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Dynamic Chiropractic
VOLUME 41, NUMBER 4
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Alternative Health News
A Postoperative Story: The Surgery Explained & Secrets to My Recovery
If working with a joint replacement patient, be sure you know the rehabilitation protocols of the particular appliance. If you don't, with permission, consult with the surgeon to learn them. Otherwise, stay away.
Stomach on Fire: Herbal Formulas for GERD
In the past five years of my clinical practice, I have seen an astonishing upsurge in the chronic use of proton-pump inhibitor (PPI) medications for the gastrointestinal issue diagnosed by allopathic medicine as GERD.
Helping Your Clients Turn Back the Clock With Nutrition
The anti-aging market is booming because, well, who doesn't want to look young, healthy and vibrant for as long as possible? And while there are many anti-aging products and systems marketed to the public, few people realize the most effective way to slow down the visible passage of time is to give the body the nutrients it needs to be truly healthy.
Multiarticulate Muscles & Injury: Understanding the Mechanical Load
Muscles have a primary role in creating and limiting movement in the body. They are also the major focus of our work in massage therapy, with many injuries caused by improper loads on the muscular system.
HHS Warning About Website Tracking: What It Means for Your Practice
In December 2022, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a bulletin with guidance concerning the use of online tracking technologies by covered entities and business associates under HIPAA.
The Benefits of Teaching Touch
This month the MTF took a look at a massage research review titled "The Effect of Massage Therapy on Children's Learning Process: A Review," written by Majid Emtiazy and Mahboobeh Abrishamkar. The article was published in the Iranian Journal of Medical Sciences.
Alligator Skin (Part 2): A Second Look at Business Contracts
I joined as the only female partner in an integrated medicine practice, shared with three other disciplines. Having developed a few scales (the first stages of alligator skin) and some good business sense, I started out with a one-year contract.
This Is Why Your Social Media Isn't Generating New Patients

CranioSacral Therapy & The Rare Case of Vertigo
I had heard of folks getting dizzy and nauseous when experiencing vertigo, but I had never heard of Benign Paroxysmal Positional Vertigo (BPPV) until my husband Joe was diagnosed with it.
Spirits of the Points: Liver Official (Pt. 3)
The liver, belonging to the wood element, is associated with the season of spring. The powers of spring include birth, growth, regeneration, vision, activity, forward movement, upward direction, vitality, optimism and hope.
How the Human Body Responds to Stress
This new series of articles will suggest a different perspective for you to view clients presenting with stubbornly chronic somatic dysfunctions. It will also propose a novel answer to the question, "How does the human body respond to stress?"
Dr. Mario Wexu: An Acupuncture Revolutionary
Dr. Mario Wexu has found himself in the middle of three revolutions. The first was when his family escaped from Romania.
You Need a Business Plan!
We schedule every aspect of our lives. Many of us live by our calendars, especially when it comes to the day-to-day running of our private practices or engaging in patient care.
Why Dialysis Patients Need Acupuncture
A pair of new studies suggest acupuncture can help manage common complications experienced by renal disease patients on hemodialysis: muscle wasting and uremic pruritis.
What Should Your Fees Be This Year?
The relative value units of CPT codes were adjusted, as they are each year; for 2023, that was about a 1-2% change in the common codes used by licensed acupuncture providers.
Exercising the Multifidi: Why Isometric Contractions Are Essential
In any given year, nearly 40 percent of the U.S. population will develop a low back injury severe enough to limit activity.
What It's Like to Be a Hospital-Based Massage Therapist
It was the early 1990s the first time I ever saw a massage therapist in a health care setting in my home state of Minnesota. I was working at a nursing home at the time, and I learned of a resident who would receive weekly massages (which I thought was great).
12 Important Reasons to Request Every Patient's Medical Records
The word why is defined as "for what reason or purpose." In recent months, I've been suggesting to students who are in their school clinics to request medical records from other doctors about their patients.
Trust the Trends, Or Trust Your Instincts?
Being a massage therapist is all about balance. There's the balance between your customers' needs and wants, the balance between what's good for clients and what's good for business, and the balance between overseeing current business and forecasting for the future.
Learn to Speak the Language of Personal Injury
For many providers, personal-injury cases and working within the med-legal arena can often be a confusing and frustrating endeavor. After all, for the majority, personal injury is a niche.
Polyvagal Theory (Dorsal Vagal Shutdown)
In order to maintain homeostasis, the autonomic nervous system responds constantly to neural feedback and environmental stimuli.
A Structural Challenge: Successfully Treating a Morton's Neuroma
Runners, triathletes, dancers, hikers, cyclists, almost all athletes, and even couch potatoes have shown up in my office looking for alternatives to surgery for neuromas. A Morton's neuroma occurs when the tissue in the foot (next to a nerve that leads to a toe) thickens and becomes fibrous.
The Role of Structured Water in Acupuncture (Pt. 1)
Structured water (H3O2) can be considered a fourth state of water between liquid and solid. It has the hexagonal structure of ice; however, missing a critical bond, it behaves more like a gel than a solid, but retains some of its crystalline structure.
Acupuncture and IVF: Patient Needs, the Evidence and What's Next (Pt. 1)
With one in eight U.S. couples suffering from infertility, it is likely you know or have worked with someone struggling to have a baby.
Electroacupuncture for Opioid-Induced Constipation in Cancer Patients
Opioids continue to be prescribed, and at unacceptable rates considering the number of clinical guidelines recommending nondrug pain-relief options first and limited use second in most cases.
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Placebo as an ally

By

Bialosky and Colleagues have conducted and published results from several studies focused on understanding the mechanisms of spinal manipulation and other manual therapies.(1-5) In a recent article, these authors discuss a pertinent issue: the “placebo mechanisms of manual therapy.”(6) The authors suggest that known placebo mechanisms should be considered an important part of the pain-reducing effects observed from manually-delivered treatments.

Once thought to be inert, imparting no possible therapeutic effect, placebo treatments are now known to generate real neurophysiological responses. These “placebo” responses occur from the complex interplay of characteristics within the treatment context. For example, pain reducing effects attributed to placebo mechanisms can be influenced by expectations. Placebo mechanism induced pain reduction improves when individuals believe they receive effective treatment and/or have prior success with a given therapy. Carefully clarifying that many manual therapies induce other physiological effects contributing to clinical improvement, this article addresses a component of care that providers and researchers should recognize as potentially therapeutic.

“…placebo mechanisms may prime the nervous system to augment the effectiveness of manual therapy (MT) or may serve as the primary mechanism of MT. Manual therapists should continue to pursue clinical excellence, while understanding that the hours spent perfecting individual approaches may result in better outcomes not strictly from precise application but rather from improved contextual factors related to reputation, confidence, and therapeutic alliance. To best serve our pa¬tients, we must stop considering placebo as the benchmark of an ineffective inter¬vention and accept placebo mechanisms as part of any treatment for pain.”

Reference List
(1) Bialosky JE, George SZ, Bishop MD. How spinal manipulative therapy works: why ask why? J Orthop Sports Phys Ther 2008 Jun;38(6):293-5.
(2) Bialosky JE, Bishop MD, Robinson ME, Barabas JA, George SZ. The influence of expectation on spinal manipulation induced hypoalgesia: an experimental study in normal subjects. BMC Musculoskelet Disord 2008;9:19.
(3) Bialosky JE, Simon CB, Bishop MD, George SZ. Basis for spinal manipulative therapy: a physical therapist perspective. J Electromyogr Kinesiol 2012 Oct;22(5):643-7.
(4) Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther 2009 Oct;14(5):531-8.
(5) Coronado RA, Gay CW, Bialosky JE, Carnaby GD, Bishop MD, George SZ. Changes in pain sensitivity following spinal manipulation: a systematic review and meta-analysis. J Electromyogr Kinesiol 2012 Oct;22(5):752-67.
(6) Bialosky JE, Bishop MD, Penza CW. Placebo Mechanisms of Manual Therapy: A Sheep in Wolf’s Clothing? J Orthop Sports Phys Ther 2017 May;47(5):301-4.

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