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.
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.
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.
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:
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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."
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?
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."
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.
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.
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?
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.
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.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
March, 2008, Vol. 08, Issue 03
By Ruth Werner, LMP, NCTMB
This month, we continue our survey of neurological issues with a topic that has generated a lot of questions from concerned bodyworkers - peripheral neuropathy (PN). This rather ambiguous umbrella term refers to virtually any damage to nerve tissue outside the central nervous system. While we often associate PN with symptoms in the feet, it can likewise affect cranial nerves - in particular the vagus nerve - with serious or even life-threatening consequences.
Types of Peripheral Neuropathy
PN often is classified by what types of peripheral nerves have been affected. You may remember that peripheral nerves (which include spinal and cranial nerves) have some fibers dedicated to the somatic nervous system (having to do with conscious processing of sensory input and voluntary muscle activity) and others dedicated to the autonomic nervous system (mostly motor fibers that control heart rate, blood pressure, digestion and other involuntary functions). PN can affect any of these fibers. In other words, it can be primarily sensory, it can affect voluntary motor control, it can affect autonomic function, or any combination of the three. Furthermore, PN may be described by the tissue that is damaged: the neurons themselves, which is called an axonal injury, or the myelin surrounding the neurons in the peripheral nervous system.
PN often is classified according to its cause. Here is a short list of some possibilities:
Injury and infection also can cause peripheral nerve damage. Examples include carpal tunnel syndrome, thoracic outlet syndrome, Bell's palsy, HIV, herpes simplex and shingles. In these cases, however, symptoms are usually unilateral rather than symmetric. This is a diagnostic clue to the cause of the pain.
Signs and Symptoms of Peripheral Neuropathy
The signs and symptoms associated with PN vary according to the cause of the problem and which types of neurons have been affected. Obviously, sensory neuron damage leads to changes in sensation. This may reflect as tingling, shooting or burning pain, or numbness. Often people with PN describe a feeling of "stockings" or "gloves" with symptoms that begin bilaterally at the extremities and work proximally up the limbs.
Motor neuron damage leads to poor coordination and specific muscle weakness, which can lead to local atrophy as muscle fibers degenerate in the absence of stimulation. Perhaps the most alarming and dangerous symptoms of PN occur when cranial nerves, especially the vagus nerve, are affected. Autonomic symptoms can vary from occasional dizziness to changes in respiration and blood pressure. Reduced sweating with resulting hyperthermia may occur, gastric motility and digestion may be impaired, and bowel and bladder control may be lost.
Treatment options for PN are determined by the cause and severity of symptoms. Peripheral neurons have the amazing capacity to regenerate, so if the irritation is stopped and blood flow is returned, the nerve tissue may regain function. The prognosis is most hopeful when damage only affects the myelin sheath rather than the neuron tissue itself.
Analgesics (painkillers), antiseizure medications, lidocaine patches and antidepressants sometimes are prescribed to mitigate the symptoms of PN. These work with pain management, but don't target rebuilding the myelin sheath or damaged nerve tissue, for which exercise and good nutrition are generally the best options.
When we have a client who reports unexplained alternating periods of numbness and sharp shooting pains in the feet, the first thing we need to recommend is that they see a doctor. While we obviously don't want to exacerbate pain, in many ways numbness is a more serious symptom in terms of bodywork, because it prevents our client from telling us when our pressure is too intense.
Many people find relief with the gentle circulatory stimulus massage gives to limbs that are tingling and painful. Clients who have been diagnosed with PN may benefit from massage as long as sensation is intact and as long as cautions concerning their underlying disease or injury process are understood and respected. These are situations during which we definitely want to be in communication with a client's health care team, and it is important to avoid any radical changes in external environment - going from a hot soak to a cold plunge, for instance.
For Next Time
We could look at some of the neurological disorders that this discussion brought up (Bell's palsy, anyone?) or we could examine a poorly understood autoimmune condition, polymyalgia. Please let me know: What's on your table? Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.