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Clinical Disorders and the Sensory System
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 4 from RC’s best-selling book:
“Basic Principles of Chiropractic Neuroscience”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 8: Clinical Disorders and the Sensory System
This chapter describes those sensory mechanisms, joint signals, and abnormal sensations (eg, pain, thermal abnormalities) that have particular significance within clinical diagnosis. The basis and differentiation of pain are described, as are the related subjects of trigger points and paresthesia. The chapter concludes with a description of the neurologic basis for the evaluation of the sensory system and the sensory fibers of the cranial nerves.
THE ANALYSIS OF PAIN IN THE CLINICAL SETTING
Although all pain does not have organic causes, there is no such thing as “imagined” pain. Pain that can be purely isolated as a structural, functional, or an emotional effect is rare. More likely, all three are superimposed upon and interlaced with each other in various degrees of status. This is also true for neural, vascular, lymphatic, and hormonal mechanisms.
Common Causes of Pain and Paresthesia
The common causes of pain and paresthesia are:
(1) obvious direct trauma or injury;
(2) reflex origins in musculoskeletal lesions, which deep pressure often exaggerates, such as trigger areas;
(3) peripheral nerve injury (eg, causalgia), which results in an intense burning superficial pain;
(4) the presence of nerve inflammations and degeneration of the peripheral or CNS, which frequently cause other changes indicative of such lesions;
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ILInet provides an interactive activity level indicator of Flu-Like Illness for the United States.
Going to work when you have a chronic pain-causing condition can be difficult or even downright impossible, depending on the job. Studies have shown that people with rheumatoid arthritis are more likely to change jobs, reduce their hours, be fired, and retire early than people without the condition.
If you have chronic pain and are in the workforce, you should try to find an occupation that isn’t too physically demanding and allows you to work at your own pace.
Best: Administrative assistant
Sitting at a desk all day is not ideal for someone with painful joints. Working as an administrative assistant, however, could have its benefits. You may not have to perform a lot of repetitive movements, unless it’s typing. Also, this position probably comes with some flexibility—it’s important to be able to move around when you need to and take breaks as necessary.
A 2012 study out of the University of Georgia found that administrative assistants and office staff in general had the fewest reported injuries of the occupations studied.
If you have a green thumb, it’s wise to limit your talents to your own yard. Landscaping tasks like pruning that involve frequent use of hand tools can cause pain in the small joints.
Landscaping also requires a lot of bending, stooping over, and kneeling, which can cause pain in joints, particularly the knees. Finally, it also involves lifting and hauling, sometimes in wheelbarrows, which can cause back pain.
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AMA on Warpath to Overturn Provider Non-discrimination Provision of the Affordable Care Act
The Chiro.Org Blog
ACA Press Release ~ June 26, 2012
Section 2706 prohibits insurance companies from discriminating against health care providers relative to their participation and coverage in health plans. It is applicable to all Employee Retirement Income Security Act (ERISA) health care plans, including self-insured, multi-state plans that are not subject to provider-friendly state laws. ACA (and the ICA) worked hard to ensure the inclusion of this provision in the health care reform legislation.
“As the voice of the chiropractic profession on Capitol Hill, ACA will not yield in its efforts to fight any threat to our patients’ access to the services of DCs and for our doctors’ right to practice to the full extent of their education and training,” said ACA President Keith Overland, DC. “AMA’s decision is outdated, and it demonstrates a desire, by some, to cling to the ‘old guard,’ but it is not in patients’ or our country’s best interests. Section 2706 will extend new health care services to millions, and it will help address the primary care shortage threatening our nation.”
The American Chiropractic Association (ACA) today reaffirmed its commitment to fighting provider discrimination, responding to a recent decision by the American Medical Association’s (AMA) House of Delegates to initiate a lobbying effort against Section 2706, the provider non-discrimination provision in the Patient Protection and Affordable Care Act (PPACA).
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One current trend into fighting antibiotic resistant bacteria is developing a new class refered to as antimicrobial peptides (AMP’s). However a newly published study published1 a proof of concept that bacteria will develop not only resistance to these new drugs but to our own innate immune response peptides as well.
A very nice summary of the findings was published in the latest issue of The Scientist online magazine.2
1. G. J. L. Habets, Michelle, and Michael Brockhurst. “Therapeutic
antimicrobial peptides may compromise natural immunity .” Biology Letters. N.p., n.d. Web. 23 Feb. 2012. <http://rsbl.royalsocietypublishing.org/content/early/2012/01/20/rsbl.2011.1203
2. Richards, Sabrina. “Antimicrobial Cross-Resistance Risk | The Scientist.” The Scientist. N.p., 24 Jan. 2012. Web. 23 Feb. 2012. <http://the-scientist.com/2012/01/24/antimicrobial-cross-resistance-risk/
DCs as Leaders in Health and Wellness: Part I: Utilizing the Practice-Based Research Network to Show Evidence of Chiropractic’s Efficacy
The Chiro.Org Blog
SOURCE: JACA Online
By Jay S. Greenstein, DC
Don’t just sit idly by and wait for your colleague down the street to sign up for ICON. We need him or her, but we need you too. Sign up today, and be part of the clinician-researcher army to show the world how important and special we are. It will help our profession, it will help your practice and most important it will help the millions of patients who don’t yet know how much we can help them.
As national health care reform takes hold, health care provider groups are staking claim to their slice of the health care pie. In fact, even in our own profession, there is an ongoing debate as to the role doctors of chiropractic will play. Should we be primary care physicians in the medical home (see www.foundation4cp.com/files/cp-medicalhome.Pdf) and/or accountable care organizations (ACO)? Should we alter our scope of practice to include prescription rights? Should we focus primarily on the spine?
While the debate rages on the aforementioned questions, I personally believe that the profession can rally around an even more important concept: Chiropractic must be the leading profession in health and wellness. We can be the cultural authority on this topic regardless of the answers to the questions above. In fact, most of us already perceive ourselves as health and wellness providers. But what does the evidence suggest? The evidence for Ds improving the overall health of our patients is paltry compared with the evidence supporting chiropractic for low-back pain. When was the last time you saw an article in a peer-reviewed journal that said, “Doctor of chiropractic services improve overall health metrics in patients compared to medical doctors”?
Anecdotally, we see this in our practices every day. Sharing stories with colleagues about how we helped our patients not only heal from their back pain but also become truly healthier is a daily occurrence. We must now turn those stories into evidence. Our profession needs evidence based on the rest of the world’s standards of what constitutes high quality research. That’s where the practice-based research network (PBRN) comes in.
Practice-Based Research Network
The PBRN, according to the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ), is “a group of ambulatory practices devoted principally to the primary care of patients, and affiliated in their mission to investigate questions related to community-based practice and to improve the quality of primary care.”
Fortunately, the chiropractic profession has Cheryl Hawk, DC, PhD, a highly- regarded researcher at Logan College of Chiropractic, who, along with researchers at Parker University and Texas Chiropractic College, has built a new PBRN for chiropractic. This PBRN is named ICON, the Integrated Chiropractic Outcomes Network. There is a great need for this initiative, as well as a great need for every DC in the country to participate in this practice-based research initiative. I recently had the opportunity to sit down with Dr. Hawk to ask her about ICON.
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