Fibromyalgia… fix the leaks

The National Fibromyalgia Association points out on their website that fibromyalgia is a syndrome rather than a disease that affects people physically, mentally, and socially. They explain that in the case of fibromyalgia , a “syndrome is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause.”

In this study, the author writes, “Ninety percent of fibromyalgia sufferers are women, who begin to experience symptoms between the age of 40 and 50. Concurrent symptoms associated with fibromyalgia include numbness, stiffness, generalized fatigue, headaches, irritable bowel symptoms, swollen feelings in the tissues, as well as anxiety, depression, and mental fogginess.”

In this case, a 45-year-old woman went to the chiropractor with complaints of migraine headaches, chronic pain in the neck, upper and lower back, fibromyalgia, numbness in fingers, sciatica, right knee pain, depression, and a duodenal ulcer. Her history had a number of issues starting with a traumatic injury sustained from diving head first into a shallow pool at the age of 15. Additionally, the patient was in 10 car accidents over the past 25 years. When she presented herself to the chiropractor, she required a wheelchair to help her complete her daily routine and reduce her tiredness.

Chiropractic examination showed an abnormal posture and spinal positioning with a reduction in most spinal ranges of motion. Numerous orthopedic tests were also positive along with sensitivity to the touch of many areas of the patient’s spine. X-rays of the patient confirmed spinal misalignments and a determination of the presence of subluxations was made. A course of care consisting of specific chiropractic adjustments was initiated to address the subluxations.

The results of this case showed that the woman had steady improvement in her conditions, and within six months of initiating her chiropractic care, she no longer needed her wheelchair for her activities. The woman noted that her fibromyalgia and left leg sciatica had been resolved. Additionally, she reported that she was able to move and perform basic daily functions and sleep in any position. She was also feeling more relaxed and had more energy throughout the day and did not require any medications.

July 14, 2011 at 11:53 Leave a comment

ERISA Claims Upheld in Aetna Recoupment Case / MEDICAL VICTORY

June 23, 2011, 10:50 a.m. EDT

ERISA Claims Upheld in Aetna Recoupment Case, Pomerantz Haudek Grossman & Gross LLP Announces


TRENTON, N.J., Jun 23, 2011 (GlobeNewswire via COMTEX) — In a decision filed on June 20, 2011, the Honorable Judge Joel A. Pisano of the District of New Jersey sustained the claims brought by a group of individual healthcare providers and state chiropractic associations against Aetna, Inc. and various of its subsidiaries under the Employee Retirement Income Security Act of 1974 (“ERISA”). In the action, the plaintiffs allege that Aetna improperly recouped monies from providers that had previously been paid on behalf of its members, based on retroactive determinations that the services at issue were not covered under the members’ health care plans. Frequently, Aetna determined after-the-fact that the services were excluded from coverage because they were “experimental and investigational” and therefore demanded that the providers return the funds. If the providers did not agree, Aetna placed them into pre-payment review, which in reality meant that Aetna simply withheld payment as a means to punish the provider and save money through undisclosed denials. The entire process, as alleged in the complaint, was in violation of ERISA because Aetna made its retroactive adverse benefit determinations that served as the basis of its repayment demands without providing a “full and fair” review of its decision, as required under the law.

“This decision is very important,” says D. Brian Hufford of Pomerantz Haudek Grossman & Gross LLP (“Pomerantz”), “as now we will be able to proceed to full-scale discovery where we anticipate finding substantial evidence supporting our claims that ERISA has, indeed, been violated as a result of Aetna’s widespread actions.” The case parallels a similar action brought by Pomerantz which is proceeding against a number of Blue Cross Blue Shield licensees in the Northern District of Illinois before the Honorable Matthew E. Kennelly, as well as a recently filed action against United Healthcare in the District of New Jersey before the Honorable Faith Hochberg, both of which allege violations of ERISA for improper repayment demands and recoupments of prior benefit payments.

In addition to the ERISA claims, Judge Pisano also upheld the standing of the association plaintiffs to pursue claims for injunctive relief on behalf of their members, including the Association of New Jersey Chiropractors, the New York Chiropractors Council, the Illinois Chiropractic Society and the International Chiropractors Association. Co-counsel John W. Leardi of Buttaci & Leardi, LLC, notes that “we are very pleased that the associations will be able to continue advocating on behalf of their members in this case, as they play an important role in defending the rights of providers and subscribers against managed care abuse.”

In addition to the ERISA claims, the plaintiffs also asserted violations of the Racketeer Influenced and Corrupt Organizations Act (“RICO”), which were dismissed. The court further dismissed one individual plaintiff, finding that he had released his claims by entering into an individual settlement prior to the filing of the class action, while granting a motion to compel arbitration against two other plaintiffs, who had arbitration clauses in their in-network provider agreements with Aetna, leaving six remaining individual plaintiffs. According to Robert J. Axelrod of Pomerantz, “while we continue to believe that RICO was violated, ERISA is the heart of our case, and we are very pleased with the result.”

Pomerantz Haudek Grossman & Gross LLP, which has offices in New York, Chicago, and Washington, D.C., is acknowledged as one of the premier plaintiff class action firms, and, in particular, has been a leader in the industry in health care class actions on behalf of providers and patients. Founded by the late Abraham L. Pomerantz, known as the dean of the class action bar, Pomerantz pioneered the field of securities class actions. Today, more than 70 years later, Pomerantz continues in the tradition he established, fighting for the rights of the victims of fraud, breaches of fiduciary duty, and corporate misconduct. Pomerantz has recovered numerous multimillion-dollar damages awards on behalf of class members.

Buttaci & Leardi, based in Princeton, New Jersey, has a dynamic national health care practice, representing licensed health care providers, group practices and other provider-related entities throughout the country. It has extensive experience representing providers in challenging post-payment audits, including those pursued by Aetna, and has obtained tremendous success on behalf of its clients.

Counsel for plaintiffs are continuing to investigate these claims, and other related claims that may be added to the litigation. If you have any questions, please contact D. Brian Hufford, Esq. of Pomerantz Haudek Grossman & Gross LLP, by phone (212-661-1100) or email (, or Vincent N. Buttaci, Esq., of Buttaci & Leardi, LLC, by phone (609-919-6312) or email (

This news release was distributed by GlobeNewswire,

SOURCE: Pomerantz Haudek Grossman & Gross LLP


June 24, 2011 at 11:53 Leave a comment





June 1, 2011 at 11:53 Leave a comment

GEN | Industry Updates: Spinal Manipulation Proves Equally Beneficial as Surgery in Sciatica Treatment

GEN | Industry Updates: Spinal Manipulation Proves Equally Beneficial as Surgery in Sciatica Treatment.

May 19, 2011 at 11:53 Leave a comment

Despite the recent surge in interest in the medical community over Manipulation Under Anesthesia, the practice known as MUA has been used in manual medicine for over 70 years!!!

Chiropractic care has a history almost as rich and longstanding as medicine itself. Its origins can be dated back thousands of years ago.  Ancient Chinese civilizations used manual medicine of the spinal region as therapy and treatment of various spinal conditions in an attempt to improve range of motions, posture and pain/discomfort.  Throughout the ages, manual medicine continued to evolve via efforts of Hippocrates and Greek civilization all the way up to the founding father of Chiropractic care, Daniel David Palmer.  Through advancements of technology, science and medicine, chiropractic care for patients has never been better.  The refinement of Manipulation Under Anesthesia, or MUA, gives patients a highly successful and cost effective alternative to painful invasive surgeries with long rehabilitation times.

The manipulative technique known as MUA was developed in the early 20thcentury, but only gained recognition by professional medical and chiropractic organizations during the 1980’s.   This increasing interest throughout mainstream medicine has aided in the creation of professional organizations/associations with the common goal of providing scientific data to establish the clinical validity of manual medicine.  The benefits of these organizational bodies is the development of accepted practices and standards in providing benchmarks and common procedures for MUA, so that they can be practiced throughout the nation in surgery centers/hospitals by nationally certified experts.  As nationally certified programs are made more accessible in teaching proper MUA techniques to practitioners, the patient can now be confident and reassured in this safe and effective alternative to invasive surgical procedures.

As MUA garners more and more of a spotlight as a non-invasive alternative to surgery, an increase in working relations has occurred between mainstream medical and chiropractic practitioners.  Within the last decade, an increasing amount of data and case studies have been collected to support and validate the practice of MUA as an effective healing technique.  This has afforded chiropractors new opportunities to essentially work alongside medical physicians in providing patient care, even though chiropractors remain the most active group of medical professionals which practice MUA.

While data is constantly being updated through ongoing case studies and trials regarding the effectiveness of MUA, it is crucial to note that no clinical trial has shown MUA to be ineffective to date in appropriately screened patients.  When due diligence of properly screened and selected patients has been addressed, all clinical outcomes have concluded with positive results.

May 3, 2011 at 11:53 Leave a comment

Manipulation Under Anesthesia (MUA)


Manipulation Under Anesthesia (MUA) is multidisciplinary manual therapy treatment system which is used to improve articular and soft tissue movement using specifically controlled release, myofascial manipulation, and mobilization techniques while the patient is under moderate to deep IV sedation using monitorized anesthesia care (MAC)[1]

This procedure is used by specially trained chiropractors and orthopedic surgeons as a means of breaking up scar tissue around a joint without complete range of motion. In cases of post operative total knee replacement, for example, if a patient is having difficulty achieving their flexibility after a 6-8 week period, the surgeon may elect to bring the patient back to the operating room, place them under anesthesia and perform a manipulation under anesthesia. The procedure takes a relatively short period of time (15- 20 min) and the surgeon can gain improved range of motion for the patient. This can also be performed for other orthopedic musculoskeletal limitations, as indicated. Knee manipulation under anesthesia (MUA) is indicated for total knee arthroplasty (TKA) patients who have not obtained at least 90º of flexion by the 6th postoperative week. [2]


Currently MUA certification courses offered through accredited chiropractic college post graduate departments are recognized by malpractice carriers for inclusive coverage. It has been important to regulatory agencies, academic institutions, professional associations and organizations and malpractice carriers to recognize appropriate training programs. Towards that end, specific criteria have been adopted to establish credible certification course offerings. Standards and protocol establishing credible certification training programs are recognized by the National MUA Academy of Physicians and the International Academy of MUA Physicians and are subscribed to by the accredited academic institutions offering post graduate certification in Manipulation Under Anesthesia.[citation needed]

Evidence basis

  • “In a first study by Siehl ad Bradford published in 1952, 33 percent of the patients … demonstrated good (symptom-free) results.” Page 294
  • “Siehl’s followup study … 96 percent reported successful (good or fair) outcomes.”
  • “In Chrisman’s study 83 percent of the subjects reported good or excellent result after a 3-year follow-up.” Page 294
  • “In Morey’s 1973 review … treating physician reported excellent or good results in 85 percent of the cases.” Page 294
  • “In a study published in 1986 by Krumhansel and Nowacek … outcomes were reported as 25 percent ‘cured’, 50 percent ‘much improved’, and 20 percent ‘better, but’. Page 294
  • “In a 1990 article by Mennell … 30 percent with symptoms cured, 35 percent with marked improvement, 29 percent with moderate improvement…” Page 294
  • “In a recent case series by West et al … VAS scores improved 4.6 points for cervical pain and 4.31 points for lumbar pain. Decrease in time off work and less use of prescription pain medication were also reported.” Page 294
  • “We have been unable to find any report of complications using more modern osteopathic and chiropractic techniques or as a result of the use of anesthesia.” Page 297 [3]

In addition, for over 30 years now, the collection of MUA procedures (including hip, pelvis, spine, and back among other body regions), has been listed as a Category I CPT [4] code in the AMA Codebook of Reimbursable Procedures.[5]. The introduction of that book notes that in order to qualify as a Category I code, “the clinical efficacy of the service/procedure is well established and documented in the United States per review literature.” This was later reaffirmed by the AMA, where they noted that simply by having a Category I code, a procedure, by definition is not experimental and has a well established clinical efficacy.

April 19, 2011 at 11:53 Leave a comment


Studies like this one published in the American Journal of Public Health are finally exposing what I’ve suspected for a long time: exposure to chlorine on your skin can potentially be dangerous to your health. For many years, researchers thought that the “exposure” came only when chlorine was ingested. But, current studies are showing that drinking the water is not the only risk. And is likely not even the most severe.
Some facts about the danger of chlorine exposure — and remember chlorine is just ONE of the chemicals in your water right now:
• On average, you consume between 1-2 gallons of water a day, but on average you expose yourself to 25 gallons of water when you shower.   The U.S. Council of Environmental Quality reports that cancer risks for people who drink chlorinated water are 93% higher than people who don’t.
• Even if your skin repels 75% of all chemicals and toxins in the water, that still leaves 25% of chemicals that make their way through your semi-permeable skin and into your body. That means one 15-minute shower is the equivalent of drinking 8 glasses of polluted water.
When you take a hot shower, toxic chemicals are liberated from the water and released as gasses, including chloroform (50% more released) and trichloroethylene (TCE) (80% more released) — both known carcinogens.
That steam you love so much — that is so relaxing to you — well, it’s potentially filled with gasses that could harm you. In fact, research shows that the dangers of vaporized chlorine are 100 times greater through inhalation and bathing than drinking. It’s a harsh reality, isn’t it?
And, the longer your shower… the bigger your potential risk. As you double the length of your shower, you quadruple the amount of harmful gasses that are accumulating.


April 14, 2011 at 11:53 Leave a comment

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