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The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
May, 2001, Vol. 01, Issue 05
By Ben Benjamin, PhD
Question: Do muscles, tendons and ligaments regularly refer pain down the arms and legs in ways that appear similar to a nerve compression injury (often referred to as a nerve root compression, radiculopathy or pinched nerve)?
Muscles, tendons and ligaments often refer pain down the arms and legs in ways that are similar to nerve compression injuries.For instance, a ligament sprain in the low back will often cause referred pain down the lateral leg to the area of the lateral gastrocnemius. A torn gluteus medius muscle in the buttock will often refer pain down the leg to the lateral calf. Nerve compression to the L5 nerve root may similarly cause pain in the lateral thigh and calf.
Another instance in which confusion arises is when there is a strain in one or several of the rotator cuff tendons, or a nerve root compression at the C5 level in the neck. For instance, a severe injury to the supraspinatus tendon will often refer pain down the arm to the wrist. This same pattern of referred pain will often be similar to the pain felt from pressure on the C5 nerve root.
Because pain patterns from nerve root compressions may overlap the areas to which muscles, tendons and ligaments refer pain, these injuries often confuse experienced and inexperienced practitioners alike. It may be easy at such a point to throw up your hands and say, "It's too complicated and difficult to figure this out, and it isn't going to change my treatment, anyway." In my experience, this is a mistake. Various types of massage and other hands-on therapy techniques can be very helpful for muscle, tendon and ligament injuries, but they are useless for a nerve compression injury. However, having the knowledge and skills needed to differentiate these different types of injuries is useful and vital to the therapist interested in working with clients who suffer from pain and injury problems.
Let's say a client comes in with a history of three to four months of pain in an area indicative of a potential muscle, tendon or ligament injury, or a nerve compression problem. Assessing the client with specific active, passive and resisted tests will help you identify a soft tissue injury. However, if you see that the involved muscles have atrophied, and the client reports a feeling of pins and needles and numb or numb-like sensations in patches of skin, you may suspect a compression injury of a nerve. In such a case, your soft-tissue techniques will not help this client; you need to refer him/her to a health care provider or other specialist. Referred pain to the arm from suprapinatus injury or C5 nerve root injury.
It's worth the effort to learn when to refer clients out because they have an injury you cannot help, and when to treat them for something you can help. It makes your work more effective because you can work primarily on the people and the pain problems you can actually help. Obtaining the skills to differentiate these confusing injuries makes you a better therapist, and adds enormous confidence to yourself and your work.
Remember, it is always wise to have a physician check a client who has a serious pain or injury problem.
Click here for more information about Ben Benjamin, PhD.
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