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Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
April, 2014, Vol. 14, Issue 04
Highlighting the Use of Massage for Children Affected by FASD
By Tina Allen, LMT, CPMMT, CPMT, CIMT
Fetal Alcohol Spectrum Disorder (FASD) refers to the very broad spectrum of health issues infants' encounter from their mother's alcohol use during pregnancy.FASD includes several different health diagnosis; fetal alcohol syndrome (FAS), alcohol-related neurodevelopmental disorders (ARND), alcohol-related birth defects (ARBD), fetal alcohol effects (FAE), and partial fetal alcohol syndrome (PFAS). There is still much debate about a safe level of alcohol use, with many advocates saying any use during pregnancy puts a child at risk for negative physical or behavioral problems.
When a mother drinks alcohol during her pregnancy, it crosses the placental barrier and into the womb. A mother's body may be able to metabolize the alcohol, while the small or underdeveloped infant liver cannot. The alcohol may then stay inside of the infant's system longer. So, even the smallest amount of alcohol can have detrimental effects to a fetus.
The amount, sequence and timing of alcohol to the fetus all directly influence the type of health issues the child may experience once born. This causes a wide range of effects on the spectrum from severe (facial anomalies) to mild (judgment skills compromised.) Even more problematic is that many issues may not arise until the child begins to grow. The child may initially appear typical until there are subtle, and not so subtle, behavioral problems associated with the prenatal injury. Children who display facial anomalies, growth retardation and developmental abnormalities of the center nervous system are associated with the severe end of the spectrum. or simply fetal alcohol syndrome (FAS.)
Diagnosis of full fetal alcohol syndrome is based on three key features, a pre- and post-natal growth deficiency, facial abnormalities, as well as brain and central nervous system dysfunction. Professor Sterling Clarren's primate and mouse research on alcohol and pregnancy found that the lip and philtrum anomaly of (full) FAS happened during a very small development period; the 19th to 20th day after conception in the human – the period called gastrulation. However, it is well documented that children with facial features are only the tip of the iceberg. For every child diagnosed with full FAS, there will be another three to ten with alcohol-related neurodevelopmental disorders.
The brain injury that results from FASD can lead to developmental delays, an information processing deficit, the inability to reason in the way that others do and a distressing inability to fit in with the rules and behaviors required by society (deficits in self-control, hyperactivity and increased rates of ADHD) due to damage of the sensory processing system, nervous system and the brain. Heavy prenatal alcohol exposure can lead to structural abnormalities in the orbitofrontal cortex, anterior singulate, hippocampus, amygdala and corpus callosum.
The corpus callosum is the part of the brain that links the right hemisphere of the brain to the left hemisphere. The right-brain handles creativity, intuition and impulse and the left-brain handles the rules, logic, order and thoughts. When the two cannot link properly, because of prenatal exposure to alcohol or another brain injury, then the person cannot always predict the outcome of his actions even though he knows and can repeat the "rules."
Primary characteristics in children, adolescents and adults affected by FASD, include memory problems, difficulty storing and retrieving information, impulsivity, distractibility, disorganization, cognitive processing deficits (may think more slowly), slow auditory pace (may only understand every third word of normally paced conversation), developmental lags (may act younger than chronological age) and inability to predict outcomes, or understand consequences and inability to show remorse. However they often have strengths such as being highly verbal, artistic, musical, mechanical, athletic, friendly, outgoing, determined and persistent. In addition to cognitive and functioning difficulties, sleeping is also of great concern for children affected by FASD.
How Massage Can Help
Growth and developmental issues are key to the diagnosis of FAS, and in research studies of pediatric and infant massage therapy, it has been demonstrated to assist in both. For infants born prematurely, the use of massage has demonstrated a measurable increase in weight for the infants who received the therapeutic intervention. Additionally, when followed to an infant's one year birthday, researchers found that the massaged infants had a weight advantage, as well as, placing 12 to 15 points higher on the mental and motor tests of the Bayley Scales of Infant Development than the infants who hadn't been massaged. Even better, these results have been replicated by at least two other groups of researchers.
Another study was done with full-term, healthy 1 to 3-month-old infants who were given 15 minutes of either massage or rocking for 12 days over a 6-week period. What the group found was that the massage group gained more weight, displayed better face-to-face interactions, improved on emotionality, sociability and soothability, displayed less stress hormones and increased serotonin levels.
Sleep issues are a common complaint for many children with FASD, massage may not only help the child fall asleep quicker, but can often improve the quality of deep sleep. Having adequate amounts of sleep can assist in the child's mood, their behavior and may even decrease hyperactivity. Attention issues are also another key issue for children and adolescents with FASD and research demonstrates that massage increases mental focus and concentration.
While research is ongoing with both FASD and massage therapy, it is important to best understand the child who may benefit from massage therapy and what those indications may be. As a practitioner, it is important to provide the time to complete a detailed intake. A safe environment benefits all clients, but in the case of children affected by FASD you should also consider an environment which is not over stimulating to other senses. Take your time and proceed slowly when introducing touch therapy, as children may experience sensory processing difficulties and may be hypo or hyper sensitive to touch.
While it is a clear that massage is beneficial for many children, those affected by FASD may see some wonderful improvements following the intervention of pediatric massage therapy.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
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