Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
May, 2016, Vol. 16, Issue 05
Massage Therapy and Trigeminal Neuralgia
By Linda LePelley, RN, NMT
Trigeminal Neuralgia (TN) is a chronic condition that causes severe, excruciating facial pain. It usually occurs when the myelin sheath of the trigeminal nerve has been worn away, sometimes due to a blood vessel causing compression to the nerve, or if the patient has Multiple Sclerosis, a disease which attacks the myelin sheath.Sometimes TN can be brought on by an arteriovenous malformation or a tumor. Trauma, dental work, and strokes affecting the nerve can also trigger TN. The trigeminal nerve consists of three branches, which service the face and up into the scalp. Any branch, and more than one, can be affected. Occasionally, it can occur bilaterally.
When diagnosed, TN is classified as one of two types, which The National Institute of Neurological Disorders and Stroke describes as follows: The typical or "classic" form of the disorder (called "Type 1" or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, in volleys lasting as long as two hours. The "atypical" form of the disorder (called "Type 2" or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.
I have seen a handful of patients over the years with TN. The first one came into an emergency room where I was doing my clinical rotation. I will never forget what she cried, "Please, knock me out, or kill me, but I can't bear this pain!" She was medicated and sent home. I've often wondered about her. The ER doctor called her a "Frequent Flyer," but once he left the room, the nurse on duty reminded me that the patient's pain is whatever they say it is. I refused to work on the first client who asked if I could help TN, referring her to a neurologist. Several years ago a long-time client with MS told me her TN, which had been in remission for a long time was back, and she wanted me to work. I told her she needed to see a neurologist, to which she replied, "My neurologist is the one who sent me to see you, so don't be a chicken!" I used a very cautious approach, fearing that massage would trigger an attack. Her jaws were almost rigid bilaterally, so I focused on relaxing and softening the tissues using gentle massage and heated eye pillows over the face. It was entirely successful. In the following years that I worked on her, she had no more complaints of TN.
It is one thing to read and learn about a condition and quite another to experience it firsthand. I had begun to experience some very short but severe episodes of pain in my upper jaw. It felt as if I were being struck with an electrical shock that would paralyze me with pain for just a second, and then be gone. I decided to have some dental work done, thinking that whatever was hurting would get cleared up at the same time. The attacks of pain became more frequent, lasting up to twenty mind-bending minutes, and the area involved expanded from my TMJ up into my eye and the side of my head. While in the dentist chair one day, I was struck with an episode. I told my dentist I would rather die than feel this pain again, which brought to mind the patient in the ER all those years ago. Before he even began explaining it to me, I realized that I was experiencing TN. I chose to treat it the same way I do headaches, heat and massage until all of the painful, tight and hardened tissues are soft and malleable. For myself, it worked completely. I haven't had an attack in about two years.
Since this experience, I have sought clients with TN, offering treatment in exchange for allowing me to experience working on them. The results I've had are excellent, with complete pain relief for three clients. However, because they either did not have an actual diagnosis of TN, there were other conditions going on, as well as other treatments being used, a reliable case study could not be produced. I live and work in a small town, but hopefully, the right client with the right diagnosis will become available to study in the near future.
TN is serious in that the pain is debilitating. According to the NIH, the incidence of new cases is about 12 per 100,000 people a year, and is more frequently found in women. Current treatment for TN begins with anticonvulsant medications, and tricyclic antidepressants are prescribed for pain relief. TN is not believed to be related to depression or psychological factors, but analgesics are generally ineffective.
TN is a progressive condition, and if medications lose their effect over time, there are more invasive treatments available for pain relief. These include injections and several different types of surgery, all which involve the risk of unpleasant side effects. The NIH handout for TN states, "Some individuals manage trigeminal neuralgia using complementary techniques, usually in combination with drug treatment." Although they list low-impact exercise, yoga, and visualization among other approaches, there is no mention massage therapy. In my limited experience, massage therapy for TN has relieved everyone who has attempted it. From what I understand of this condition, it progresses over time. As the tissues become more compressed, the pain becomes more intense. If heat and massage can soften, mobilize, and relieve pain elsewhere in the body as it does, it can certainly relieve at least some of those cases of TN. It only makes sense to try therapeutic massage before administering drugs or performing surgeries.
Click here for previous articles by Linda LePelley, RN, NMT.
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