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Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
The Ulnaris Muscles
Let's take a close look at the anatomy and injury profiles of the extensor carpi ulnaris and flexor carpi ulnaris. Two difficult injuries to differentiate.
The extensor carpi ulnaris is attach to the lateral epicondyle, and it has a second head originating at the posterior border of the ulna. From there, it extends downward, crossing over the forearm to insert at the base of the pinky (the fifth metacarpal). This muscle-tendon unit not only extends the wrist and moves the hand into ulnar deviation, but also helps to stabilize the ulnar side of the wrist. One motion that's particularly dependent on the extensor carpi ulnaris is accelerating a motorcycle; the wrist moves into extension, twisting the throttle grip toward you.
The position of the extensor carpi ulnaris, relative to the other structures in the wrist, will differ depending on whether the forearm is pronated or supinated. Injuries are more likely to occur during supination, particularly when combined with wrist flexion and ulnar deviation. Many extensor carpi ulnaris injuries occur when the wrist is placed in this vulnerable position during sports such as tennis and golf. Others result from a sudden lateral force affecting the wrist while the tendon is strongly engaged. A stereotypical case is when a golf club hits a hard object on the ground, interrupting the momentum of the swing and forcing the hand into radial deviation, while this muscle-tendon unit is contracted isometrically. Such injuries are more likely to occur distally near the wrist, either at the tendon attachment or in the tendon body, causing pain in the wrist. Other activities like a backhand in tennis tend to cause injuries at the proximal attachments, which cause pain at the elbow.
Like the extensor carpi ulnaris, the flexor carpi ulnaris has both a humeral head and an ulnar head. One attaches to the humerus at the medial epicondyle, via the common flexor tendon. Its second attachment is at the olecranon process (the bony "point" of the elbow) and the posterior border of the ulna. The distal tendon inserts on the pisiform, hamate, and fifth metacarpal bones.
Strenuous wrist flexion activities like hammering, squash, and racquetball can also contribute to injury of the flexor carpi ulnaris, especially when the wrist is cocked in an awkward position. Tendon tears at the distal attachment will cause pain near the wrist, and tears at the proximal attachments will cause pain at the elbow.
The primary assessment test is resisted ulnar deviation of the wrist. The same test causes pain for both the extensor carpi ulnaris and flexor carpi ulnaris injuries. With the client's palm facing the floor, grip the forearm an inch or two above the wrist with one hand, and grasp the outer portion of the hand with the other. Ask the client to hold their hand firmly in place as you try to pull the hand toward the thumb side of the hand.
If the pain is felt on the flexor surface or at the medial epicondyle it's the flexor carpi ulnaris, if it's felt at the extensor surface of the forearm or near the lateral epicondyle then it's the extensor carpi ulnaris.
Often, you'll be testing to differentiate between one of these injuries and either tennis or golfer's elbow. Pain felt on resisted extension of the wrist may indicate either the extensor carpi radialis brevis or longus (which is tennis elbow) or the extensor carpi ulnaris. Pain on both resisted extension and resisted ulnar deviation tells you that the extensor carpi ulnaris is injured. (Of course, it's also possible for both structures to be injured simultaneously.)
If the pain is felt on resisted flexion of the wrist, it may indicate either the flexor carpi radialis (which is golfer's elbow) or the flexor carpi ulnaris. Pain on both resisted flexion and resisted ulnar deviation tells you that the flexor carpi ulnaris is injured. (Again, it's also possible for both structures to be injured simultaneously.)
Extensor and flexor carpi ulnaris injuries respond well to a combination of friction therapy, massage therapy and a combination of stretches and strength building exercises for the ulnaris muscles.