resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
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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