Well, just a short post about an article by Leon Chaitow entitled: Breathing Pattern Disorders and Lumbopelvic pain and Dysfunction: An Update.
Those of you who have seen me in my Portland Oregon Chiropractic and Functional Movement Clinic, Optimum Function, or at my NCNM teaching clinic shift, may have wondered why I recommended breathing exercises as the first line of low back pain treatments; well, Dr. Chaitow will help explain it in his article.
Enjoy….. and take a few deep, belly-breaths today to honor your core and exercise your diaphragm.Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
OK, many of you know that I have been involved in the efforts to allow chiropractors to perform dry needling (especially if you are a patient). This spring, the Oregon Board of Chiropractic Examiners (OBCE) ruled in our favor, allowing chiropractors to use this technique in the treatment of myofascial trigger points. What is dry needling? I’ll get to that in a bit….
Chiropractors in Oregon and the rest of the world, have been treating myofascial trigger points and myofascial pain since we became a profession. The big issue here is that many of us want as many tools to treat these issues as possible; this is where using small gauge, solid filament needles comes into play. Currently, there are a number of states that allow chiropractors to use this tool in the treatment of their patients with myofascial problems; I have chiropractic colleagues in Colorado who use dry needling to treat their patients and have communicated with chiropractors in other states that allow dry needling about how effective it is in treating myofascial trigger and tender points. I was first introduced to dry needling while I was working as a massage therapist in an osteopath’s office in Colorado. I observed hundreds of patients receive this treatment and the osteopath I worked with was great with regards to teaching me what and why he was performing it.
Dry needling involves placing a very thin, single use, disposable, sterile, solid filament needle (not hollow) with clean needle technique into a myofascial trigger point and/or tender point. The number of needles used during any individual visit and the number of visits you are given this treatment depends on many factors that differ from patient to patient. These points are detected an number of different ways. As chiropractors, we have been assessing myofascial dysfunction and treating it with various techniques, like:
- Chiropractic adjusting
- Manual trigger point therapy
- Pin and stretch techniques
- Physiotherapy modalities like electric stim and cold laser
- Active rehab and myofascial release
- Instrument-assisted soft tissue therapies
We fully understand why and how myofascial problems arise; aberrant biomechanical processes, joint dysfunction, injury and repetitive stress are all avenues to developing myofascial pathologies and chiropractors are aptly trained and qualified to both detect, diagnose and treat these pathologies. Using dry needling is yet another tool with which we treat these issues; in my experience observing, performing and having dry needling performed on me, I can say that it is often more efficient, just as effective and less painful than the other therapies listed. This is why I have been fighting for the inclusion of this technique into my scope of practice since I was still a chiropractic student.
What’s the problem? Well, the acupuncture community in Oregon have been duped into thinking that this ruling means chiropractors will be stealing patients from them and it would hurt the profession. This is just not the case, in most of the states where chiropractors are allowed to perform dry needling, acupuncture, as a profession, is doing just fine and has been growing at rates that are as good, if not better than in those states where chiropractors can’t perform dry needling. Having a chiropractic clinic in SE Portland and a teaching shift at the NCNM clinic in SW Portland, I refer patients for acupuncture all the time when it is appropriate; I have even referred my patients for acupuncture for myofascial issues. When I give these types of referrals, I have often been very disappointed in that the acupuncturist sometimes ignores needling the injured tissue and treats the patient more constitutionally, needling distant acupuncture points. This is the beauty of acupuncture, it is a healing modality at the foundation of Oriental medicine that works wonders with patients on many levels. Dry needling is an incredibly superficial technique compared to the broad scope of acupuncture and is only used to treat myofascial pathologies.
Last week, the OBCE approved me to utilize dry needling in my practice and I did, on many patient suffering from myofascial pathologies, the results were profound and now this week, because the Oregon Association of Acupuncture and Oriental Medicine filed an injunction, I cannot continue to use this technique to benefit my patients. Will I send these patients to an acupuncturist? No, there’s no need, I have other treatments that will work just as well as dry needling but may take longer and cause a bit more discomfort. Would these patient have gone to see an acupuncturist for their problem to begin with? No, they came to see me because it is more appropriate for them to do so, for this specific issue.
It’s really quite silly, as a chiropractor, I often perform high velocity, low amplitude thrusts to joints that need to have movement restored. The reason chiropractors do this is to help restore balance in the body so our innate healing properties can flourish. Does this mean chiropractors “own” this technique? No, there are other providers that use the same high velocity, low amplitude thrusts to joints; usually, these other providers are using this tool for slightly different reasons and what they are doing is not inherently chiropractic. Acupuncturists use solid filament needles to perform their craft; as a chiropractor, I would use the same needles to treat myofascial trigger and tender points; does this mean I would be performing acupuncture? Absolutely not, in fact, to imply this is a slap in the face to acupuncturists and Oriental medical practitioners just as saying a physical therapist who performs joint mobilizations is performing chiropractic. Both are using similar s tools for VERY different reasons!
What Oregon has is an opportunity to create dry needling verbiage in the Oregon rules and regulations that actually protects the scope and right of acupuncturists. there are states (I am not going to name them), who allow chiropractors to perform “chiropractic acupuncture” and “biomedical acupuncture”; these are unprofessional, inappropriate terms that disrespect the ancient art that is acupuncture. Oregon can be the first state to clearly define dry needling as completely separate from acupuncture just as joint mobilizations and manipulations performed by non-chiropractic providers are completely separate from the art of chiropractic.
I needed to replace the memory in a laptop computer today and getting to it with traditional tools seemed impossible without damaging the computer. I was able to use a couple of bicycle-specific tools to do the job effectively, efficiently, and without undue damage to the computer. Was I performing bicycle mechanics to my computer? No, that’s obvious, I was just using another tool for the job, a tool that performed better than the more traditional tools in my toolbox.
The acupuncture association in Oregon is now going to spend $30,000 to fight this and, in the end, chiropractors will likely be able to perform dry needling in Oregon; what a waste of money! In addition, I am also concerned that this move may create a false sense of extreme competition between chiropractor and acupuncturists and erode any collaborative efforts our two professions may put forth to bring more complementary medical treatments to Oregonians.
OK, rant over, I needed to get that off my chest. I hope this is over soon so I can use whatever tool necessary toYours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
A Study published in October entitled: Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer suggests that initiating care through a chiropractic doctor for back pain was more cost effective than initiating care through a medical doctor. In fact, this study found that care initiated through a chiropractic was 40% less than that initiated through a medical doctor.
Chiropractor can and do often act as portal of entry and/or primary care physicians; this is very similar to many general practice medical doctors. As a chiropractor who practices like this, I often see patients that receive care from me and other providers on my recommendation. In addition, I can act as a “hub” for the patients’ care, to help organize care and keep all the providers on the same page. In Oregon, chiropractors are primary care physicians; this means we diagnose and treat a variety of health conditions, naturally, and predominantly with manual medicine. In addition, there are those of us like me who also use nutrition (in the form of actual food) and functional medicine to help patients reach all of their health and wellness goals.
So, the next time you have back pain, consider seeing a chiropractor first. Most chiropractors will do a thorough examination, let you know what’s wrong, and if they can’t help, they can get to to the correct provider. With health care costs sky-rocketing; you can help to decrease spending by up to 40% by doing this; at least regarding back pain treatments.Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
Do you have shin splints? Do you run AND take a creatine supplementation? Well, here’s a link to an article that found a relationship to anterior compartment problems (like shin splints), running and creatine.
Don’t get me wrong, this is not an anti-creatine blog entry. I recommend creatine to quite a few of my patients to help them build muscle and anaerobic endurance. If you want to know more, contact me.Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
A recent review article came out suggesting that cold laser, AKA low-level laser therapy is beneficial for decreasing acute neck pain and decreasing chronic neck pain for up to 22 weeks after the treatment!
I have been using col laser in my SE Portland chiropractic and nutrition practice for 3 years now with astounding results, the least of which is decreasing pain.
Here’s a link to the citation: Low-level laser therapy for neck pain
Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009 Dec 5;374(9705):1897-908. Epub 2009 Nov 13. Review. Erratum in: Lancet. 2010 Mar 13;375(9718):894.Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
The nutritional advice with respect to carbohydrates I give in my SE Portland Chiropractic and Nutrition clinic, Optimum Function often goes something like this, “…eat most of your carbs from mostly vegetables with a little fruit, if you are going to eat more starchy carbs, ‘earn them’. Only eat them after you have performed at least 20 minutes of physical activity….”
Well, the scientific community has been studying the relationship between simple or high glycemic carbohydrates and heart disease. Here’s an article suggesting these types of carbs affect women greater than men: White bread, rice, and other carbs boost heart disease risk in womenYours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health