A December 2018 article by Roy Benaroch, MD, published by KevinMD.com, and blogged on ‘Pediatric Insider’, describes physical profiles defining this Acute Flaccid Myelitis (AFM). You may have seen reports of a ‘polio-like’ illness causing pediatric paralysis. 80 cases were reported in the USA in 2018. Although the cause is currently unknown, several viral infections have been found in AFM children.

Here’s what to watch for:

  • Sudden (defined as beginning in the last few hours or days) illness causing extremity paralysis in singular or multiple limbs.
  • Typical presentation: Fever, runny nose, cough, vomiting or diarrhea 1-2 weeks prior to AFM symptoms.
  • Lesser seen symptoms: Stiff neck, headache, pain in limbs, eyelid or facial droop, difficulty swallowing, speaking or a hoarse or weak voice.
  • Near complete paralysis to varying degrees of paralysis follows two weeks after viral infection.
  • Affected body parts are weak and floppy.
  • The disease starts in the spinal cord and may mimic severe trauma.
  • History is key in diagnosis.
  • MRI shows distinctive changes of inflammation, confirming diagnosis.
  • Most cases appear in late summer and early fall; August through October.
  • Average age of occurrence: 4-6 years.
  • Most commonly, no viral infection is found.
  • Investigation of specific viral causes includes but is not yet definitive: enterovirus D68, West Nile Virus, Japanese Encephalitis viruses, herpes viruses and adenoviruses.

Children with this profile need hospitalization. Neurologists and infectious disease specialists direct care to include IV immunoglobulin, steroids, and plasmapheresis. Some children recover quickly while others may need long-term care. This article focuses on how to prevent viral infections by educating parents and children.

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NCCIH and CARBON Program – 2015-2020 Research

The NCCIH is sponsoring the Centers for Advancing Research on Botanical and Natural Products (CARBON) Program. Research scheduled for 2015-2020 includes:

The goal of this center in it’s second five-year research cycle is to delineate molecular mechanisms by which botanical oils prevent or impact disease with a particular focus on immunity and inflammation. The study will study different populations to determine where botanical lipids are most likely to be effective. For more information on this program visit https://ods.od.nih.gov/Research/Dietary_Supplement_Research_Centers.aspx


Myofascial Massage for Chronic Pain After Breast Surgery

A 2018 research article published by the International Journal of Therapeutic Massage & Bodywork highlighted massage to improve upper extremity mobility and decrease pain following breast cancer surgery. The study included 21 female subjects at 3-18 months post-surgery, receiving 16, 30-minute massage sessions, over 8 weeks, using Swedish technique on the entire body. Control subjects received the same treatment, but avoided any massage of the affected breast, shoulder and chest. Outcome measures included pain scales and quality of life questions. Compared to the control group, the subjects with site specific treatment had more favorable outcomes. However, all subjects reported reduced self-reported pain and decreased feelings of ‘downheartedness’. The site specific group had better outcomes with decreased pain and improved mobility.

http://www.ijtmb.org/index.php/ijtmb/article/view/354/434


Medical Doctors and Chiropractors Top Choices for Neck and Back Pain

According to a recent Gallup-Palmer College poll, patients with neck and back pain in the US who saw healthcare professionals in the last 12 months were most likely to seek care from a medical doctor or a chiropractor.  Approximately one-third saw a massage therapist or physical therapist.  Acupuncturists were also on this list of top choices for spine care.

Did you see any of the following healthcare professionals for your neck or back pain in the last 12 months? (asked of those who saw a healthcare professional for neck or back pain in the past 12 months)

Provider Type Yes
Medical Doctor 62%
Chiropractor 53%
Massage Therapist 34%
Physical Therapist 34%
Physician’s Assistant 26%
Nurse Practitioner 22%
Surgeon who can operate on spine 22%
Doctor of osteopathic medicine 15%
Acupuncturist 9%
Sample sizes: 988-1,157
Gallup-Palmer College, March 12-April 10, 2018

For more, go to: https://news.gallup.com/poll/243302/medical-doctors-chiropractors-top-choices-spine-care.aspx


Positive Thoughts Towards Others Improves Healthy Behavior

According to a 2018 study with 220 subjects, when patients adopt a regular habit of focusing on ‘others well-being’ they are more likely to participate in exercise and other healthy behaviors affecting positive lifestyle changes. “Self- Transcendence” refers to a shift in mindset from focusing on self-interests to the well-being of others. Subjects were asked to focus on loved ones or making positive wishes for others. This activity of self-transcendence upregulated activity in a region of the ventromedial prefrontal cortex. This area of the brain is responsible for reward processing. Providers would do well encouraging patients to focus away from their conditions of chronic pain and illness in a way that encompasses a bigger picture. Helping patients see the need to do so is a form of Pain Neuroscience Education (PNE). Explanations that include basic neuroscience education as it relates to mental health are within the scope of chiropractors, naturopathic physicians and acupuncturists, as long as the provider does NOT introduce discussion of case-specific patient mental health conditions. Discussion of specific conditions are in the venue of mental health.

http://www.pnas.org/content/early/2018/09/12/1805573115.short?rss=1


Study Links Mindfulness to Brain Changes and Pain Sensitivity

People who are more naturally mindful (paying attention to the present moment without over-reacting to it), differ among individuals. There is evidence showing mindful people tend to have less pain. A study of 76 healthy people who had no experience with meditation completed a Frieburg Mindfulness Inventory, evaluating innate mindfulness. Subjects with a higher innate mindfulness score, reported less pain to a thermal probe delivering a series of brief, uncomfortable heat stimuli to the lower leg. In addition, an MRI scanner of their brain during testing demonstrated changes in blood flow  associated with greater deactivation of a brain region extending from the precuneus to the posterior cingulate cortex. This part of the brain is involved in attention and subjective emotional responses to sensation. It plays a role in how one reacts to experiences. This is another study supporting Pain Neuroscience Education (PNE) principles. Teaching patients about the neuroscience of pain, and how to change brain perception by participating in meditation, positive thinking or helping others, diverts and changes the way a human perceives  acute and/or chronic pain.

https://nccih.nih.gov/research/results/spotlight/mindfulness-brain-changes-and-pain-sensitivity?nav=govd


Integrative Cancer Care Options: In Depth

NIH and The National Center for Complementary and Integrative Health have produced a collection of research and facts for integrative approaches and treatments surrounding cancer. The research focuses on patient safety, outcomes and options to reduce symptoms in this patient population. Cautions are given to help providers understand scope limits and best practice recommendations when treating cancer patients. Adding some of the suggested integrative treatments is shown to reduce anxiety, pain, nausea and more.

https://nccih.nih.gov/health/cancer/complementary-integrative-research?nav=govd


Effects of forward head posture (FHP) on forced vital capacity and respiratory muscles activity

A January 2016 research project by the Journal of Physical Therapy Science produced excellent findings supporting the need to assist patients with correction of forward head posture (FHP) and proper breathing technique, for overall better health outcomes with any care plan. Adding corrective posture and breathing exercises may enhance total oxygen uptake and produce better patient outcomes. Providers should take note of cervical-thoracic posture and respiration cycles in all patients, but especially chronic pain patients and those with multiple co-morbid health factors. In addition, recognizing certain occupations as ‘greater risk’ for FHP and shortened inspiration abilities is key to offering these treatment options.

 


The CHP Group Announces New Charitable Giving Campaign in Washington State

Leader in High-Quality Integrative Healthcare Plans Initiative to Assist Local Non-Profits Helping Food Insecure Seniors This Winter

Dec. 11, 2018 (PORTLAND, Ore.) – The CHP Group (CHP), the partner of choice in integrative healthcare (IH) announced today a new charitable campaign to provide financial support to Washington-based non-profits this holiday season.

“We are very proud to be expanding our business in Washington state and want to give back to the communities that we serve.” says Michell M. Hay, the CEO and President of The CHP Group.

The CHP Group, a regional leader in managing IH provider networks, recently announced a new line of business to provide access to chiropractic and naturopathic physicians and acupuncturists for Medicare Advantage recipients in the State of Washington. As part of its expansion, CHP is actively recruiting evidence-based providers to join their high-value network.

The focus of this campaign is on providing support for seniors in the Washington community who are struggling with hunger and isolation. “It seems a natural fit to support Meals on Wheels,” says Steven Sebers, DC, FACS, Chief Clinical Officer of CHP, “as we build a high-quality network to support the Medicare Advantage population in Washington. This is especially so during this time of year when we have a heightened awareness of loneliness and food insecurity among this vulnerable group.”

The ‘CHP Gives Back Campaign’ which builds on the company’s long history of high-impact and locally-focused charitable support will donate $10 for each new provider that applies to the join the CHP network in the State of Washington through December 17st, 2018. “Charity is part of our corporate DNA,” says Hay, “and our commitment to provide smart solutions and healthy results.”


Chronic pain prevalence in the United States

The National Center for Complementary and Integrative Health Care reports in a September 2018 article, chronic pain and ‘high-impact’ chronic pain (daily pain affecting at least one major life activity), are on the rise in specific populations. Providers are encouraged to pay special attention to women, older adults, adults not currently employed, living in poverty, non-Hispanic white adults or adults living in rural settings. These populations have the highest prevalence and may warrant more detailed history and treatment to support more successful outcomes with treatment. Helping patients regain function should be included in all early stage care plans. Active care including exercises, stretches and mind-body awareness to support any manual therapies will produce better outcomes.