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The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
January, 2003, Vol. 03, Issue 01
The Facilitated Segment
By John Upledger, DO, OMM
The concept of the facilitated segment is highly relevant to neuromusculoskeletal and psychoemotional problems. The word "facilitated" usually has a positive connotation, implying that some process is made easier or more efficient.In the case of the facilitated segment, however, it means that the stimulus threshold in a particular spinal cord segment has been reduced. This means that the facilitated segment of the spinal cord is highly excitable, and that a smaller stimulus will trigger excessive impulse firing in the segment.
Depending on the tissues involved, this hypersensitivity may be detrimental to the body as a whole. For example, if the segment that innervates the stomach becomes facilitated, the stomach becomes hypersensitive. Mildly irritating foods may cause disproportionately large pains or stomach dysfunctions. A person who suffers from this problem may be said to have a nervous stomach, food allergies or intolerances. If the situation continues, gastritis or ulceration may follow.
The concept of the facilitated segment originated in the work of Dr. I.M. Korr and his associates, beginning in the 1940s at the Kirksville College of Osteopathy and Surgery. The word "segment" means "one of the parts into which something separates or divides." In the phrase "facilitated segment," the word can be somewhat misleading. It suggests that the spinal cord is naturally divided into pieces or segments. To some extent this is true, but bear in mind that the spinal cord is a longitudinal structure, both functionally and structurally. It connects the brain with the nerve roots, which branch out to form the peripheral nervous system.
The spinal cord can be compared to a freeway, and the spinal nerve roots to on- and off-ramps. The spinal cord is a continuous structure, but the nerve roots branch off at regular intervals, and can be viewed as delimiting "segments" of the spinal cord. In this sense, a spinal segment can be defined as a level of the spinal cord at which two dorsal nerve roots (sensory) enter, and two ventral nerve roots (motor) exit. In a facilitated segment, these roots are overly sensitive, or hair-triggered. The hyperactive ventral motor root from the segment passes through the intervertebral foramen and joins the sympathetic nerve chain, which thereby comes under constant bombardment. This keeps the sympathetic nervous system in a state of chronic overactivity, ultimately resulting in damage to the target organs and the patient's health. If the trophic-nerve-function hypothesis is true, this process may also result in protein deprivation in the target organs.
A facilitated segment produces a palpable change in tissue texture. The local paravertebral muscles and connective tissues develop a "shoddy" feel, and joints in the area are less mobile. The tissues are tender to the touch and often painfully irritable. I believe that the term "fibrositis" can be applied to the connective tissues in this situation. Sympathetic system dysfunction at the level of the facilitated segment also produces changes in skin texture, sweat gland activity, and capillary blood supply to the skin.
Dr. Korr compares the facilitated segment to a neuronal lens, in that it seems to gather nerve impulses. It does not pass on its sensory input; rather, it accumulates and hoards not only those stimuli that come into it directly, but also those that attempt to pass through to other segments. Experimental electromyographic work done by Dr. Korr and his associates has demonstrated that stimulus of the nervous system almost anywhere will result in increased electrical activity of the muscles serviced by nerve roots derived from a facilitated segment.
Facilitated segments seem to occur at areas of focus for postural stress, sites of trauma, and segmental levels related to visceral problems. Once established, a facilitated segment can continue for years, even contributing to death. A facilitated segment at T4, for instance, may cause decreased vitality of the heart, leading to a blockage of coronary arteries and myocardial infarction. A facilitated segment also tends to perpetuate itself; that is, the hyperactivity of the motor root causes the related sympathetic ganglion to become hyperactive, leading to dysfunction and deterioration of the target organs. A variety of sensory stimuli related to the dysfunction are sent back to the spinal segment, further increasing its level of facilitation, and so on.
Different types of problems are associated with facilitated segments at specific levels, e.g., T9/10 (gall bladder), T12/L1 (kidney), L5 (urogenital), etc. Once a segment becomes facilitated, all of the associated target structures (connective tissue, muscle, bone, blood vessels, skin, sweat glands and internal organs) will be adversely affected.
Therapeutically, any approach that interrupts the self-perpetuating activity of the facilitated segment is helpful. The sensory input to the segment must be reduced. Effective approaches, therefore, include those that: relax the muscles (massage, soft-tissue manipulation); mobilize the area, reducing stasis and edema (structural manipulative therapy); (3) reduce postural stress (Rolfing, Alexander Technique); and reduce the number of signals from higher centers of the central nervous system (relaxation techniques, biofeedback, hypnotherapy, psychotherapy, tranquilizers).
CranioSacral Therapy is particularly helpful with facilitated segments, in that it reduces autonomic tone (sympathetic activity); reduces general stress and anxiety; enhances endocrine function; assists in postural balancing; and improves fluid exchange. It's also extremely helpful when used to mobilize the dural tube within the spinal canal, because restrictions of the dural tube, or its sleeves, contribute to segmental facilitation.
To locate these areas of restricted mobility, the therapist tests the mobility of the dural tube and releases restrictions as they're found, using gentle traction techniques. These releases are mandatory - if a peripheral restriction is released, but the dural tube restriction and facilitated spinal cord segment are not, the peripheral problem usually reoccurs.
Once the peripheral body and the dural tube have been treated for restrictions, the therapist can focus on the cranium and sacrum. During this time the therapist also helps correct both primary and secondary dysfunctions of the skull bones, facial bones, hard palate and sacrococcygeal complex. All related sutures and joints are gently mobilized. The therapist then focuses on correcting abnormal dural membrane restrictions, irregularities in cerebrospinal fluid activities, and dysfunctional energy patterns and fluctuations related to the craniosacral system.
It is at this stage that the patient often moves from a phase of having obstacles removed to one of self-healing, with the therapist simply facilitating the process. In essence, the patient moves out of the realm of fighting disease and into one of enhancing health. That's why CranioSacral Therapy is also a preventive-medicine modality - it mobilizes natural defenses, rather than focusing on the etiologic agents of diseases.
Click here for previous articles by John Upledger, DO, OMM.
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