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What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
May, 2001, Vol. 01, Issue 05
Snap, Crackle and Pop, Part I
By Neal Cross, PhD, NCTMB
The human temporomandibular joint (TMJ) is involved in the etiology of several clinical complaints, including jaw pain, tongue pain and headache. Although small, this joint has a rather complex structure and function.By placing your middle finger over the TMJ (just inferior and slightly anterior to the external auditory meatus) and slowly opening and closing your mandible, you should feel a nice smooth motion bilaterally. This motion will start as a jaw opening (depression); at the end of the movement ( at the point just prior to fully opening the jaw), you should feel the joint glide anteriorly. Some will feel one side move out of synch with the other; others may feel one or both sides suddenly "snap" anteriorly. A few may feel a "crackle" (crepitus) on one or both sides; still others may feel and/or hear a "pop" as the articular disc releases.
Let's consider some of the underlying anatomical and functional aspects of the TMJ. The TMJ is formed by parts of two bones: the temporal bone and the mandible. More specifically, the condyloid process of the mandibular ramus fits into the mandibular (glenoid) fossa of the zygomatic process of the temporal bone. This mandibular fossa is bounded posteriorly by the retroarticular process and anteriorly by the articular tubercle. There is a well-defined articular disc within the joint cavity and an articular capsule enveloping the joint. (Author's note: For more information, please refer to one of the atlas pictures listed below.) Interestingly, the disc separates the joint cavity into two functionally separate compartments: one inferior and one superior. Another unique feature of this joint is that the articular surfaces are covered by dense fibrous connective tissue instead of hyaline cartilage, as is usual in synovial joints. This type of connective tissue allows for joint remodeling. The disc attaches to bone medially, laterally and posteriorly, but blends with the articular capsule anteriorly. The articular capsule and the lateral ligament further stabilize this joint. Medially, the sphenomandibular ligament assists in TMJ stabilization. Posteriorly, the stylomandibular ligament assists in joint stabilization.
The TMJ is considered a compound joint, because it operates as two separate but related functional units. The articular disc and the mandibular condyle form the first functional unit. These two act together in most hinge-type movements. This is when the jaw is depressed. The condyle and the disc together move (glide) on the articular eminence for full mandibular opening. The jaw may also be protracted (protruding the mandible) or retracted. In addition, there is lateral displacement about the TMJ. The primary muscles producing these mandibular movements are: depression-lateral pterygoids with help from the digastric, mylohyoid and geniohyoid muscles; elevation-masseter, temporalis and medial pterygoids; retraction-posterior temporalis; protraction-lateral pterygoids; and lateral displacement-contralateral lateral pterygoid. Earlier descriptions of a separate "superior pterygoid" muscle acting solely upon the articular disc seem to have been unfounded.1
The innervation of the TMJ is derived from branches of the mandibular division of the trigeminal nerve; specifically, the masseteric and auriculotemporal branches. The blood supply is derived from the superficial temporal and maxillary branches of the external carotid artery. Lymphatic drainage is primarily into the deep cervical nodes.
Next month, I will discuss various TMJ dysfunctions as they relate specifically to the underlying anatomical features. It will then become clear why so many clinicians of various types treat TMJ dysfunction.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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