Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
January, 2010, Vol. 10, Issue 01
Heating Up Your Practice Safely, Part 2
By Dixie Wall, Contributing Editor
In December's issue1 we discussed heat therapies and their positive effects in the treatment room. We covered treatment procedures such as skin typing, which will help us give an effective heat therapy treatment while minimizing the risks of burns. We mentioned the use of an informed consent document during the preliminary consultation and reviewed the most common mistakes that can lead to accidental burns. This month, we will discuss the gathering and assessment of subjective and objective information to formulate the best treatment plan for our clients.
First we will begin by reviewing the physiological effects of heat on the body. These involve the endocrine, circulatory and nervous systems. The body's temperature is regulated by the hypothalamus (endocrine system), which strives to keep the body in balance. Common therapeutic responses of the circulatory system include increased circulation and blood flow to the muscles by the vasodilatation of the peripheral nervous system. Sometimes the client will feel slightly sedated from heat by the release of neurotransmitters that tend to make us feel good and cause a decrease in pain and joint stiffness.
Nevertheless, there are certain conditions, diseases and body types that may cause abnormal reactions to heat therapy and/or compromise a client's perception of heat. There are several types of heat therapies used by massage therapists, the most popular include: hot stones, immersion baths, electric heating pads, moist heat packs (hydrocollater packs) and infra-red saunas. In order to use these tools safely, we must remain flexible to our client's individual needs by incorporating our intuition and professional knowledge. It may be best to check first with a client's primary care physician when working with sick patients. A certain client's condition or symptoms may be exacerbated by heat therapies. Considering the aforementioned therapies, what are the subjective and objective factors to consider when treating with heat therapies?
The first precautionary measure we can take is by simply asking our clients for a basic medical history. These findings are subjective unless we actually talk to, or receive a note from, a client's primary care physician confirming diagnosis given by the client. Most therapists gather subjective information by an initial interview where the client fills out a complete medical history on their first visit. This document should include, but is not limited to: medical background including medications and supplements, and an informed consent. Some therapists include an extra form specifically for hot stones, or other types of modalities to be filled out by the clients before treatment. Here are some of most common contraindicated and cautioned diseases and conditions to be aware of with use of heat therapies:
Contraindicated diseases and conditions:
Acute conditions and special needs clients:
Subjective information is essential, however, objective observations are equally important and effective when creating a treatment plan for clients. By careful observation, we can use our intuition to determine the particular need of each client. For example, noticing that a client is generally in a hurry, feels "hot," tends to sweat easily or is easily irritated may raise a red flag for heat therapies. This client's symptoms point to a general heat pattern in the body and may be exacerbated by adding more heat.
Many types of alternative medical practitioners use subjective and objective information in order to reach a diagnosis and treatment plan for their patients. Legally we cannot diagnosis, but a therapist can still gather information to formulate the best treatment plan for each individual client.
In traditional Chinese medical theory, a practitioner may avoid heat therapies such as moxabustion and fire cupping on certain types of patterns of disharmony or disease. A diagnosis or pattern of disease may indicate whether or not the patient has a too much or not enough heat. Generally, Eastern doctors will not use heat therapies on heat patterns (excess yang or deficient yin/ hot body types) but will use them on patients who have cold patterns (excess yin or deficiency of yang/cold body types) in their diagnosis to warm up the body. The practitioner's intention is to promote the balance of hot (yang) and cold (yin) within the body.
From a similar perspective, Ayuervedic medicine also tries to achieve balance through body typing and diagnosis, and tends not to use heat therapies on people with a high pitta conditions (since pitta represents the fire-water element in the Ayurvedic tradition).
If still not sure on whether or not to use heat, a therapist can palpitate the client's pulse. From a traditional Chinese medicine perspective, pulses over 80 beats per minute (BPM) indicate a mild heat condition and a pulse over 90 BPM indicates a severe heat condition. However, pulse rates can be affected by many factors that should always be considered.
Ultimately, we must always make the client's well-being our top priority by creating balance through the use of our modalities. We must remain flexible based on our clients' needs. Coupling both our intuition and education, we can provide safe and effective treatments for our clients. As always, I welcome and appreciate any comments or concerns at .
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