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.
January, 2016, Vol. 16, Issue 01
Positional Release Techniques: What are the Mechanisms?
By Leon Chaitow, ND, DO
At its simplest, positional release techniques as used in manual therapy settings, involve the unloading of tissues, placing them into less-stressed, "ease" positions. In such a comfort state, a number of beneficial changes may emerge including reduced pain perception and reduced inflammation,15 greater local muscular strength, reduced fascial stiffness,1,2 reduced pain-medication use and number of days of hospitalization, as well as enhanced peripheral circulation, post-surgically.11
There are four main forms of PRT methods:3
The benefits of reduced stimulation, applied to the whole body may help us to understand the effects of PRT. For example, time spent in a flotation tank, immersed in neutral temperature water, of high salt concentration to increase buoyancy - described as Restricted Environmental Stimulation Technique (REST) – reduces anxiety, depression and pain in individuals suffering chronic pain.
In 2001, Kjellgren et al, described 37 patients suffering from chronic pain who were randomly assigned to either a control group (17) or an experimental group (20) who received nine REST treatments over a 3-week period. The most severe pain intensity was significantly reduced, but low perceived pain intensity was not influenced. REST treatment elevated optimism, reduced the degree of anxiety or depression, and improved sleep.
In another study, Edebol et al (2008) reported the benefits of the REST method in the management of the chronic effects of whiplash injuries. And of course, relaxation, mindfulness, meditation approaches – are all known to be useful as means of reducing general over-sensitive states, whether mental, or physical. Here are some suggested mechanisms for manually induced stimulus reduction.
Neurolophysiological changes might involve muscle, fascial and joint mechanoreceptors (e.g. Ruffini corpuscles, Golgi tendon organs, muscle spindles),10 as well as pain receptors. To explore the role of muscle spindles, and the hypothesis that sensitivity of the deep tendon stretch reflex contributes to range-of-motion restrictions, Howell et al. (2006) measured stretch and H-reflex latency and amplitude before and after strain counterstrain treatment. The results suggest that SCS affected the sensitivity of the muscle spindle, thought to be heightened by the existence of tendonitis.
Proprioceptive theory is probably the most commonly discussed explanation for the efficacy of SCS. It is suggested that when a disturbed relationship exists between muscles and their antagonists, following strain, the positioning of these tissues into an unloaded, ease, position, may allow spindle resetting and partial or total resolution of inappropriate motor impairment.9
Mechanotransduction: Altered fibroblast responses resulting from changes in the shape and architecture of cells through mechanotransduction can be anti-inflammatory. Meltzer et al.14, observed that traumatized fascia disrupts the normal functions of the body, causing myofascial pain and reducing ranges of motion. Resulting inflammatory responses - involving fibroblasts - can be reversed in as little as 60 seconds by changes in load on the tissues, delivered either by counterstrain or myofascial release. In 2007, Standley & Meltzer observed that "fibroblast proliferation and expression/secretion of pro-inflammatory and anti-inflammatory interleukins may contribute to the clinical efficacy of indirect osteopathic manipulative techniques..." such as SCS. Standley and Meltzer (2008) also reported that "it is clear that strain direction, frequency and duration, impact important fibroblast physiological functions known to mediate pain, inflammation and range of motion."
Ligamentous reflexes: Solomonow13 identified the sensory potential and major ligamento-muscular reflexes that have inhibitory effects on associated muscles. He states, "If you apply only 60 to 90 seconds of relaxing compression on a joint... an hour+ of relaxation of muscles may result. This may come not only from ligaments, but also from capsules and tendon" (personal communication 2009). A possible clinical application of this ligamentous feature may be seen when joint "crowding" is induced as part of Facilitated Positional Release and/or SCS protocols. Such effects would be temporary – 20 to 30 minutes – but this would be sufficient time to allow an enhanced ability to mobilize or exercise previously restricted structures.
Wong16 summarizes current thinking regarding ligamento-muscular reflexes and SCS: Ligamentous strain inhibits muscle contractions that increase strain, or stimulates muscles that reduce strain, to protect the ligament.7 For instance, anterior cruciate ligament strain inhibits quadriceps and stimulates hamstring contractions to reduce anterior tibial distraction.7
Hydration: Crowding (compression) of soft tissues – as used in SCS and Facilitated Positional Release (FPR), has an effect on the water content of fascia, leading to temporary (20 to 30 minutes) of reduced stiffness of fascial structures – with the potential for enhanced mobility during that period. This window of opportunity can be usefully employed to enhance function and for the individual to experience less painful movement.
Hysteresis: In a study at the Philadelphia College of Osteopathic Medicine (Barnes 2012), 240 subjects were palpated for cervical articular somatic dysfunction. This was followed by use of a durometer to objectively measure soft-tissues overlying each cervical segment pre- and post-intervention, using a single consistent piezoelectric impulse, quantifying hysteresis (tissue stiffness/densification). Various soft-tissue techniques, including SCS, myofascial release, muscle energy technique and high velocity manipulation were tested. The results showed that all methods - but not the sham intervention - improved symptoms and stiffness of tissues but that SCS resulted in the most significant beneficil changes.
To what degree all, or any, of these mechanisms are operating during application of PRT in general, and StrainCounterstrain (SCS) in particular, remains to be more definitively established. Meanwhile positional release methods are among the safest and most effective ways of easing painful symptoms and inducing a healing response.3
Click here for more information about Leon Chaitow, ND, DO.
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