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-56462 2013-04-15T12:00:32-07:00 2013-04-15T12:00:07-07:00

After 18 years of diagnosing, treating, lecturing and writing about chronic pain, what was at first difficult to diagnose and treat has been simplified by experience into six conditions most clinicians miss because the presentations are not typical or do not generally respond to chiropractic. If chiropractic care has not produced resolution of even chronic pain in 12 weeks, it is probably not going to. Ninety percent of the patients who contributed to my experience had failed with chiropractic care, physical therapy or medical treatment.

By Carolyn McMakin, MA, DC After 18 years of diagnosing, treating, lecturing and writing about chronic pain, what was at first difficult to diagnose and treat has been simplified by experience into six conditions most clinicians miss because the presentations are not typical or do not generally respond to chiropractic. If chiropractic care has not produced resolution of even chronic pain in 12 weeks, it is probably not going to. Ninety percent of the patients who contributed to my experience had failed with chiropractic care, physical therapy or medical treatment. tag:mpamedia.com,2008:post-56275 2012-12-16T12:00:32-07:00 2012-12-16T12:00:07-07:00

Imagine this scenario: You're hurting and you just want to make it through the day with as little pain as possible so you can keep your job and maintain a normal life. Unfortunately, many people do not have to imagine this because it is their way of life. Whether it's an injury, chronic pain or degenerative condition that leaves a person in pain, the goal of any patient is to feel better. However, you know as doctors of chiropractic that feeling better doesn't necessarily mean getting better.

By Kent Greenawalt Imagine this scenario: You're hurting and you just want to make it through the day with as little pain as possible so you can keep your job and maintain a normal life. Unfortunately, many people do not have to imagine this because it is their way of life. Whether it's an injury, chronic pain or degenerative condition that leaves a person in pain, the goal of any patient is to feel better. However, you know as doctors of chiropractic that feeling better doesn't necessarily mean getting better. tag:mpamedia.com,2008:post-56096 2012-09-23T12:00:32-07:00 2012-09-23T12:00:07-07:00

In the past three-and-a-half decades, filmmaker Donald Barrett has been involved in 33 documentaries including "Scared Straight," the first program to win the Academy Award for Best Documentary, an Emmy Award for Best Documentary and the George Foster Peabody Award for Best Public Service Programming.

By Peter W. Crownfield, Executive Editor In the past three-and-a-half decades, filmmaker Donald Barrett has been involved in 33 documentaries including "Scared Straight," the first program to win the Academy Award for Best Documentary, an Emmy Award for Best Documentary and the George Foster Peabody Award for Best Public Service Programming. tag:mpamedia.com,2008:post-56057 2012-08-12T12:00:32-07:00 2012-08-12T12:00:07-07:00

The prevalence of hip pain is terribly rampant in our modern society. Current statistics indicate that one in four people may develop painful hip arthritis in their lifetime. A recent study found that 14.3 percent of participants ages 60 years and older reported significant hip pain on most days in the previous six weeks.

By Kevin M. Wong, DC The prevalence of hip pain is terribly rampant in our modern society. Current statistics indicate that one in four people may develop painful hip arthritis in their lifetime. A recent study found that 14.3 percent of participants ages 60 years and older reported significant hip pain on most days in the previous six weeks. tag:mpamedia.com,2008:post-56042 2012-07-29T12:00:32-07:00 2012-07-29T12:00:07-07:00

Is there ancient wisdom that can be applied to modern problems? I believe so. I also believe in yin and yang, or the union of opposites. Polarities are a good example of this concept. People generally think of hot and cold temperatures in terms of opposites. But in actuality, cold is the absence of heat, not the opposite of it. These polarities, like many things in life, are distinguishable from one another, but never separate. They exist exclusively in relation to each other.

By Brian Capaldi, DC Is there ancient wisdom that can be applied to modern problems? I believe so. I also believe in yin and yang, or the union of opposites. Polarities are a good example of this concept. People generally think of hot and cold temperatures in terms of opposites. But in actuality, cold is the absence of heat, not the opposite of it. These polarities, like many things in life, are distinguishable from one another, but never separate. They exist exclusively in relation to each other. tag:mpamedia.com,2008:post-56036 2012-07-29T12:00:32-07:00 2012-07-29T12:00:07-07:00

Patellofemoral pain syndrome is one of the most common gait-related disorders, affecting more than 25 percent of the running community. Despite the high prevalence, identifying the cause for this condition has been enigmatic. Early research based on an off-weight-bearing model of knee function suggested the most likely biomechanical cause for patellofemoral pain syndrome was a lateral shifting of the patella between the femoral condyles. The most frequently cited causes for this include an increased Q-angle and/or weakness of the vastus medialis obliquus muscle (VMO).

By Thomas Michaud, DC Patellofemoral pain syndrome is one of the most common gait-related disorders, affecting more than 25 percent of the running community. Despite the high prevalence, identifying the cause for this condition has been enigmatic. Early research based on an off-weight-bearing model of knee function suggested the most likely biomechanical cause for patellofemoral pain syndrome was a lateral shifting of the patella between the femoral condyles. The most frequently cited causes for this include an increased Q-angle and/or weakness of the vastus medialis obliquus muscle (VMO). tag:mpamedia.com,2008:post-56008 2012-07-29T12:00:32-07:00 2012-07-29T12:00:07-07:00

The National Institutes of Health's Pain Consortium, established "to enhance pain research and promote collaboration among researchers across the many NIH Institutes and Centers that have programs and activities addressing pain," has named 11 "Centers of Excellence in Pain Education" at universities across the nation in an unprecedented effort to better equip health care practitioners to manage pain effectively.

By Peter W. Crownfield, Executive Editor The National Institutes of Health's Pain Consortium, established "to enhance pain research and promote collaboration among researchers across the many NIH Institutes and Centers that have programs and activities addressing pain," has named 11 "Centers of Excellence in Pain Education" at universities across the nation in an unprecedented effort to better equip health care practitioners to manage pain effectively. tag:mpamedia.com,2008:post-55879 2012-04-18T12:00:32-07:00 2012-04-18T12:00:07-07:00

Performance Health has made a donation of Biofreeze pain reliever, at a retail value of $212,000, to SupportOurTroops.Org. This donation, large enough to serve 25,000 troops, will be provided to U.S. service members in Afghanistan.

Performance Health has made a donation of Biofreeze pain reliever, at a retail value of $212,000, to SupportOurTroops.Org. This donation, large enough to serve 25,000 troops, will be provided to U.S. service members in Afghanistan. tag:mpamedia.com,2008:post-55841 2012-04-09T12:00:32-07:00 2012-04-09T12:00:07-07:00

Michael is a 70-year-old male who came to me with a diagnosis of plantar fasciitis (PF). Like most cases of PF, his symptoms developed insidiously and are worse in the morning with his first steps out of bed. (It is also typical for most cases to be aggravated with prolonged weight-bearing and activity, and with the first several steps after prolonged sitting or non-weight-bearing movement.)

By Jeffrey Tucker, DC, DACRB Michael is a 70-year-old male who came to me with a diagnosis of plantar fasciitis (PF). Like most cases of PF, his symptoms developed insidiously and are worse in the morning with his first steps out of bed. (It is also typical for most cases to be aggravated with prolonged weight-bearing and activity, and with the first several steps after prolonged sitting or non-weight-bearing movement.) tag:mpamedia.com,2008:post-55757 2012-02-12T12:00:32-07:00 2012-02-12T12:00:07-07:00

Over the years, understanding and treating the extremities has moved to the forefront of my practice. Integrating extremity analysis and adjusting into your patient protocols can make you a more skilled practitioner. It gives you the confidence in knowing and understanding how the entire body can and does affect spinal stability.

By Kevin M. Wong, DC Over the years, understanding and treating the extremities has moved to the forefront of my practice. Integrating extremity analysis and adjusting into your patient protocols can make you a more skilled practitioner. It gives you the confidence in knowing and understanding how the entire body can and does affect spinal stability. 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, CCSP 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.