resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
Positional Release Self Care for Soreness and Other Pains
If your patients are anything like mine, they will report to you that there is commonly a degree of discomfort, soreness or stiffness a day or so following manual treatment no matter how gentle or appropriate that treatment might have been. As a result, I offer advice regarding home care of such problems, and I tend to repeat a mantra to most patients who have received treatment for musculoskeletal problems as they depart. I ask them to largely ignore any soreness they might feel the next day. I tell them that it is perfectly normal for there to be an adaptive reaction/response to treatment for a day or so of their knee, neck, or whatever focal point of distress brought them to see me and that it will probably not be until around 48 hours later that they will know whether today's treatment was helpful.
And of course, if your patient happens to have a chronically painful problem, it's highly likely that a degree of sensitization will have occurred, making their responses and reactions to treatment far less predictable and potentially excessive. For more on that subject please see my May 2011 article, "Understanding Central Sensitization"
How common are short-term adverse effects following manual therapy? Bronfort et al (2010), conducted a major review of the effectiveness of manual therapies and it also looked at negative effects: "Adverse events associated with manual treatment can be classified into two categories: 1) benign, minor or non-serious and 2) serious. Generally, those that are benign are transient, mild to moderate in intensity, have little effect on activities, and are short lasting. Most commonly, these involve pain or discomfort to the musculoskeletal system. Less commonly, nausea, dizziness or tiredness are reported."
Carnes et al (2010), also conducted a detailed review of the evidence relating to the safety and side-effects following use of manual therapy modalities and concluded that: "Nearly half of patients after manual therapy experience adverse events that are short-lived and minor; most will occur within 24 hours and resolve within 72 hours. The risk of major adverse events is very low, lower than that from taking medication."
Even in relation to muscle energy technique (MET), one of my favorite modalities because of its extreme versatile efficacy, gentleness and safety, there are commonly minor degrees of discomfort for a day or two following treatment, even when appropriately applied. Greenman (2003) has explained some of the processes leading to post-MET-treatment discomfort: "All muscle contractions influence surrounding fascia, connective tissue ground substance and interstitial fluids, and alter muscle physiology by reflex mechanisms. Fascial length and tone is altered by muscle contraction... The patient's muscle effort requires energy and the metabolic process of muscle contraction results in carbon dioxide, lactic acid and other metabolic waste products that must be transported and metabolized. It is for this reason that the patient will frequently experience some increase in muscle soreness within the first 12 to 36 hours following MET treatment. Muscle energy procedures provide safety for the patient since the activating force is intrinsic and the dosage can easily be controlled by the patient, but it must be remembered that this comes at a price. It is easy for the inexperienced practitioner to overdo these procedures and in essence to overdose the patient."
In other words, when correctly applied, MET will commonly lead to mild discomfort for several days, BUT, when incorrectly applied (contractions too strong, stretching too vigorous, etc.) more severe reactions may result and without the bonus of benefits that correct usage might offer! For more on muscle energy techniques, you can visit my web site, www.leonchaitow.com/muscle.htm.
Are there strategies that you might be able to teach patients to manage this adaptive stage? What else might you offer your patients as self-care for minor reactions to treatment? Depending on the specifics of the individual's problems, a number of options are available, ranging from simple hydrotherapy (hot and cold compresses, ice massage) to relaxation methods, self-stretching (if appropriate) and from my perspective the most potent self-care we can teach patients in pain is self-applied positional release.
Derived from osteopathy, Positional Release Technique (PRT), or that version of it known as Strain-Counterstrain (SCS), can relieve pain by relaxing tight (shortened) tissues and improving local circulation. Unlike massage and stretching, PRT is safe to apply even on damaged or inflamed tissues. If painfully shortened (hypertonic) soft tissues can be gently placed into a position in which they are made even shorter, pain is usually temporarily removed. If that "position of ease" is maintained for a minute or so, the tight, tense muscle (and often trigger points housed there) are likely to release and relax, sometimes permanently, but at least for a while with pain diminishing subsequently.
Try the following exercise, self-treatment of tense suboccipital muscles, and consider teaching it to patients as an example of this remarkable method of self-care. This is adapted from Chapter 5 of my book, Positional Release Techniques.
Patient instructions for suboccipital self-treatment using SCS:
General Guidelines For SCS Self-Care Of Pain Anywhere Else
If a painful point/local area is on the front of the body, bend forward to relieve it; the further it is to one side, the more you should slowly turn toward that side. If the point is on the back of your body, bend slightly backward until the pain reduces a little, then turn away from the side where you feel the pain, and "fine-tune" to release the discomfort. If the point is on a limb, try to shorten the relevant muscles (don't stretch them) by slowly moving the area to find the position in which the pain is most reduced. When there are many areas of pain it is often best to start with those nearer the head and nearer the middle of the body, using this extremely noninvasive and effective form of treatment.