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Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
April, 2014, Vol. 14, Issue 04
Familiar Client, Fresh Perspective
By Debbie Roberts, LMT
The following is an example of a true story about one client's journey through treatment and how easy it can be to ignore valuable signs and information when something is out of balance and needs medical attention.We are always glad when a client has given us their trust and continues a long term relationship with us. We strive to maintain a good, solid, profitable aand reputable practice. Pose to yourself this question: do I keep an objective eye on each visit even after 5, 10, 15 or 20 years of the same client? To help keep you doing just that, let's discuss the important pieces of information that are beneficial. In addition, we will also explore applied kinesiology as a worthwhile assessment tool.
Client Case Study
The weekly relaxation client came in complaining of back pain. She explains, "it is a gnawing, nagging, dull ache that seems to have taken up home in my back." Well that sound's typical of this client because she is a young mother. Since beginning with you, she has changed jobs and added two children to the mix. You give her back more attention and try some different modalities to address the issue and she leaves feeling better and certainly refreshed. But the problem begins when she comes in week after week and the pain doesn't seem to be resolving. Some weeks the complaint of pain didn't seem so bad and she gave the impression the massage was helping. Again, the trouble is that the complaint is not really changing only the fact that she is dealing with it. You rationalize that she must be under so much stress it is making the back pain worse. You do take notice that it seems like the complaint has been going on for several weeks.
You decide on the next visit to do a structural assessment of the low back and her pelvis. The findings indicate the pelvis to be a little anteriorly rotated. You address the issue and she leaves feeling better however she comes back again the following week with the same complaint. So, you make a referral to a chiropractor. He thinks the issue is not enough deep tissue work. He suggests another therapist to address the knots in her lumbar region, but nothing is completely helping. Now, the question becomes how long do you watch this pattern continue?
You decide the next visit to use applied kinesiology. Using the assessment, you find that the back pain indicates some energy disruption around her female organs. She has had a past history of fibroid tumors in her ovaries but it was a long time ago when she filled out any health history form so you don't remember this valuable piece of information. This is a missed opportunity to correlate your new findings with her past history. You lightly mention that your assessment indicates there is something disrupting the energy flow around her female organs. She is not knowledgeable of what that really means. So she doesn't remind you of her past history with fibroids. You don't push the issue for her to see another medical professional because at times she seems to get better.
She comes in the next week and you try a different modality thinking that maybe this one is the missing piece. No need to do the applied kinesiology assessment again because you are sure it must be something musculoskeletal out of balance. The issue goes unresolved for more than 6 months. Finally, in desperation, she went to a medical doctor and they did a series of tests and found a cantaloupe size tumor around her ovary. Everyone who treated her was well intentioned, but somehow missed that this time her back pain was something more than her usual chronic back pain.
How To Avoid This Mistake
A health history form should be updated on a regular basis. This keeps your objectivity and helps you avoid becoming too accustomed with the client. The new complaint was not treated like a new client. After filling out a new health history form, the client should have had a structural assessment, as well as an applied kinesiology assessment to look for functional imbalances.
An assessment at every visit should have been done. When the findings of the assessment are not changing, that lets you know whatever modality of therapy you have chosen is not resolving the issue. Refer out.
Correlating a health history form and an evaluation is important in case the pathology you find would need another medical professional involved and requires a referral. If the pain doesn't go away and the assessment doesn't change over two to four weeks tops, refer out. Don't keep treating, we are only a part of the process.
Whether you have a long standing practice or want to develop one, there is extreme importance of keeping a fresh perspective on the clients you treat. People's bodies are always changing and it seems these days at rapid rates. The longer you have a regular client, the higher the percentage that something in their body can and will change. Assuming their new pain complaint is old stuff that has just resurfaced can be dangerous for you and the client. Have you ever studied a sunrise or a sunset, it happens every day but it is never the same. Your objectivity of the client coming in week after week should be a similar point of view. The client shows up at the same time every week, but they are not the same cellular structure they were the week before. Physically, mentally and chemically they are a different human being than their last visit with you. Doing some form of an assessment each visit reassures your dedication to accuracy and helps keep you alert to a new symptom or new problem. The other dangerous thing here is losing your objectivity to the findings. When the pain doesn't go away and the assessment never gets better STOP the insanity. There is something wrong that may need more medical attention.
As the preacher completed his sermon, the other preacher listened closely. He found it odd that for the third week in a row the preacher was giving the same sermon. So he asked him, why didn't you give a new message this week, you gave that same message last week and the week before. "Good question, glad you asked" It is because even though everyone heard the message, only some people acted on it and changed while other people are still doing the same things. When the congregation not only hears the message, but acts on it, I will quit giving the same message.
We all know the definition of insanity is doing the same thing over and over and expecting different results. This is what we can become guilty of if we become too familiar with our clients and don't take a fresh view point each and every time they walk into the room. When is the last time you had your clients fill out a new health history form? When is the last time you did a structural and functional assessment on your clients? You don't have to make it complicated. Just tell yourself this is a NEW complaint, so this is virtually a NEW client. What would you do with a new client? Follow that same protocol and start with a fresh health history form, a fresh assessment, see if anything correlates with their past history, listen closely to see if things are really getting better or remaining the same and make a referral if necessary. When in doubt always refer out.
Applied Kinesiology was developed in the mid 1960's by Dr. George Goodheart, a second generation chiropractic physician from Detroit. Dr. Goodheart noted that each muscle in the body is related to a specific organ. He found that each organ shared reflex points and acupuncture circuits with a specific muscle or muscles. Treating a weak muscle in a number of ways to turn on reflex points and acupuncture circuits would return strength to a previously weak muscle and the function of a related organ.
Utilizing muscle testing procedures, one can find weak muscle "energy" because of an imbalance in the specific organ they relate to. When doing muscle testing, you are feeling for a locking in place of the muscle and not complete weakness. It should be explained that this is not a contest of strength and that gradual pressure is used.
There are four major categories of muscle weaknesses:
What is an alarm point? The alarm points are reflex points associated with the meridians. In Chinese philosophy, it was believed that if disease occurred in the internal organ associated with the meridian, the alarm point would become tender. When tenderness is present upon light pressure, the meridian is considered to be overactive; and upon deep pressure underactive.
How to use the alarm points:
Touch for Health is a book that has been around for a long time which is a great resource of study on the use of applied kinesiology. Just remember that all findings should be correlated with standard diagnostic methods, such as laboratory tests, x-rays and even MRI's.
Click here for more information about Debbie Roberts, LMT.
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