that, at first glance, might appear to be nerve entrapment but are an entirely different pathological condition. Complex regional pain syndrome (CRPS) falls into that category.
A brief review of fundamental neuroanatomy is helpful to properly understand what occurs in CRPS. The autonomic nervous system has efferent fibers that control activity in various smooth muscles, glands and cardiac muscle. Within the autonomic system there are two divisions, the sympathetic and parasympathetic. The primary function of the sympathetic branch is to stimulate activity, while signals from the parasympathetic branch serve to inhibit activity. Of these two, the sympathetic branch is more involved in CRPS.
The sympathetic nervous system has a vital role in protective reflexes as the body responds to stress. It is in high gear during the "fight or flight" response. However, excess sympathetic system activity can generate and maintain pain states in different regions of the body. It is this excess sympathetic activity that causes the symptoms of CRPS. While there still is not a complete understanding of how excess sympathetic branch activity causes these pain conditions, it appears there is some spillover of noxious input from the sympathetic efferents into various nociceptors, especially in the extremities.
The term complex regional pain syndrome has only recently been added to the medical lexicon. It includes two separate conditions that have similar symptoms, but are different in cause. The two conditions were formerly called reflex sympathetic dystrophy (now called CRPS 1) and causalgia (now called CRPS 2).5 The primary difference between them is how they occur. In CRPS 1, symptoms commonly occur as a result of some traumatic incident, but there is no evidence of specific nerve damage. In CRPS 2, there also is some event that initiated excess sympathetic activity, but this condition also involves identifiable damage to the nerve. Most of the symptoms of CRPS 1 and 2 are similar and are listed below:
Symptoms of CRPS
Distinguishing CRPS from other neurological disorders is aided by detailed evaluation of several clinical features in addition to those listed above. The condition can affect either the upper or lower extremity, but is more common in the upper extremity, and the pain usually is aggravated with moving the affected limb. Various myofascial dysfunctions also might accompany the extremity pain.1 Women are affected more often than men by approximately a three-to-one ratio.2 Some degree of depression or psychological dysfunction is common with CRPS. However, it is unclear if this psychological dysfunction is a causative factor or a result of the condition, because depression and similar psychological manifestations are common in severe and chronic pain conditions.4
Treatment for CRPS varies widely, but physical therapy is a primary component of most treatment protocols. The goal of most physical therapy treatments is to desensitize the area and restore normal function of the affected extremity. Massage might play a fundamental role in this process. Because myofascial dysfunction often is a part of the array of symptoms, addressing the myofascial component might interrupt the cycle of pain and dysfunction. In many cases, if the myofascial pain condition was properly addressed, the whole syndrome may resolve.3 Massage is also likely to be helpful because it is effective at decreasing overall sympathetic system activity.
If you have a client demonstrating signs and symptoms that indicate the possibility of CRPS, it is important to have them properly evaluated by a physician. There are a number of other treatment strategies such as nerve blocks and medications that are effective in addressing the problem, and it might be important to start these treatments as early in the rehabilitation process as possible.
CRPS can be a debilitating condition. Because it occurs more often in the upper extremity, it might be easy to dismiss many of the symptoms as arising from a peripheral compression neuropathy such as carpal tunnel syndrome. However, awareness of the variety of symptoms associated with CRPS allows the practitioner to look at a bigger picture and catch this condition early on, if present, so it can be most effectively treated.
Click here for more information about Whitney Lowe, LMT.
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