resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
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."
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.
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.
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.
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.
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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