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.
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.
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."
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.
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.
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.
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.
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."
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?
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
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.
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.
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?
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:
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.
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.
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.
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).
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.
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.
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.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
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.
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.
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.
Trigger Point Release: Thoracic Mobilization Using Tennis Balls
Nearly 20 years ago, Janet Travell and David Simons, the two leading pioneers of management of myofascial pain, described a simple myofascial-pain self-treatment approach, particularly when interscapular areas are involved. They advised putting two tennis balls into a sock, and placing this onto the floor (ideally carpeted), in a way that allows the person to lie back onto them — so inducing a compressive force that is almost entirely under the control of the individual.
If this direct pressure is uncomfortable, more weight could be taken on the forearms, and less on the sensitive areas. The advice was to have kept the balls in a freezer, before use, so that they are very cold, adding cryotherapy pain-relief to the process.
A few minutes of such treatment, no more than once a day, should effectively reduce myofascial pain — remembering that the underlying causes and aggravating features, of the dysfunction — whether involving poor posture, or due to overuse should be addressed in order to avoid recurrence.
Travell and Simons advised that: "Whenever the patient hits a "hot spot" or a painful trigger point, he or she can maintain that position and control the pressure by starting gently and gradually increasing body-weight pressure on the tennis-balls, until the trigger point releases."
My own approach to use of this method, for paraspinal muscle tension or pain, were described in my book, "Maintaining Body balance, Flexibility & Stability." A: Place two tennis balls into a sock. B: Place the balls on a carpeted floor. C: Lie so that your spinous processes rest between the balls, and the balls press into the tense muscles alongside the spine. 1
It is often found to be useful to move gently, so that the balls roll up and down the paraspinal muscles, for a minute or two. There are several important cautions regarding self- applied treatments of any sort, including trigger point deactivation. If you offer advice for home care/self-treatment it's important for the individual to be advised that:
Thoracic mobilization using tennis balls
Recently a more general thoracic mobilization variation of the use of the "two tennis balls" has been described and validated by research. In 2012 a two-stage method, for self-mobilization of the thoracic area, was described by Johnson & Grindstaff.2
Stage 1: Paraspinal Muscle Release
The individual lies back onto the two tennis balls, that have been confined in something such as a sock — so that the balls press lightly (and painlessly) into the stiffest paraspinal soft-tissues, with the spinous process resting in the groove between the balls.
The arms should be crossed over the chest, as the person slowly raises the head-and-shoulders off of the floor, for a count of three seconds, before lowering back down to allow the balls to press into the tense tissues for a few seconds. It is suggested that — once daily — this process should be repeated up to 15 times.
Then, following a few minutes of rest, the sequence should be repeated once more. Different levels of paraspinal stiffness can be treated, in the same way, by placing the balls appropriately. Slow deep breathing should accompany the exercise, and no pain should be experienced.
Stage 2: Supine Arm Circles
The tennis balls should be placed on one side or the other — in tense tissues, lateral, or inferior, to the scapula, so that the two balls are parallel to the thoracic spine. The arm on the side being treated should be raised so that the shoulder is flexed to 90 degrees, with the arm straight.
The arm should be moved in slowly increasing circles, clockwise, for about 30 seconds, and then anti-clockwise for the same length of time. After resting for a minute or so, the process should be repeated — before the other side is self-mobilized in the same way. Slow deep breathing should accompany the exercise, and no pain should be experienced.
Validation of the usefulness of these methods was reported in 2015, by Jung et al., who observed that when the protocol, as described above, was used by people with thoracic restrictions, there was a marked difference in thoracic mobility (as evidenced by a significant increase in the degree of chest expansion) between those who performed the exercises (three times weekly for six weeks), compared with those who did not.