tag:typepad.com,2003:weblog-1250480 %ISSUE_DATE%T09:25:32-07:00 Techniques, research and how-to's for professionals. TypePad tag:mpamedia.com,2008:post-55665 2011-12-16T12:00:32-07:00 2011-12-16T12:00:07-07:00

My last article was on thoracolumbar dysfunction as a source of superior cluneal nerve pain. In these cases, the patient will complain of lumbar and pelvic pain; but the source is the superior cluneal nerves at their origin at the thoracolumbar junction and along the nerves' course. Is this a common phenomenon, that sensory peripheral nerves get irritated and cause pain above and beyond the usual tunnel syndromes?

By Marc Heller, DC My last article was on thoracolumbar dysfunction as a source of superior cluneal nerve pain. In these cases, the patient will complain of lumbar and pelvic pain; but the source is the superior cluneal nerves at their origin at the thoracolumbar junction and along the nerves' course. Is this a common phenomenon, that sensory peripheral nerves get irritated and cause pain above and beyond the usual tunnel syndromes? tag:mpamedia.com,2008:post-55647 2011-12-02T12:00:32-07:00 2011-12-02T12:00:07-07:00

Elevated Production of Inflammatory Mediators in Patients With Neck Pain; Self-Rated Disability, Fear Avoidance and Nonorganic Signs in Whiplash Patients; The Neck Flexor Muscles and Chronic Neck Pain: Changes After Cervical Spine Mobilization; Neck Muscle Activity During Prone Hip Extension Based on Lumbar Motion Patterns; Lumbar Stenosis Rates in Symptomatic Patients Using Weight-Bearing and Recumbent MRI; A Clinical Scale for Assessing Abdominal Muscle Coordination; Tests for Screening and Diagnosis of Cervical Spine Myelopathy.

Elevated Production of Inflammatory Mediators in Patients With Neck Pain; Self-Rated Disability, Fear Avoidance and Nonorganic Signs in Whiplash Patients; The Neck Flexor Muscles and Chronic Neck Pain: Changes After Cervical Spine Mobilization; Neck Muscle Activity During Prone Hip Extension Based on Lumbar Motion Patterns; Lumbar Stenosis Rates in Symptomatic Patients Using Weight-Bearing and Recumbent MRI; A Clinical Scale for Assessing Abdominal Muscle Coordination; Tests for Screening and Diagnosis of Cervical Spine Myelopathy. tag:mpamedia.com,2008:post-55640 2011-12-02T12:00:32-07:00 2011-12-02T12:00:07-07:00

A study published recently in The Lancet should be causing surgeons and hospital administrators some serious concerns. The study examined the percentage of Medicare beneficiaries who undergo surgery in their last year of life.

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher A study published recently in The Lancet should be causing surgeons and hospital administrators some serious concerns. The study examined the percentage of Medicare beneficiaries who undergo surgery in their last year of life. tag:mpamedia.com,2008:post-55608 2011-11-04T12:00:32-07:00 2011-11-04T12:00:07-07:00

One of the frustrations chiropractors face in practice is treating spinal and associated extremity pain that does not resolve. Often our patients will ask our opinion about epidural steroid injections, or we will refer the patient to a neurologist or orthopedist, who will then suggest the procedure. Like many procedures performed for unremitting pain when neither the medical nor the chiropractic profession is able to relieve the patient by other means, it is important for our patient's sake that we become familiar with the validity of these procedures.

By Warren Hammer, MS, DC, DABCO One of the frustrations chiropractors face in practice is treating spinal and associated extremity pain that does not resolve. Often our patients will ask our opinion about epidural steroid injections, or we will refer the patient to a neurologist or orthopedist, who will then suggest the procedure. Like many procedures performed for unremitting pain when neither the medical nor the chiropractic profession is able to relieve the patient by other means, it is important for our patient's sake that we become familiar with the validity of these procedures. tag:mpamedia.com,2008:post-55585 2011-10-21T12:00:32-07:00 2011-10-21T12:00:07-07:00

With all the debates and foot-dragging on the order of Richard III as to where health care needs to go, I get the unmistakable impression that much of the true conscience of American medicine lies within recent reports from the Institute of Medicine.

By Anthony Rosner, PhD, LLD [Hon.], LLC With all the debates and foot-dragging on the order of Richard III as to where health care needs to go, I get the unmistakable impression that much of the true conscience of American medicine lies within recent reports from the Institute of Medicine. tag:mpamedia.com,2008:post-55571 2011-10-07T12:00:32-07:00 2011-10-07T12:00:07-07:00

I have been fortunate thus far in my chiropractic career to have been exposed to many different types of patients with a variety of ailments conducive to chiropractic care. Although I will always love my roots in spinal adjusting, I really get a charge out of doing extremity work. Let's focus on one of the most common problem areas people come to see us for: the shoulder.

By Kevin M. Wong, DC I have been fortunate thus far in my chiropractic career to have been exposed to many different types of patients with a variety of ailments conducive to chiropractic care. Although I will always love my roots in spinal adjusting, I really get a charge out of doing extremity work. Let's focus on one of the most common problem areas people come to see us for: the shoulder. tag:mpamedia.com,2008:post-55538 2011-09-23T12:00:32-07:00 2011-09-23T12:00:07-07:00

If you're wondering what consumers - your patients and potential patients - think about chiropractic care, particularly as it relates to its effectiveness managing common health conditions, consider findings from a Consumer Reports online survey of more than 45,000 of its subscribers. Survey results suggest that with the exception of back and neck pain, consumers - and Consumer Reports itself - continue to buy into the pharmaceutical model Big Pharma and others spend billions annually to promote.

By Peter W. Crownfield, Executive Editor If you're wondering what consumers - your patients and potential patients - think about chiropractic care, particularly as it relates to its effectiveness managing common health conditions, consider findings from a Consumer Reports online survey of more than 45,000 of its subscribers. Survey results suggest that with the exception of back and neck pain, consumers - and Consumer Reports itself - continue to buy into the pharmaceutical model Big Pharma and others spend billions annually to promote. tag:mpamedia.com,2008:post-55520 2011-09-09T12:00:32-07:00 2011-09-09T12:00:07-07:00

Nonspecific neck pain is a common affliction, with an estimated annual prevalence of 30-50 percent. The clinical course of this condition is usually episodic, with the level of symptom severity and recovery varying over time. Although chronic neck pain is not as costly as low back pain, it is estimated that 50-85 percent of neck pain patients still report symptoms one to five years after initial onset, and complete recovery is unusual.

By Shawn Thistle, DC, BKin (hons), CSCS Nonspecific neck pain is a common affliction, with an estimated annual prevalence of 30-50 percent. The clinical course of this condition is usually episodic, with the level of symptom severity and recovery varying over time. Although chronic neck pain is not as costly as low back pain, it is estimated that 50-85 percent of neck pain patients still report symptoms one to five years after initial onset, and complete recovery is unusual. tag:mpamedia.com,2008:post-55417 2011-07-01T12:00:32-07:00 2011-07-01T12:00:07-07:00

As insurance chair for two state associations, I often get calls regarding reimbursement and medical-necessity challenges. A good friend of mine and chiropractic colleague, Tim, called me last week and said, "These managed care plans are driving me nuts! I have chronic patients and all the insurance companies want to do is limit their visits to six and done. What do I do?"

By Jay Greenstein, DC, CCSP, CGFI-L1, CKTP As insurance chair for two state associations, I often get calls regarding reimbursement and medical-necessity challenges. A good friend of mine and chiropractic colleague, Tim, called me last week and said, "These managed care plans are driving me nuts! I have chronic patients and all the insurance companies want to do is limit their visits to six and done. What do I do?" tag:mpamedia.com,2008:post-55415 2011-07-01T12:00:32-07:00 2011-07-01T12:00:07-07:00

Dystonia is a movement disorder that causes the muscles to contract and spasm involuntarily. The neurological mechanism that makes muscles relax when they are not in use simply does not function properly. Opposing muscles often contract simultaneously as if they are "competing" for control of a body part. These involuntary muscle contractions force the body into repetitive, twisting movements and awkward, irregular postures.

By Nancy Martin-Molina, DC, QME, MBA Dystonia is a movement disorder that causes the muscles to contract and spasm involuntarily. The neurological mechanism that makes muscles relax when they are not in use simply does not function properly. Opposing muscles often contract simultaneously as if they are "competing" for control of a body part. These involuntary muscle contractions force the body into repetitive, twisting movements and awkward, irregular postures. tag:mpamedia.com,2008:post-55353 2011-06-17T12:00:32-07:00 2011-06-17T12:00:07-07:00

William Morgan, DC, has been appointed to the United States Navy's Musculoskeletal Continuum of Care Advisory Board (MCCAB), an entity created to address the prevalent musculoskeletal injuries sustained by U.S. armed forces personnel during active-duty operations.

By Editorial Staff William Morgan, DC, has been appointed to the United States Navy's Musculoskeletal Continuum of Care Advisory Board (MCCAB), an entity created to address the prevalent musculoskeletal injuries sustained by U.S. armed forces personnel during active-duty operations. tag:mpamedia.com,2008:post-55347 2011-05-20T12:00:32-07:00 2011-05-20T12:00:07-07:00

More than 50 million Americans suffer with chronic pain, accounting for more than 25 million physician visits per year for low back pain alone. The outcome is a nation of people who rely on nonsteroidal anti-inflammatory drugs (NSAIDs) for relief. Unfortunately, this is associated with various side effects that can be life-threatening for some. The second leading cause of peptic ulcers is the use of NSAIDs. Concerning ulcer-induced mortality, one third of NSAID / aspirin deaths are associated with low-dose aspirin use, presumably to prevent cardiovascular disease.

By David Seaman, DC, MS, DABCN More than 50 million Americans suffer with chronic pain, accounting for more than 25 million physician visits per year for low back pain alone. The outcome is a nation of people who rely on nonsteroidal anti-inflammatory drugs (NSAIDs) for relief. Unfortunately, this is associated with various side effects that can be life-threatening for some. The second leading cause of peptic ulcers is the use of NSAIDs. Concerning ulcer-induced mortality, one third of NSAID / aspirin deaths are associated with low-dose aspirin use, presumably to prevent cardiovascular disease. tag:mpamedia.com,2008:post-55239 T12:00:32-07:00 T12:00:07-07:00

To help you enhance your practice and increase your bottom line, Dynamic Chiropractic PracticeINSIGHTS asks practicing doctors of chiropractic, like you, for ideas and solutions that have been tested in real-world environments. In this issue, we asked: "What drug-free approach has been the most effective in addressing your patients pain? (not including an adjustment/manipulation)?"

By Christie Bondurant To help you enhance your practice and increase your bottom line, Dynamic Chiropractic PracticeINSIGHTS asks practicing doctors of chiropractic, like you, for ideas and solutions that have been tested in real-world environments. In this issue, we asked: "What drug-free approach has been the most effective in addressing your patients pain? (not including an adjustment/manipulation)?" tag:mpamedia.com,2008:post-55238 2011-03-26T12:00:32-07:00 2011-03-26T12:00:07-07:00

A recent article was brought to my attention that should send the medical profession (and its drug suppliers) seeking shelter. Titled "Why Almost Everything You Hear About Medicine Is Wrong," the article can be found on the Newsweek Web site. Perhaps the most powerful statement in the article comes from Dr. John P.A. Ioannidis, the new head of Stanford University's Prevention Research Center: "'People are being hurt and even dying' because of false medical claims, he says: not quackery, but errors in medical research."

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher A recent article was brought to my attention that should send the medical profession (and its drug suppliers) seeking shelter. Titled "Why Almost Everything You Hear About Medicine Is Wrong," the article can be found on the Newsweek Web site. Perhaps the most powerful statement in the article comes from Dr. John P.A. Ioannidis, the new head of Stanford University's Prevention Research Center: "'People are being hurt and even dying' because of false medical claims, he says: not quackery, but errors in medical research." tag:mpamedia.com,2008:post-55090 2011-01-01T12:00:32-07:00 2011-01-01T12:00:07-07:00

Fibromyalgia is a cyclic and progressive illness that affects millions of people regardless of age, sex or race. Symptoms vary but involve multiple body areas and are usually unrelenting, affecting various body systems, including the CNS, such as fatigue and depression; musculoskeletal, as in soft-tissue pain; gastrointestinal, as in IBS; dermatological; etc.

By Kenneth Muhich, DC Fibromyalgia is a cyclic and progressive illness that affects millions of people regardless of age, sex or race. Symptoms vary but involve multiple body areas and are usually unrelenting, affecting various body systems, including the CNS, such as fatigue and depression; musculoskeletal, as in soft-tissue pain; gastrointestinal, as in IBS; dermatological; etc. tag:mpamedia.com,2008:post-55089 2011-01-01T12:00:32-07:00 2011-01-01T12:00:07-07:00

Have you ever had a patient complain of increased pain post muscle injection? I have. Three of them. With the rise of clinical prediction rules and decision-making guidelines, I decided to review the literature for guidance on this matter, but found the evidence was insufficient. In some cases, injections significantly reduce symptoms, while in others they only provide a transient, albeit welcome, respite from suffering. I also stumbled upon a few case reports that noted occurrences of isolated neuropathies, infections, tissue necrosis and even induced psychosis6 post injections. None of this information proved helpful. So I went back to my cases.

By Marco Lopez, DC, CCEP Have you ever had a patient complain of increased pain post muscle injection? I have. Three of them. With the rise of clinical prediction rules and decision-making guidelines, I decided to review the literature for guidance on this matter, but found the evidence was insufficient. In some cases, injections significantly reduce symptoms, while in others they only provide a transient, albeit welcome, respite from suffering. I also stumbled upon a few case reports that noted occurrences of isolated neuropathies, infections, tissue necrosis and even induced psychosis6 post injections. None of this information proved helpful. So I went back to my cases. tag:mpamedia.com,2008:post-55081 2011-01-01T12:00:32-07:00 2011-01-01T12:00:07-07:00

One of the primary lessons I have learned over the years in clinical practice is that things are never what they seem when it comes to musculoskeletal pain. We often get mired in chasing pain and treating symptoms without looking deeper into other causative factors. It's the "site versus source" conundrum.

By Perry Nickelston, DC, FMS, SFMA One of the primary lessons I have learned over the years in clinical practice is that things are never what they seem when it comes to musculoskeletal pain. We often get mired in chasing pain and treating symptoms without looking deeper into other causative factors. It's the "site versus source" conundrum. tag:mpamedia.com,2008:post-54889 2010-09-09T12:00:32-07:00 2010-09-09T12:00:07-07:00

These are days of intense challenges in the field of chiropractic. Health care reform, competition from other professions performing adjusting, and decreasing insurance coverage plant fear in the hearts of many chiropractors. However, the future is actually very bright if DCs focus on what they do best: getting sick people well. Because we have such a wide scope of practice in most states and the need for treatment is so great, it is surprising that so many chiropractors feel their practices are not thriving. I want to make sure we all understand that our ability to adjust, provide nutritional support, exercise and rehabilitation, and use electrotherapy modalities, if done properly, is all a doctor needs to gain traction and build the practice of their dreams. However, to do this you must look to the research community to validate what you do; don't listen to the snake oil salesmen and gurus. In this article, let's consider the value of electrotherapy modalities, especially laser therapy.

By Curtis Turchin, MA, DC, DACBN, DCBCN These are days of intense challenges in the field of chiropractic. Health care reform, competition from other professions performing adjusting, and decreasing insurance coverage plant fear in the hearts of many chiropractors. However, the future is actually very bright if DCs focus on what they do best: getting sick people well. Because we have such a wide scope of practice in most states and the need for treatment is so great, it is surprising that so many chiropractors feel their practices are not thriving. I want to make sure we all understand that our ability to adjust, provide nutritional support, exercise and rehabilitation, and use electrotherapy modalities, if done properly, is all a doctor needs to gain traction and build the practice of their dreams. However, to do this you must look to the research community to validate what you do; don't listen to the snake oil salesmen and gurus. In this article, let's consider the value of electrotherapy modalities, especially laser therapy. tag:mpamedia.com,2008:post-54793 2010-07-29T12:00:32-07:00 2010-07-29T12:00:07-07:00

I recently had to appear before the Industrial Accident Board in my home state (Delaware) to describe my care of a patient. He had suffered a well-documented injury and all of the data supported a chronic diagnosis. The opposing counsel even presented information that he had already been deemed permanently disabled. I was being asked to defend my continued care, as another doctor who worked for the insurance company claimed that my care was of "no benefit."

By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM I recently had to appear before the Industrial Accident Board in my home state (Delaware) to describe my care of a patient. He had suffered a well-documented injury and all of the data supported a chronic diagnosis. The opposing counsel even presented information that he had already been deemed permanently disabled. I was being asked to defend my continued care, as another doctor who worked for the insurance company claimed that my care was of "no benefit." tag:mpamedia.com,2008:post-54698 2010-05-24T12:00:32-07:00 2010-05-24T12:00:07-07:00

Performance Health / Hygenic Corporation has made a donation of Biofreeze pain reliever, at a retail value of $1.2 million, to SupportOurTroops.Org. Donations to Support Our Troops are used to bring aid and comfort to U.S. troops in the field. Support our Troops is a non-partisan, non-political organization founded to directly help citizens and community-minded businesses find constructive ways to show their patriotism and appreciation for those that sacrifice so much to protect our country, our homes, and our families.

Performance Health / Hygenic Corporation has made a donation of Biofreeze pain reliever, at a retail value of $1.2 million, to SupportOurTroops.Org. Donations to Support Our Troops are used to bring aid and comfort to U.S. troops in the field. Support our Troops is a non-partisan, non-political organization founded to directly help citizens and community-minded businesses find constructive ways to show their patriotism and appreciation for those that sacrifice so much to protect our country, our homes, and our families. tag:mpamedia.com,2008:post-54664 2010-06-03T12:00:32-07:00 2010-06-03T12:00:07-07:00

While the complexities of the new health care reform law may elude most, one thing seems clear: Despite increased emphasis on wellness and prevention, Americans will be making more visits to health care providers, particularly allopathic doctors, who will likely continue doing what they do best: prescribe medication.

By Peter W. Crownfield, Executive Editor While the complexities of the new health care reform law may elude most, one thing seems clear: Despite increased emphasis on wellness and prevention, Americans will be making more visits to health care providers, particularly allopathic doctors, who will likely continue doing what they do best: prescribe medication. tag:mpamedia.com,2008:post-54591 2010-04-09T12:00:32-07:00 2010-04-09T12:00:07-07:00

Spinal care should always be diagnosis-based and tissue-specific to achieve the best results. The treating doctor should identify the source of pain before recommending treatment. However, some patients experience pain more intensely than others. These individuals may be predisposed to developing chronic pain and disability. If the initial pain experience is severe and continues this way without reduction, central pain hypersensitivity (CPH) may develop. Rapidly deceasing pain after an injury or acute episode prevents the development of chronic pain, disability and CPH.

By Marco Lopez, DC, CCEP Spinal care should always be diagnosis-based and tissue-specific to achieve the best results. The treating doctor should identify the source of pain before recommending treatment. However, some patients experience pain more intensely than others. These individuals may be predisposed to developing chronic pain and disability. If the initial pain experience is severe and continues this way without reduction, central pain hypersensitivity (CPH) may develop. Rapidly deceasing pain after an injury or acute episode prevents the development of chronic pain, disability and CPH. tag:mpamedia.com,2008:post-54587 2010-04-09T12:00:32-07:00 2010-04-09T12:00:07-07:00

There are a number of important points presented in the "Report to Congress on the Evaluation of the Demonstration of Coverage of Chiropractic Services under Medicare." While some of these findings may not be earth shattering, they paint a picture of today's chiropractic patient that we should all be paying attention to, because understanding your patients and their needs is step one in providing proper care. The evaluation included a survey sent to 3,464 users of chiropractic services under the Medicare system, with a 71 percent response rate.

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher There are a number of important points presented in the "Report to Congress on the Evaluation of the Demonstration of Coverage of Chiropractic Services under Medicare." While some of these findings may not be earth shattering, they paint a picture of today's chiropractic patient that we should all be paying attention to, because understanding your patients and their needs is step one in providing proper care. The evaluation included a survey sent to 3,464 users of chiropractic services under the Medicare system, with a 71 percent response rate. tag:mpamedia.com,2008:post-54582 2010-04-09T12:00:32-07:00 2010-04-09T12:00:07-07:00

When I was in school, I remember being told that reflex sympathetic dystrophy (RSD) was the modern term for causalgia, a condition first described by doctors during the Civil War. After graduation, I recall attending a seminar and learning that causalgia was the correct term to use if RSD was severe. Because of the confusion surrounding these two terms (as well as others), the condition was re-named in the mid 1990s to complex regional pain syndrome (CRPS), with CRPS Type 1 replacing RSD and CRPS Type 2 replacing causalgia. The differences were that the nerve dysfunction in CRPS Type 1 patients stemmed from traumas like sprains, fractures and surgeries, in which there was no direct nerve damage. The CRPS Type 2 label was reserved for those with a direct nerve injury. (However, due to the fact that the symptoms of the two classes do not differ, many doctors and therapists continue to call the condition RSD.)

By G. Douglas Andersen, DC, DACBSP, CCN When I was in school, I remember being told that reflex sympathetic dystrophy (RSD) was the modern term for causalgia, a condition first described by doctors during the Civil War. After graduation, I recall attending a seminar and learning that causalgia was the correct term to use if RSD was severe. Because of the confusion surrounding these two terms (as well as others), the condition was re-named in the mid 1990s to complex regional pain syndrome (CRPS), with CRPS Type 1 replacing RSD and CRPS Type 2 replacing causalgia. The differences were that the nerve dysfunction in CRPS Type 1 patients stemmed from traumas like sprains, fractures and surgeries, in which there was no direct nerve damage. The CRPS Type 2 label was reserved for those with a direct nerve injury. (However, due to the fact that the symptoms of the two classes do not differ, many doctors and therapists continue to call the condition RSD.) tag:mpamedia.com,2008:post-54446 2010-01-29T12:00:32-07:00 2010-01-29T12:00:07-07:00

The feet are the foundation of support for the pelvis and spine. They provide the necessary stability to perform daily activities. Central to the success of the pedal foundation is its arched structure, which is actually a complex of three bony arches: the medial longitudinal arch, the lateral longitudinal arch and the anterior transverse (metatarsal) arch.

By Mark Charrette, DC The feet are the foundation of support for the pelvis and spine. They provide the necessary stability to perform daily activities. Central to the success of the pedal foundation is its arched structure, which is actually a complex of three bony arches: the medial longitudinal arch, the lateral longitudinal arch and the anterior transverse (metatarsal) arch. tag:mpamedia.com,2008:post-54442 2010-01-29T12:00:32-07:00 2010-01-29T12:00:07-07:00

Some neurological lesions are beyond current science's ability to repair. We may, however, get back some neurological function which was apparently not "dead," but simply inhibited or "asleep." This possibility is what chiropractic neurology is about.

By Edgar Romero, DC, DACNB Some neurological lesions are beyond current science's ability to repair. We may, however, get back some neurological function which was apparently not "dead," but simply inhibited or "asleep." This possibility is what chiropractic neurology is about.