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.
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.
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."
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.
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.
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.
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."
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?
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.
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.
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?
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:
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 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.
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).
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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 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.
December, 2009, Vol. 9, Issue 12
Heating Up Your Practice Safely, Part 1
By Dixie Wall, Contributing Editor
Over the last decade, many bodyworkers have begun using stones, not to replace human touch but as an additional relaxing and leveraging technique. Traditionally used by Egyptians, Shamans and American Indians, stones have a long history of therapeutic use and spiritual healing.Today, incorporating stones in one's practice offers this ancient tool, to not only relax clients but also give our hands a rest. Hot stones are a form of thermal and magnetic therapy, requiring a unique trust between the client and practitioner. A respect for the trust bestowed in us by our clients need to be developed by a safe and meticulous protocol to perform this primal technique.
After attending a hot stone seminar this summer, I was immediately reminded how splendid hot stone massage is, not only for the client but also for the therapist. Throughout my years of practice, I was always hesitant to use any type of tool, I never cared for the way the tools felt on my skin, either giving or receiving. Yet with rocks, especially smooth and warm ones, the feeling is different. There is an instant primal connection to a real rock from the ocean or a riverbed, which is relaxing to the spirit and nurturing to the soul.
Hot stone massage is usually done with basalt lava stones, which contain high levels of calcium, magnesium and iron. These minerals can facilitate balance within our energy centers or chakras, and they can move stagnation within our channels and meridians. Many therapists use cold stones as well. These may be smaller marble stones or quartzite crystals. Cold stones are commonly used on the face.
Stones and heat are both very powerful. When not treated with respect and vigilance, they can actually injure the client. Other types of heat therapy to keep in mind include hydroculator wet packs, water bottles, herbal compress bags and infra-red heat lamps.
Last fall, I published a three-part series on malpractice and liability claims. Many of these claims frequently involve burns from hot stones, cupping and hydroculator packs.
And while we are well aware of all the benefits of hot stones and other heat therapies. Over the winter months, we will discuss several treatment procedures, contraindications and cautions of which we should be aware as we provide therapeutic heat, especially hot stones to our clients. This month, we will discuss treatment procedures, skin typing and informed consent.
It is of utmost importance to have set procedures. We must follow a methodical, yet simple, protocol in our treatment rooms to ensure the safety of ourselves and our clients. Sloppy procedures and little or no training are the number one causes of burns in the treatment room. Why do client's get burned? Usually because stones are too hot.
According to Michael Schroeder, vice president of the American Massage Council, "The most common problem with hot stones is the method therapists are using to cool down the stones. If they are too hot, therapists often use cold water to cool them down, but this only cools the external layer of the rock.
"After placing them on a client, the superficial layer of the stone quickly becomes hot again, sometimes burning the client. The therapist doesn't realize they have only temporarily cooled the external layer. This means if the stones are too hot, the only way to cool them down is time. We can put them on a washcloth next to the heater, turn down the temperature and wait for them to cool."
Additionally, always test stones on your own forearm before placing them on the client. Our own hands may not be a safe temperature gauge because they are less sensitive to heat than the rest of our bodies.
Never give a hot stone massage using silicon gloves. If you use a glove rather than tongs or a skimmer to remove the stones out of the water, never put them straight onto client. If the palm of your hand cannot hold the stone, most likely the client will not tolerate the heat. Again, test the temperature on your own forearm first.
Always use a temperature gauge in the water while heating up the stones. Warm stones (90 F - 110 F) are used for those with sensitivity to heat or for large stones that are going to compress the body without a sheet or towel. Hot stones (110 F - 125 F) are used for active massage. Temperatures will vary according to client, always test your equipment, set the heater at low without a cover and go from there.
It's better to start on tougher (yang) areas first (back and lateral portions of the body), then work toward medial and anterior portion (yin).
In general, "stones do not care for bones". We should avoid all bony clefts and spinal processes. No stones should be placed on the eyes if the client wears contact lenses.
Fitzpatrick Classification Scale
Another tool we can use to keep our clients and ourselves protected is becoming familiar with skin typing. The Fitzpatrick Classification Scale (developed in 1975 by Thomas Fitzpatrick, a Harvard Medical School dermatologist) classifies a person's complexion and tolerance of sunlight. The scale is used by several different health practitioners to determine how their patients will respond to heat therapies.
We can educate our clients by including a skin typing chart in our initial examination documents or by incorporating it into our informed consent documents.
Another important facet of a long-term successful practice using heat therapies is always having the client sign an informed consent document, specifically for hot stone therapy, before receiving treatment. This document may explain benefits and risks of hot stones therapy, contraindications and cautions, and explain the skin-typing procedures.
By enlightening our clients through a professional intake procedure, we further establish a foundation of love and trust that facilitates their healing.
In the chilly months ahead, heat therapies may be suitable to offer your clients as a seasonal special or a holiday gift. When incorporated into practice with a healthy respect and awareness, we can securely integrate these healing modalities into our current practices. In the coming months, we will discuss contraindicated diseases, conditions and medications for heat therapies.
I would love to hear your experiences or comments. Please feel free to contact me at .
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