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.
How the Human Body Responds to Stress
This new series of articles will suggest a different perspective for you to view clients presenting with stubbornly chronic somatic dysfunctions. It will also propose a novel answer to the question, "How does the human body respond to stress?" Simply put, from the inside to the outside.
The place to start in this new perspective is with the movements that stress provokes within the anatomy of our visceral organs. All forms of external and internal stress stimulate visceral organs to respond via a combination of cringing, shortening, narrowing, and sometimes even twisting. Now add to this the concept that the visceral organs are a composition of sacs and tubes. The sacs surround our major organs including the brain and spinal cord, heart, lungs, and about half of the abdominal and pelvic organs are housed within the peritoneal sac. Tubes are the major components within our organs and they also connect them one to the other.
Repercussions for Stress
Stress provokes our sacs to cringe, while the tubes shorten, narrow, and sometimes even twist.1 These combined multi-planar actions pull the body toward its center. This perspective further suggests that our organ systems are moored from our bones, suspended forward and downward from the cranium itself, and from the anterior surfaces of the cervical and lumbar spines.2
This is a different way to conceive how our anatomy is organized, and to perceive the interactions within our physiology, yet this is what my clients have taught me and what has helped me to assist them the most. With our visceral systems moored from our bones, being slung forward and down, it is quite easy to understand how visceral tensions would strain the interlocking nature of our axial spine producing dysfunctions of motion along its kinetic chain. Reflect on just how many of your clients come to you because of soft tissue pain along the spine whether in the cervical, thoracic, or lumbar regions.
Add to this the number of joint problems you work with on a daily basis. The viscera also discharge their tensions into segments of the spinal cord via viscero-somatic reflex arcs. These neurological reflex arcs also contribute to joint related dysfunctions of the upper and lower extremities. In response to whatever joint misalignment occurs, the soft tissues contract or even spasm to protect the related joints.
Follow the Hierarchy
This provides us with a hierarchy to follow within our therapeutic perception especially when dealing with chronic somatic dysfunction and pain. Chronic symptom profiles consistently include the tensions of organs conveyed by their suspensory ligaments to the bones from which they are moored; those that are affected by the discharge of visceral tensions, and then finally to the soft tissue structures whose primary job it is to protect the joints.
Conceiving of an inside-to-the-outside approach provides you with a broader and more functional palette for creating treatment strategies. Summarizing to this point, stress first affects our viscera with their suspensory ligaments, then our joints, then the myofascial structures dedicated to maintaining the integrity of the affected joints.
You may ask why are the viscera more primary? They begin their functioning first during our complex human development. In utero and as infants our human anatomy and physiology is ingesting, digesting, and excreting long before our musculoskeletal system is capable of producing voluntary movements. Lansing Barrett Gresham conceptualized this as an inverted triangle of human learning during our developmental movement sequencing.
Whatever develops first is more primary than what follows. It is a simple thematic whose time has come to be threaded into our perception of how the human body really works.3
Effective treatment of chronic difficulties has consistently evidenced that keeping this functional sequence clear in one's perceptual field produces better results for clients.
Compression, Congestion & the Dis-Coordination of the Nervous System
A second idea that has clearly evidenced itself for more than nearly 40 years of clinical practice is the triad of compression, congestion, and the dis-coordination of the nervous system. Soft tissues contract or spasm around joints that are displaced by the pull of the suspensory visceral ligaments. Such shortening of the soft tissues inevitably produces localized, regional and systemic states of congestion within the fluids of our bodies.4
Together, progressive states of compression and congestion confuse the nervous system about where and how often to deliver fresh blood. Along with this notion, a simple awareness has emerged; until old blood moves out, the delivery of new blood is slowed to find its way to the tissues and cells that need it the most.
This is exactly what happens when soft tissues go into protective spasm around a misaligned joint. The spasm itself participates in starving the joint surfaces, as well as themselves, adding to the progression of less range of motion and more pain due to the accreting ischemia.
The Viscero-Somatic Referral Region
There are additional perspectives and conditions to be considered. For now, simply allow yourself to reflect on what was just described through the all-too-common scenario of clients presenting with chronic right shoulder/upper back problems. The right shoulder and right upper back is generally accepted by the medical profession as a viscero-somatic referral region where the liver / gall bladder complex often discharges its tensions.
Add to your understanding that the heart and diaphragm embryologically originate in the neck at the level of C2 and descend caudally, coming to rest parallel to the anterior fifth rib. Include that the liver is suspended from the underneath side of the diaphragm by the coronary ligament.
The phrenic nerve is the sole motor nerve of the diaphragm yet, according to Dr. Jean Pierre Barral, the developer of Visceral Manipulation, the sensory side of the phrenic nerve receives input from the capsule of the liver, the gall bladder and the pancreas which are transmitted back to its origins at C3-4-5. This overlaps the brachial plexus' origins in the spinal cord from C4 - T2. It is from the brachial plexus that blood and nerve supply is distributed to the shoulder, arm and hand.5
Most of us have learned the crucial function of restoring the flow between the brachial plexus to the shoulder and upper back. Yet the notions of how and why visceral distress can feed into chronic musculoskeletal disorders has been overlooked. They now need to be included within the palette of our treatment strategies. All chronic symptom profiles have multiple tributaries. Many of them originate from within our visceral organs. Stress affects our visceral organs first. The body is an integrated whole.
The last article series on the common bile duct conveyed how central the liver, gall bladder and pancreas complex were to our evolutionary success and are on a day-to-day basis to our clients' quality of life. I continue to extend the invitation to become part of your clients' early detection team.