Professional Documents
Culture Documents
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ISBN
978-974-8388-93-9
2
1 2550
7,000
()
()
0 2965 9194, 0 2951 0028, 0 2951 0069 0 2 965 9195
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[1]
(Modern Medicine) (Alternative Medicine)
common interest common Knowledge
overlap
Pathology of Low Back Pain
low back pain
12 (rib cage 12) (gluteal fold)
(Pain)
pain
neuropathic pain 2
(nerve injury) brachial plexus injury
(disorder
of function) post-herpetic neuralgia electrodiagnosis
myofascial pain
http://www.dtam.moph.go.th/alternative
pain
pain (stress)
pain
80% 2 :
(low back)
Low Back Pain
complementary 15-20
anatomy
low back pain 80
2 90 6
Confirm 80% 2
2 80%
(chronic pain)
2
1 (classification)
Acute Low Back Pain Chronic Low Back Pain
2 Acute Low Back Pain
2 3 Sub Acute Low Back Pain
3 Chronic Low Back Pain
2 Etiology (risk factor)
(pain free world)
http://www.dtam.moph.go.th/alternative
(Factor of Persistence)
1.
2.
http://www.dtam.moph.go.th/alternative
Low Back Pain Kirkaldy Willis
(Complementary Medicine)
Low Back Pain
1 A New Look at an Old Problem
Low Back Pain
(1) 80 2
Kirkaldy Willis
(concept)
(New Look) (Respect old concept)
(Treatment modality accepted today will be proven inadequate tomorrow)
(Chronic pain)
Alternative Complementary Medicine
Complementary
2 Anatomy of lumbosacral spine
http://www.dtam.moph.go.th/alternative
Biomechanics
dynamic chain
biomechanics chain arthrokinetic chain
(Acupuncture)
http://www.dtam.moph.go.th/alternative
accumulative microtrauma
mechanism base
symptom base
10
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Myofascial Pain myofascial pain autonomic
symptom
autonomic nervous system (vaso-constriction)
symptom base
Acute Low Back Pain myofascial pain
Placebo effect
(unbelievable)
Chronic Pain
http://www.dtam.moph.go.th/alternative
11
(Trauma) osteoporosis
(compress fracture spine)
(Tumor) clinical presentation
Neurofibroma (nerve root) x-rays
foramen (painless weakness) Meningioma
progressive paraplegia/progressive weakness
(Metastasis CA)
pedicels (severe night pain)
(Infection) compomise host (Inflammation)
Ankylosing Spondylitis x-rays
Bamboo Spine
(Miscellaneous) Degenerative Spine
Osteoporosis
(Iatrogenic) Chronic Pain
(somatization) Pain
somatization (multiple
compliance) Iatrogenic Investigation false positive
disc herniation MRI 30%
Investigation x-rays
common sense
one-way ticket normal change
degenerative spine text 80%
(conservative)
Iatrogenic myofascial pain fibromyalgia
vague symptom, physical findings equivocal investigations inconclusive
(organic)
(psychological)
Pain (dual diagnosis)
12
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alexithymia
alexithymia
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13
[2]
20-30
Alternative medicine
WHO Complementary and
Alternative Medicine Department
2
5
.. 2538 ..2545
.. 2438 . .
100
100
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15
3
mechanics Biomechanics
16
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L4, L5 disc Casher
1 L4, L5 8
3
Repetitive injury
X-Rays MRI
80 % 2 2
2
Rehab Exercise
Fitness
(Recover)
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17
Pressure
2
(Muscle gurarding)
2
18
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(jogging) 15
90
(Cycle Elias joint)
mechanics
2 2 1
3
3
6
:
:
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19
30
(Flexibility)
Fitness
: X-Rays
: X-Rays X-Rays
X-Rays
6 1
X-Rays Dispanation MRI
MRI 1 3 Dispanation 30
Dispanation
MRI
(Information)
MRI
:
:
25
16-17
10 20
emergency room
20
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(Sciatica pain)
.
(Sciatica pain)
2
90
7
L4, L5
(inflamation)
(Disc Panation)
10 3 3
.
90
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21
(Tension)
Mobilization Spine
.
Mobilization
100%
Mobilization
Mobilize
Soft tissue
Mobilization Mobilization
Position
Posture
Mobilize
:
: 80
C1, C2, C3
22
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.
(review Meta Analysis)
Low Back Pain Neck pain Acute Pain
Paper
.
(1)
(2)
(Risk Factor)
.
(Anatomy) Anatomy Physiology
Pathology
Transverse Process Laminar lumbar Contact point
Isolate
Focus
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23
4
skill case
.................... ....................
24
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[3]
(Main Channel)
(Muscle Channel)
(Du mai) 2
3 (Shenshu =
BL-23) Spinous process L2 1.5
Pathogenesis 3
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25
2
Trauma
3
(Genetic) 1
2
1
26
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menopause
Muscle Pain Trauma
(Stabbing Pain)
Dull Pain
(cun)
1 (cun)
( 2)
1 2
60
Scale
Sciatic foramen Sciatic nerve
(Injury)
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27
1
Syrene
(Ah shi)
(Du mai)
(Hua Tou Jia Ji) 2
(Mid line) 0.5 (Shu)
1.5
Extra Point
2
Area of Interest
(Distance Points)
(Local Point) ()
28
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(Distance Point)
* BL-62 Weizhong
* DU-26 Renzhong
* BL-10 Tianzhu
* SI-3 Houxi
* Yaotongxue
* BL-58 Feiyang
* BL-62 Shenmai
* BL-59 Fuyang
3 (Distance Point)
Confirm
5 Local Point
2
(Houxi) 2
20
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(Distance Points)
(Acute pain)
S.I.-3 Houxi
4 (Houxi)
30
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5 (Weizhong=BL-40)
6 (Xinhui=GV22)
(Renzhong=GV26 DU26)
(Xinhui=GV22)
2
(Tianzhu=BL10) 2
Serious
Blood Circulation Sympathetic ganglia
7 (Tianzhu=BL10)
(Houxi=SI-3)
Limitation
(Houxi = SI-3) S.I. Small Intestine
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31
( = )
(Shenmai BL-62) (Houxi = SI-3)
BL-58
Sciatic nerve
(Sciatica)
8 (Local point)
32
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Spinous process
L2 (Yaoyangguan = GV3) L4 L5 3
Common site
Sciatic Foramen
(Inflammation)
Piroxicam indomethacin Comparable
Side Effect
L4 1.5
(Shenshu = BL- 23) L2 1.5
(Zhishi = BL-52) 2
(Heyang = BL- 55)
(Weizhong = BL-40)
Side Effect False aneurysm
MOXA
()
MOXA
Moxa Cake
9 (MOXA)
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33
2 9 Moxa
Create
negative pressure
( 10)
10
pain mediator
pain mediator
pain Mediator
Spine
(Yinqiao mai)
( 11)
11 (Chronic back pain-spine)
34
http://www.dtam.moph.go.th/alternative
13 (Radiate-HIP)
3 (Sciatica) Yang
Yangqiao Yang
Houxi Shenmai
Side effect
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35
14
Scoliosis
3 Segment
Mid line 1.5
15 Mox Row
16 (Scolionsis)
:
:
36
http://www.dtam.moph.go.th/alternative
:
: Randomized Control Trials Meta analysis
WHO
- Cochrane Systemic Review Meta analysis
Positive
: Case Muscle pain /
:
:
: Central Opiod
2 Hz 15 Hz 100 Hz
15 Hz Enkepharin Enkepharin Endomorphine
Mediator
Enkepharin
Receptor Receptor Morphine
Alpha Beta fiber Fiber (Sensation)
Fiber c-fiber fiber
Posterior Colum Spinal Cord
Inter neurone Inter neurone
Wide Dynamic Range Neurone
Alpha/Beta Fiber Inter neurone
inhibit c-fiber
c-fiber Primary sensory Neurone
(Ganalia) Spinal Cord Pain Mediator Substance-P
Substance-P Interneurone
Interneurone
Enkepharin Enkepharin Receptor Nerve Ending Primary Neurone
Receptor Enkepharin Substance-P
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Secondary Neurone
c-fiber
(Inflammation)
.................... ....................
38
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[4]
1...2...3...4...5...6...7...8...9...10
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39
10 10
-
2
1
2 ...
1
45
1
1)
5)
2)
6)
3) 2 7)
4)
10 1
2 ( 1)
40
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2 80
- 3
5
10
1) 4
1
6
2)
3)
4)
2
7
5)
6)
7)
3
8
8)
9)
10)
4
9-10
3 ( 2)
10
2
3 4
3
9
1) 4
2)
3)
4)
9-10
4 ( 3)
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41
5)
6)
7)
8)
9)
4 2
2
1 2 3 4 5 6 7 8 9 10
9
1)
2)
3)
4)
5)
6)
7)
8)
9)
5 ( 4)
.....1
.....2
.....3
.....4
.....5
10
6 ( 5)
42
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6
1 2 3 4 5 6 7 8 9 10...
2
1 10
- 3 - 3
9-10
7 ( 6)
sit up
sit up
sit up sit up
sit up
7 2
8 ( 7)
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43
8
5
1 10 2
1 1
9 ( 8)
2
2
10
3
1
44
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...
11
12
2
30
80 50
1 2
1
... 2
3
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45
13
14
1.
2.
3.
4.
5.
6.
2528
3
80
46
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3
3
1 1
2
2-3
4-5
48
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1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
( )
13.
14.
15.
16.
17.
()
18.
19.
20. ()
21. ( )
1.
2.
3.
4.
5.
()
15 ()
6.
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.
1 3 1
2
.................... ....................
50
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[5]
What is that ? WHY
(Equilibrium)
Art and Science
(Acupuncture)
(Integrated)
Equilibropathy integrated Medicine Four in One
4
Emergency Room CCU. ICU.
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51
20
80
2531
(Etiology) Back pain
(Holistic)
Schizophrenia
2 2 2
52
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4
(Structure)
(Function) (Holistic)
(Macroscopic) (Microscopic)
(structure) (Function)
(Social)
(Dynamic) (Static)
(Concept)
(WHY)
Copy
copy
360
Stretching
Why to do that?
http://www.dtam.moph.go.th/alternative
53
2
Holistic Natural
Healing Process Why
Thermo Imaging
Aorta
Vertebrobasillar Insufficiency (Resistance)
(Flow) (Pressure)
WHY
(When)
Structure Position Function
Structure Function Position Position
8 36 Position
54
http://www.dtam.moph.go.th/alternative
Professor
TCM 50% Fantasy Point 40%
trigger point Dr.Gunn
.. 2531
Terminate Bone
MRI
10
(Facial Palsy)
(CSF)
Review 10
(Unknown Etiology)
(Health Promotion)
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55
30
Health Promotion Prevention
Primary Health Care
(Family Medicine) G.P.
()
Holistic Integrated Medicine
Primary Care Secondary Care
Tertiary Care Intensive Health Care emergency room
MRI Stroke
Stroke
MRI
2
Vertebrobasillar Insufficiency Brain stem
Rest Ice Compression Elevation
.. 1986
.. 1995 WHO
(Indication) (Contra-indications) 1. 2.
3. (Diagnosis) 4. (Need Surgical
Intervention)
56
http://www.dtam.moph.go.th/alternative
(Reference)
How to do that?
Interactive Learning
Through Action Passive Learning
7 E
E Education
E 2 Equilibrium (Flexion)
(Extension) (Pronation) (Supination)
(Equilibrium)
E 3 Exercise Exercise Mobilization
Exercise
Breathing Exercise
Interactive Learning Through Action
How to do that?
(dynamic)
http://www.dtam.moph.go.th/alternative
57
Dynamic
Static
E 4 Eating
E 5 Excretion
Excretion
E 6 Emotion
Endorphin
(
)
E 7 Environment
Pathophysiology
70-80%
20-30%
58
http://www.dtam.moph.go.th/alternative
5
(Laboraory)
(Diagnosis) Differential Diagnosis
Holistic
(WHO)
Health for all in the year 2000
Health for all in the year 2000 in the year 4000
Health for all All for health
Health for all in the year 2000
All for health
Integrated Medicine
All for health
.................... ....................
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59
[6]
Hydro Therapy Aqua Therapy
(Hippocrates)
Galen Celsus
(..1679) Sir John Flayer
(..1797) James Currie
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61
Vineenz Priessnitz
Grafenberg
3
1. (buoyancy)
2. (hydrostatic pressure)
3. (resistance)
62
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70
0.95
20
Buoyanc force
CB
CG
Weight force
Buoyanc
force
Buoyanc force
CB
CG
CB
CG
Weight force
Weight force
CB
CG
1 (Torque)
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:
1
22.4 1
40
4
90 2
64
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2-3
3
5
1.
2.
3.
4.
5.
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65
5
3
3
66
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Anti-diuretie hormone
50
(endorphin)
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67
30
4
3
37
37 34-36
28
68
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Hubbard Tanks
Whirlpools Whirlpools
Whirlpools Jacuzzis
Whirlpools Jacuzzis
(Internal hydrotherapy)
Colonic
irrigation Detox
1.
2.
33-36 36
3.
4.
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69
1.
2.
3.
(COPD) 1
1
4.
180/190-190/200
5.
6.
7.
8.
3
28
: 40-42
:
70
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40
: (Jacuzzis)
?
:
Jacuzzis
Jacuzzis
Jacuzzis
Jacuzzis Jacuzzis
:
?
:
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- -
warm and cold
3-4
2 3 3-4
.................... ....................
72
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[7]
(Yoga for Back Pain)
Mind/Body Medicine
3 1
2 3
(Lifestyle modification)
(Lordosis) (Kyphosis)
(Cervical
Spondylosis) (Lumbar spondylosis)
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73
2, 3, 4
1) 65-80
2) 15-20
2) 50 1
90 8 7-10
3-6
10
5
2
1 10
2 80
Mechanical low back pain, Myofascial pain syndrome, Fibromyalgia, Tension myalgia
75-90 4-6
70-80 1 30
6, 7
74
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1
(Semi-vegetarian)
2
(low fat high fiber)
(Too much of a good thing is never good)
2
6
(Tadasana)
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75
2
3
(Padhastasana)
(Dow facing dog)
(Flexion)
6
(child pose)
76
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5
3
(Paschimottanasana)
7
(Extension)
(Setu Bandhasana)
3
8
(Bhujangasana)
3
9
(Shalabhasana)
3
10
(Dhanurasana)
3
11
(Ushtrasana)
3
(trigonasana)
3
12
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77
13
(Ardha-Matsyendrasana)
3
(Jathara
Parivartanasana)
3
14
3 (Yoga Nidra)
78
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15
5-10
(Chronic degenerative diseases)
9, 10, 11, 12, 13, 18, 19
(Spiritual Practice)
() ()
() ()
()
() ()
() ()
( )
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79
. (Patrick Randolph)
(The International Pain Institute at Texas Tech University Health and Science
Center) (Mindful Yoga)
798
(Herbert Benson)
. (Trancendental
Meditation)
36 17
(Jon Kabat Zinn)
51
(Mindfulness Meditation) 10
6515, 16
(www.iayt.org/
yoga health bibliography)
.................... ....................
80
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1) . .
1, ,.. , 2542.
2) , ,
, , , 2543-44.
3) Rosomoff HL,Rosomoff RS. Low Back Pain: Evaluation and management in the
primary care setting, Med Clin North Am 1999;83;643-662.
4) Borenstein DG, Low Back Pain. In; Klippel JH, Dieppe PA,eds. Practical Rheumatology,
Mosby-Wolfe London 1977;53-73.
5) Deyo RA, Bass JE, Lifestyle and Low Back Pain; the influence of smoking and
obesity,Spine 1989;14:501-506.
6) Von Korff M,Deyo RA,Cherkin D, Barlow W, Back pain in primary care; outcomes
at one year.Spine 1993;18;855-62.
7) Biering- Sorensen F, A prospective study of low back pain in the general population.
I-occurrence, recurrence and aetiology, Scand J Rehab 1983;15;71-80.
8) Randolph,PD,Caldera YM,Tacone AM et al. The long-term combined effects of
medical treatment and a mindfulness based behavioral program for the multidisciplinary
management of chronic pain in West Texas. Pain Digest 1999:9:103-112.
9) Bruce ME,Eliot S, Stress and the individual Mechanisms leading to Disease,
Arch Int Med 1993;153;27.
10) Sheldon C,Davis AJ,Andrew PS. Psychological Stress and Susceptibility to the
common cold , N Engl J Med1991;325;29.
11) Nancy FS,Francois L,Mario T. Depression Following Myocardial Infarction
JAMA;1993;270;15.
12) Lisa FB,Linda DS,Ralph I H. Emotional Support and Survival after Myocardial
Infarction Ann Intern Med 1992;117;1003-1009.
13) James JS, John SL, Jeffrey SH. et al, Cost Offset From a Psychiatric ConsultationLiaison Intervention with Elderly Hip Fracture Patients Am J Psyc 1991;148;8.
14) David S, Helena C K, John RB, Ellen G. Effect of Psychosocial Treatment on
Survival of Patient with Metastatic breast cancer, Lancet;1989.
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81
15) Kabat Zinn J, Lipworth L, and Burney R, The clinical use of mindfulness meditation
regulation of chronic pain. J Behav Med 1985;8;163-190.
16) Kabat Zinn J, An outpatient program in Behavioral Medicine for chronic pain patient
based on the practice of mindfulness meditation; Theoretical considerations and
preliminary results, Gen Hos Psy1982;4;33-47.
17) Caudill M, R. Schnable et al, Decreased clinical use by Behavioral medicine
intervention in chronic pain patients Cli J Pain 1991;7;305-310.
18) Annika Rosengren, Kristina Orth-Gomer, Hans Wedel, Lars W. Stressful life evens,
social support, and mortality in man born in 1933BMJ:307:1102-1105.
19) Kendall NAS, Linton J, Main CJ, Guide to assessing psychological yellow flags in
acute back pain: risk factors for long-term disability and work loss. Accident
Rehabilitation & Compensation Insurance Corporation of New Zealand and the
National Health Committee. Wellington N Z 1997;1-22.
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[8]
Concept
(WHO)
4
4
4
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83
Osteopathy
84
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Safe t-cut
Safe t-cut
Andrew Taylor Still
(.. 1874)
Craniosacral
Therapy
(Chiropractic)
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85
Nerve
12
8 10
2 (Physical Medicine)
Energy Medicine Energy medicine
David Palmer - Harvy
Lilard 17
86
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()
5 (Line)
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87
( 2)
(Balance)
2
88
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Anatomy
100% 70%
30% 10 7
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3-4 1 Support
2 3
90
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4 3 4
3 4
1
4
2 3
Support 4
1
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3
4
8
1 - 1 2
2 2
2 1
1
92
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1
2 10
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93
3
1
( )
( 30 )
94
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(30 )
3
(30)
3
3-5
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: ?
?
:
: ?
:
6 6
2
Support
.................... ....................
96
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[9]
:
:
:
2
:
2-3
(pain)
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WHO
5
4-5
pain
Concept
Mono Factor
1 Conceptual Principle
Homeostasis
NCCAM (National Center for Complementary and
Alternative Medicine)
.. 2002 36
62 Concept
62
98
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36
2
55
50 28
36-47
12-20
Pain
(Acupuncture)
WHO Pain
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(Acupressure) (Massage)
(Chiropractic) Osteopathy Biofield Therapy
Biofield Therapy
(Universal) (Astral Energy)
(Cosmic Energy) (Purification
Manual Healing) Metaphysical,
Electromagnetic Field Effect, Undefined, Potentially Quantifiable
Metaphysical Approach Spiritual Energy
Interactive Human and Universal Energy Fields Harmonie Induction
Repatterning of Resonant Vibration Field
Resonant
HIGHLY SIGNIFICANT DECREASES IN PAIN SCORES RECORDED ON THE MC GILL - MELZAK PAIN
QUESTIONAIRE BY PATIENT WITH TENSION
2 Atlternative Treatment for Pain HEADACHE (KELLER, 1993, KELLER AND
BZDEK, 1986) POST OPERATION PATIENTS WAITED LONGER BEFORE REQUESTING ANALYSIS (MECHAN, 1985, 1988)
Energy Medicine
Physiology (Self Healing)
Thoracic Pain Muscle Pain Head Ache Migraine
Osteopathy
(Acupressure)
100
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:
6-7
5
5 5
Meridian
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101
1.
Osteotitis
3
2.
3
102
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3.
90 90
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103
6
3 3
104
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90 /
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105
90
11
10
4 4 4
12
13
106
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:
8
3
1. (Myofascial pain)
2.
(Herniated disc) (Radiculopathy)
3. Micro Factor
(Myofascial pain)
108
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Trigger point
Vicious Cycle
(Vasodilation)
2
1. (Trigger point)
2.
1
2
diclofenac
http://www.dtam.moph.go.th/alternative
109
2-3
Manipulation
Traction
(Osteoporosis)
14
110
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Phytoestrogen
Chronic Acute Pain
path way
nociceptor Peripheral nerve Central
Brain Central Brain
nociceptor Central Brain
Central Brain
Block New receptor
Central Brain
Modorate
http://www.dtam.moph.go.th/alternative
111
(Abnormal spinal alignment)
:
(Spiritual)
Diclofenac 15
15 (Spasm)
(tetanus) tetanus
Spiritual
Back muscle
Relaxation
Spiritual
112
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:
Spiritual
10
...
wait and see
Concept
3
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113
Spiritual Balance
Practice Consult
Pain
Bone Setting
10
14
4-5
2
(Balance)
Approach
114
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115
(Transfer)
Healing
(Endocrine System)
(Relax)
Growth Hormone, Pituitary gland, Thymus gland, Thyroid gland
(Healing)
Path way
Negative
Alternative Alternative
outcome
Alternative outcome
Process
116
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14
()
2
3 2
:
2
3 2
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107
:
outcome Evidence Base
Result Base Result Base Evidence Base
Evidence Base
:
10 10
3
Ibugan Cafergot
Acute Chest Pain
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117
3 3 2
5
6
7 C7
10%
1
C7 1-2
10% Metabolism 10%
Metabolism
118
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3
4-5 2 1
3-4
OTOP
2 /
OTOP
2 2 1
3-4
2
2 1
10
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119
3-4 2 1
70
()
13 4-5
5 2 Ultra low fat vegetarian
diet
3
2 3
10
10 3
120
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Big size 5
40-50
:
Discussion 15
:
3
. :
1 :
. :
.................................( 2-3 )...............................................
. :
1 :
. :
2 :
. :
2 : .
. : ..
.................................( 2-3 ).................................
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121
. :
2 :
. :
Energy Field
Quality Theory
Membrane potential
Membrane potential
E.E.G E.K.G Membrane potential Sodium Potassium
20
7
induce Energy Field
Physiological
Physiology
Disturb Energy Field
C7
122
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3
Sense Control
Psycho neuro Immunology
20
Melatonin 50 euphoria
Endorphin
Insulin Growth Factor Insulin Growth Factor
Growth Factor
:
DMS6
http://www.dtam.moph.go.th/alternative
123
:
2
VCD
49
49
VCD
124
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Physical Exercise Spiritual Exercise Spiritual Exercise
4 4
Intensive 10
4
4
:
Sensation
Sense Flow
100%
Side Effect
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125
:
3-4
Claim Down
3
Intensive Lifestyle Change
3
126
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(Metabolism)
Flow
2
Adrenalin Adrenalin
(Periphery)
:
Review
Action
Food
Intolerances
Antibody Antigen
ITE, ITG
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127
Lab
100 8,000
Lab
Toxin
(Arsenic) Arsenic
poisoning
6
Tissue Colon Cleansing
Toxin
:
Chelating Agent
:
Free Zone
128
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Free Zone
Treatment
Free Zone
100 300-400
Reflex
Reference
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129
Feed Back
.................... ....................
130
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