resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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?
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 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.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
December, 2002, Vol. 02, Issue 12
Living in the Laboratory
By John Upledger, DO, OMM
One day in September 1998, I went to the dentist to have a cavity in a lower molar filled. I had a slate of patients that afternoon, so my dentist suggested I go without anesthetic.It took one shot of air into the cavity to convince me I was not of the ilk to have a non-anesthetized filling. That single squirt of air put me into orbit.
Consider that the right lower molar is innervated by the right mandibular nerve, which feeds into the trigeminal ganglion. This ganglion receives input from the other two branches of the trigeminal nerve: the maxillary and ophthalmic nerves. That shot of air sent a shock into my trigeminal ganglion, which then went straight into the trigeminal nuclei. These nuclei, which are bilateral, extend from the upper pons down through the medulla and into the upper spinal cord.
It just so happens that the trigeminal system has the most plentiful connections to the reticular alarm system of any of the 12 cranial nerve systems. My connections were obviously effective. I found myself in a ready-alert condition that wouldn't quit. I even tried to talk to my reticular alarm system to soothe it, but the relief was only temporary. Then I tried visualizing a gauge from 1 to 100, with the needle pointing at the number representing my level of alertness. My needle was at about 90, nearly to the max. With a lot of hard visualization I was able to get it down to about 30, but every time I got tight again the needle would shoot up to 90.
This went on until the dentist was able to see me again the next week. It was after hours, so he was slightly rushed. As he froze my jaw, he explained that he was doing a mandibular nerve block instead of the usual "infiltration," since it worked faster. Of course, my mouth was full of instruments, so I couldn't object.
As he injected the lidocaine near the medial aspect of my right mandibular ramus, I felt excruciating pain. It felt like he was sprinkling hot embers on my chin from the lip to under the mandible, and from the mandibular notch forward to the vertical midline of my chin. What went on for minutes felt like hours. My rational mind knew instantly that his needle point had pierced my mandibular nerve. In my mind's eye, I could see the two or three cc's of lidocaine fluid separating my nerve bundles and tearing apart the integrity of the supporting structures formed by the glial cells, as the hydraulic forces of the fluid wreaked havoc on my mandibular nerve. I could feel my trigeminal ganglion quivering with anxiety as it sent a continuous SOS message to my reticular alarm system.
At this point, I had to control an urge to run or attack my attacker. Instead I sat quietly, mouth wide open, with all the suction pumps and drills making their noises. I'm sure he did a nice technical job, but by the time he was finished nearly an hour later, I was on full alert.
That evening, the right side of my mouth stayed numb and lacked motor control for about five hours. Then, at about 3:00 a.m. I awoke with an extremely sore throat. It was on the right side, extending through all the hyoid-related tissues down to my right clavicle. The sore throat evolved into a cough which stayed in the throat, above the clavicle. By the next day, the pain was complemented by neck stiffness and right-sided temporal head pain, which involved the right occipitomastoid and the right temporoparietal sutures.
To make a long story short, I was a mess. Unfortunately, I had to fly to Detroit to do a three-hour CranioSacral Therapy presentation the next day. I did fine, but had to work harder to concentrate, and my throat, neck and head still hurt quite a bit. I flew home totally exhausted, which is unusual for me. Instead of recovering, I was deteriorating.
Over the next few weeks, I received sessions in a variety of modalities - CranioSacral Therapy, energy cyst release, SomatoEmotional Release, myofascial release, chiropractic -and started to feel some relief. Then came Sunday, September 27, 1998. My whole world opened up when the root causes of my troubles presented themselves. At this point, my wife Lisa was getting a bit concerned about me. I had never been so exhausted and miserable for such a prolonged period of time - three weeks. I called the dentist's office to find out exactly what he used to inject my mandibular nerve. It was lidocaine with epinephrine.
First synthesized in 1937, lidocaine is a stable local anesthetic, also used intravenously to treat cardiac arrhythmias, especially during catastrophic events such as myocardial infarctions. As an anesthetic, it prevents the generation and conduction of the nerve impulse. The main site of action is in the nerve cell membrane. Supposedly, there is little or no residual effect upon the neuron when lidocaine is used in the small doses required to interrupt impulse generation and conduction. Conventional thought is that when the gross effect wears off and sensation returns, the drug is gone. However, in our Upledger Institute workshop "The Brain Speaks," we have gotten the distinct impression that local anesthetics are stored for long periods of time between the lipid layers of the neuronal membranes. This, in turn, has a long-term effect on the neurons in question: it produces post-anesthesia hyperexcitability.
If you think about your teeth - their crowns, root canals, fillings and things that just don't feel right, or remain hypersensitive to heat, cold, sugar, what have you - it could be that the innervation to these teeth has remained hyperexcitable because of residual effects of the local anesthetics in the neuronal membranes.
Now, let's consider the epinephrine. A synthetic version of a natural hormone that comes largely from the adrenal gland, it's used with local anesthetics because one of its effects is to constrict the blood vessels with which it comes in contact. This keeps the local anesthetic from being too rapidly cleared from the site of injection. The result is a prolonged anesthetic effect. Functionally, epinephrine is adrenalin. Whatever the name, it has a powerful effect upon the sympathetic nervous system. It raises heart rate, increases blood pressure, inhibits visceral activity, and generally increases the alertness of the reticular alarm system. But my reticular alarm system was already riding high. It did not need an epinephrine boost.
Now, back to that Sunday in 1998, when my concerned wife treated me with CranioSacral Therapy. She began by "arcing" from my feet, then coming up to my mandible just to the right of the midline. As she placed her hand there, I began to experience the same strong taste I had in my mouth when the dentist injected me with lidocaine and epinephrine. The taste remained for most of the session. Soon Lisa was releasing a tremendous "energy cyst" from my anterior mandibular region just to the right of the midline, and from the ramus of the mandible on that side. I felt the effects of her work in my right ear, all of my lower teeth on the right side to the anterior midline, some of my upper teeth on the right side, into my head and neck, down into the hyoid and into the right clavicle and shoulder. The related muscles were all very much involved.
The overwhelming sensation was deep ache and pain in all these structures and tissues. In my imagery, the right mandibular nerve had been damaged by the injection. It was also clear that Lisa was removing energy and subatomic particles that were residual within the nerve. As I visualized this energy ,I saw electrons derived from the nerve injection material that had spread throughout the course of the mandibular nerve into the trigeminal ganglion. The ganglion was trying to contain these toxic energies and electrons, but wasn't completely successful. Some of these energies and electrons had spilled into the maxillary and ophthalmic nerves, as well as into the spinal cord, thus creating effects in the neck and throat.
Much of the cranial dysfunction was the result of the toxic effects upon the meninges, especially by challenging the magnetic crystals located in the dura and the pia mater. It has been shown that there are 100 million single-domain magnetite crystals in a single gram of both dura and pia mater membranes, and five million per gram of brain tissue. I'm sure errant energies and electrons or other subatomic particles could easily stress these systems and result in pain and dysfunction.
After Lisa cleared most of this toxic residue, I experienced remarkable relief. I thought we were finished. No sooner did I get that thought than a crown on the 2nd molar on the lower right side began to hurt again. This crown had been less than comfortable for the decade I'd had it. It had felt hypersensitive and somewhat out of place. Lo and behold, the same thing happened. In my imagery, residue of the local anesthetics began to clear and more energy cysts released. As this occurred my crown began to feel more comfortable in my mouth.
That's when I started feeling much less tired, more comfortable, and less wired. Certainly there was a more to go, but by that time I was well on the road to recovery.
So, what's the moral to this story? There is perhaps no better way to learn than by living in your own laboratory.
Click here for previous articles by John Upledger, DO, OMM.
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