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News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
May, 2001, Vol. 01, Issue 05
Nerve Compression and Tension
By Whitney Lowe, LMT
The nervous system is a fascinating communication network. When functioning properly, it can coordinate a tremendous amount of essential information moving throughout the body.When it is impaired, it can cause us excruciating pain or even complete limitations to movement. Because we work so closely with the soft tissues of the body, it is valuable for the massage therapist to understand more about various nervous system pathologies.
The nervous system is a complex network for the transmission of information going in two different directions. We have sensory (afferent) signals moving from the periphery of the body back to the central nervous system and motor (efferent) signals moving from the central nervous system to the periphery. Both types of signals are transmitted along the same nerve tissue. Therefore, if there is an impairment of nerve function, it is likely to affect both sensory and motor signals.
During the course of normal daily function, the structures of the nervous system are exposed to a variety of different forces. The two forces that cause problems most frequently in the nervous system are compression and tension. When something causes a problem with the proper function of nerve tissue, it is called a neuropathy. Therefore, when speaking of nerve compression and tension injuries, we call them compression or tension neuropathies.
Compression neuropathies are the most common type of nerve injuries. There may be various causes of compression neuropathy. Compression by other structures in a small space (such as an anatomical tunnel) is a common cause. Examples would include compression of the median nerve in the carpal tunnel, the posterior tibial nerve in the tarsal tunnel, or a spinal nerve root as it travels through an intervertebral foramen. Often there is some reason that the tunnel or space through which the nerve travels has narrowed, and the adjacent structures will compress the nerve. This location, where nerve tissue is immediately adjacent to other tissues that often impinge on it, is referred to as the "mechanical interface."1
Sometimes a compression injury will be caused by an outside mechanical force. For example, the radial nerve is often injured in the axillary region from improperly fitted crutches. Prolonged pressure underneath the axilla from the crutches will compress the radial nerve. Long-distance cyclists often experience a similar problem, termed "handlebar palsy." Handlebar palsy is a compression of the ulnar nerve in the wrist that occurs from long periods of direct pressure on the nerve, when the weight of the upper body is resting on the handlebars.
Tension neuropathies, while not as common as compression neuropathies, are increasingly viewed as important clinical problems. It has been demonstrated that for the body to move properly, the nervous system must have significant mobility. This is especially true in the extremities, in which the nerves must bend around joints and allow for increases in length as the joints bend at sharp angles. If such mobility is compromised, increased tension on the nervous tissue can cause pathological changes.2
Symptoms of compression or tension neuropathies are very similar. In fact, you can't tell the difference in a compression or tension neuropathy simply by the symptoms. In many instances compression and tension neuropathies will exist together. For example, if there is excess compression on the brachial plexus, proper mobility of the nerves of that plexus will be impaired. Therefore these nerves may be subjected to tension neuropathies farther down the arm, because the compression of the brachial plexus has limited the neural mobility.
The most common symptoms of compression and tension neuropathies include pain (often described as sharp, stabbing or electrical in nature); paresthesia (the sensation of pins and needles); numbness; or muscle weakness. These various symptoms will usually be identified with a thorough client interview and detailed physical examination procedures. In future installments of this column, we will look at a number of special tests for evaluating specific nervous system pathologies.
One of the most fascinating aspects of compression and tension neuropathies is something called the double (or multiple) crush phenomenon. This was originally described because a large number of patients with carpal tunnel syndrome also appeared to have brachial plexus neuropathies. The investigators wondered if it was possible that one site of nerve compression might make another site more sensitive and susceptible to compression pathologies. To understand how this occurs, it is helpful to investigate nerve anatomy more closely.
The nerves are not only responsible for transmitting afferent and efferent signals along their length; they are also responsible for moving their own nutrient proteins, which are essential for optimal function. The movement of these nutrient proteins is accomplished through a special type of cytoplasm within the nerve cell called axoplasm (referring to cytoplasm of the axon). The axoplasm moves freely along the entire length of the nerve. If there is a blockage to the flow of the axoplasm (called axoplasmic flow), the nerve tissue distal to that site of compression is nutritionally deprived and more susceptible to injury.
Because of the increased understanding of neural anatomy, the presence of double and multiple crush syndromes has gotten a great deal more attention. Many clinical practitioners are now finding explanations for groups of signs and symptoms that previously didn't make much sense, but are much more easily explained with the idea of the double crush. The massage practitioner whose client may have compression or tension neuropathies is strongly encouraged to study nervous system structure and function more thoroughly. Since many of these neuropathies occur because of soft tissue restriction, there is a great deal that we can often do to help alleviate these problems.
Click here for more information about Whitney Lowe, LMT.
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