Supplement Safety: Is It Time to Give Big Pharma a Chance?
Why in the world would I, a chiropractor, consider Big Pharma when I make a vitamin / supplement recommendation to a patient? There are several supplement manufacturers at every chiropractic conference, even at some of our schools.
A Little More Chiropractic, A Lot Less Pain
Why should I visit a doctor of chiropractic when I'm not experiencing pain or other symptoms? That's the question many patients still ask themselves, despite the growing body of research supporting the value of chiropractic maintenance care.
The Carcinogen Most Patients Consume
A known carcinogen is being naively consumed by many, if not most of your patients, who have little to no understanding of how dangerous it really is. Depending on the age of the patient, this carcinogen is a leading, if not the leading, risk factor for death and disability.
Renying-Cunkuo Pulse: The Essential Pulse Method of the Ling Shu
The Ling Shu is a Han Dynasty classic book on the practice of Chinese medicine. It presents five main channel systems: Muscle Channels, Chapter 13; Luo Collaterals, Chapter 10 and others; The Main Channels, Chapter 10 and many more; Separate Channels (Divergent Channels) Chapter 11; and the Eight Extraordinary Channels, referenced in chapters throughout the book (there is very little theory).
A Moment of Silence for Dr. Leon Chaitow (1937-2018)
After months of declining health, Dr. Leon Chaitow – clinician, author and teacher – passed away on Sept. 20, 2018 at the age of 80.
How to Address the Question, "Do You Accept Insurance?"
Do you ever dread getting asked the question, do you accept insurance—when you only accept cash, or when you are out-of-network? As part of my daily practice, mentoring acupuncturists to grow their practices faster and more effectively, I talk to a lot of practitioners.
Pregnancy Health: Looking at the Lower Extremities
When patients tell us they are pregnant, many times we focus on the obvious pregnancy signs and symptoms related to their current trimester of pregnancy, and the biomechanical impact on the spine and pelvis.
Procuring a Place for the Future
As the acceptance of acupuncture continues to grow in the U.S. it is important that the profession be licensed in every state, and nationally board certified.
A New NCCIH Director ... One That Backs Acupuncture
The third time is a charm—the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH), announced it's newest director, Dr. Helene Langevin.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 1)
In the absence of acute trauma, a usual strength-building session includes concentric, eccentric and isometric exercises. Popular exercise programs typically include concentric movements as the major muscle contraction and should constitute approximately 70-75 percent of the workout time.
Paradise Lost: AWB Relief in Hawaii
In November, 2014, Acupuncturists Without Borders (AWB) was hosting a training seminar on Oahu. A couple of us from the big island (aka "Hawaii" County) contacted AWB because the big island was in the middle of a crisis.
Manual Muscle Testing for Cervical Radiculopathy (Pt. 2)
Dr. John Bandy developed a protocol that associated specific muscles with myotomal nerve root levels. The deltoid is associated with the C6 nerve root; the triceps with the C7 nerve root; and the finger abductors with the C8 nerve root.
World Acupuncture Day: A Meeting in Paris
World Acupuncture Day is an event organized by the World Acupuncture Day Organization (WADO) in response to the eighth anniversary that UNESCO has included acupuncture and moxibustion on it's Representative List of the Intangible Cultural Heritage of Humanity.
Creatine: Muscle Fuel No Longer Just for Athletes!
Erase that image of the 20-year-old, muscle-bound bodybuilder using creatine. Replace it with the image of a lean, strong, fit 80-year-old hiking up a mountain. Creatine, a staple of athletes for more than 50 years, is now being used by athletes and non-athletes alike to help slow normal age-related muscle loss, improve exercise recovery, increase strength, and live a more active lifestyle.
Travel-to-Treat Coverage Finally Becoming a Reality?
Long-awaited legislation poised to hit the president's desk extends liability insurance coverage from one state to another for DCs and other state-licensed health care professionals who care for athletes / athletic teams that cross state lines.
NBCE Exams: Better, Shorter, More Opportunities
The NBCE's Written Exams department, led by Bruce Shotts, DC, developed a solution to computer-based testing on college campuses. Their work has resulted in 11 exam opportunities per year. CBT exams are on schedule to begin January 2019 as follows:
The Husband/Wife Imbalance
The Husband/Wife Imbalance, like Aggressive Energy, is an energetic block that will result in death, unless cleared, as its presence indicates that nature has given up the fight against the internal or external pathogenic factors that have assaulted the body/mind/spirit of the patient.
Case Study: Osteoporosis and the Role of Orthotic Support
The following is the second of three case studies by Dr. Wong on conservative management of lower-extremity complaints. Article #1 (September issue) explored chiropractic management of patellofemoral arthralgia.
Bait & Switch: Are You Guilty?
One of my three sons recently shared a story with me regarding an experience with a chiropractor, which stimulated me to write this ethics article. According to my son, he called a chiropractor's office and asked if his insurance was accepted at the office.
Cyberthreat Checklist: 10 Key Steps to Defend Your Practice
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.
Vertebral Subluxation: Give Credit Where Credit Is Due
Vertebral subluxation: have any other words caused as much turmoil and controversy in the chiropractic profession? As a chiropractic term, vertebral subluxation did not make its debut until six or seven years after the profession's founding.
Chiropractic Integration a Big Success, Suggests Research
Whether chiropractors should integrate with other health care professionals in medical / multidisciplinary settings remains a contentious issue, depending on whom you ask, but there's no denying two realities.
An Effective Herb for Stress
We all know stress has become a significant factor in the increasing number of reported mental health disabilities and a contributor to various physical health conditions, such as ulcers, high blood pressure, heart disease, and so on.
On Point: Acupuncture Theory & Discussion
Welcome to my new column for Acupuncture Today, which will focus exclusively on the theoretical discussion and clinical application of acupuncture theory and acupuncture points. One of the most common questions I encounter from novice to experienced practitioners is "how do I choose the correct acupuncture point?". I hope this column can help answer some of these questions.
The NCCIH Seeks Participants for Acupuncture RCT
The National Center for Complementary and Integrative Health (NCCIH) is seeking participants for a new Funding Opportunity Announcement (FOA)—a Randomized Control Trial (RCT), which will evaluate the impact of, and strategies to best implement acupuncture treatment of older adults (65 years and older) with chronic low back pain (CLBP).
Checking Your Posture: A Wholistic View From Head to Toe
As you begin reading this article, what position is your body in? Are you sitting down, standing up, lying down, or walking down the street perhaps? Whatever position you are in, stop and observe your posture.
Avoid These New-Patient Turnoffs (Before It's Too Late)
I can't believe this doctor is making me watch this video in a room by myself, your new patient thinks to herself as she texts her best friend.
The Road to TCM, A Talk With Bob Doane
Bob Doane, a veteran acupuncturist, talks about his journey to TCM, the evolution of this medicine, and what he foresees in the future.
Cynicism, Burnout and the Search for the Ideal Patient (Pt. 1)
There is a video on the Internet that has gathered 6 million views as I write this article (so likely millions more by the time you read it). The video is of a doctor in an ER mocking a patient who is extremely weak and distressed.
Placebos, Presence and the Zero Point
We spend a huge amount of time learning the techniques and methods of acupuncture and Chi-nese medicine, and are given professional licenses based on our ability to remember and accu-rately apply them.
A Moment of Silence for Dr. Leon Chaitow (1937 – 2018)
After months of declining health, Dr. Leon Chaitow – clinician, prolific author and teacher – passed away on Sept. 20, 2018 at the age of 80.
News in Brief
The Next Generation of Chiropractic Researchers: Historic NIH Grant; Cleveland University – Kansas City VP Joins CCE Site Accreditation Team; NUHS Opens Second Veterans Clinic; R.I. Chiro. Society Celebrates 100 years.
October, 2011, Vol. 11, Issue 10
Massage and Diabetic Peripheral Neuropathy
By Rita Woods, LMT
You can use your massage skills and talents to work on clients with diabetic and chemotherapy induced peripheral neuropathies. The degree of success is dependent upon the stage/severity of the neuropathy, client compliance with their own medical care and the "homework" you give them, and your understanding and use of the correct massage therapy protocol.
Neuropathies are characterized by a progressive loss of nerve fiber function. Diabetic peripheral neuropathy or (DPN) can be defined as "the presence of symptoms and or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes." This is by far the most common form of neuropathy and one that you are likely to see in your massage practice. Symptoms include pain, tingling, a burning sensation, numbness or loss of feeling, pins and needles feeling and even muscle weakness. This neuropathy usually starts in the toes (in the most distal peripheral nerves) then progresses to the foot, then up the ankle and so on. The hands can be affected in the same way. This condition is almost always bilateral, involving both feet and or both hands. While DPN can involve organs and other body systems, our goal here, staying within our scope of practice, is to normalize function in the feet and hands using appropriate massage therapy techniques. It's important to understand some processes to help hone your skills and to help educate your clients about why it is important to follow their doctors orders. Understanding the why of something often encourages participation and compliance.
First, let's look at the condition itself. The feet of a person with long-term or poorly treated diabetes will often look discolored in a mottled pattern, bluish, shiny/tight or swollen. The client may or may not have been diagnosed with diabetes. Often, it's the neuropathy that causes them to go see their doctor. Early stages usually show no outward physical signs but more advanced stages may show blue toes. This can (and usually does) eventually turn to gangrene where the tissue dies and turns black. The first sign of gangrene can look like a small poppy seed sized black spot. This tissue cannot be regenerated and amputation is the end result of this progression. Naturally, the goal is to begin working on these feet before the condition gets to that point. Following is a case study provided by Charlotte Versagi, LMT, using the massage protocol. This was her first and most dramatic case that eventually led to the saving of hundreds of toes and feet.
The client was a 55-year-old male construction worker with severe diabetes and bilateral cold/blue feet with numbness and tingling. He could barely stand to have his feet touched and his feet were so painful from neuropathy that he could barely get his feet into his work boots in the morning and almost cried when he pried his boots off at night. When he went to the doctor, he was told, "you should plan on an amputation sometime in the near future." There was no mention of any treatment option, no additional medication proposed, just "plan on amputation."
He came to Charlotte asking what she could do. She started the protocol, very slowly, very lightly and called in his wife to teach her. After a few weeks, they were going in "to the bone" as the protocol suggests. He came once per week. His wife was performing the protocol twice a day. He rubbed his own feet whenever he could. In four months, he had almost no pain, had full function and his feet were warm to the touch and normally colored. The doctor retracted his statement about amputation. It should be noted that the client was following a strict diet and taking his medication as directed and was compliant with all aspects of his diabetes care.
Glucose in the body undergoes a series of chemical reactions. If you consume normal amounts of sugars (fructose, sucrose, any form of "sugar" including honey) the early stages of the chemical reactions form an equilibrium reaction. This is called a reversible reaction and allows the body to function optimally. On the other hand, if too much sugar is consumed, these reactions are not reversible and a cascade of events take place by joining the glucose molecule with a protein or fat in an abnormal process which is pathological in nature. This process is called glycation and involves every fundamental process of cellular metabolism. Eventually, through a series of reactions, you wind up with advanced glycation end products or AGEs. These are bad things and cause nothing but harm and damage.
Glycation has been implicated in many diseases and inflammatory processes. It affects the cardiovascular system in a very big way. Tissues that have a slow turnover (more permanent) in the body are most affected by glycation. So the cardiovascular system, connective tissue and skin, nerve tissue and renal tissue are major targets. Inside a blood vessel are elastin fibers to which AGE molecules will attach, thus decreasing the diameter (or caliber) of the blood vessel. There is also a lot of collagen in the arterial walls that can cross-link with the AGE molecules further compromising the blood vessels ability to function properly. Each time there is a glucose spike and AGE molecules are formed, distal circulation is compromised and the blood vessels themselves become occluded beginning with the small capillaries. Unable to supply the surrounding tissue and nerves with nutrients and oxygen the resulting oxidative debt turns toes blue and causes nerves to malfunction sending signals to the brain of pain, tingling, burning and numbness. In addition to the mechanical damage, it is believed these toxic AGE molecules (and other toxins) also trigger the release of substances that further damage the adjacent nerves.
The most important factor to getting DPN under control is to first stop the sugar spikes. Clients must maintain their glucose at a balanced level. No great highs or lows. (They know what level their doctor wants them to maintain.) With diet and medication under control, the massage therapy protocol (coming next article) can truly help save toes and feet from amputation and relieve some or all of the pain and misery of the neuropathy. The next article will discuss chemotherapy induced peripheral neuropathy and give the detailed step-by-step massage therapy protocol for peripheral neuropathy as developed by Charlotte Michael Versagi who has graciously allowed me to share it, in its entirety, with Massage Today readers.
Editor's Note: For additional information, see Step-By-Step Massage Therapy Protocols for Common Conditions by Charlotte Michael Versagi with contributions by Rita D. Woods. Published by Lippincott Williams & Wilkins, 2011. To find this book and more on medical protocols, visit www.charlottemichaelversagi.com or www.darienlourde.com.
Click here for previous articles by Rita Woods, LMT.
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