resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
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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