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Low Melatonin Linked to Risk of Advanced Prostate Cancer
Epidemiological and experimental studies suggest the hormone melatonin, which plays a role in regulating the sleep-wake cycle, may play a role in the development of prostate cancer, as lower melatonin levels have been associated with an increased risk of prostate (and breast) cancer.
Changes in Herbal Medicines from Ancient Times to the Present
The classical literature of Chinese medicine remains highly relevant in the modern era, as many of the basic theories and herbal combinations emphasized in clinical practice were first established in texts that are nearly 2000 years old.
Don't Trust What Your Patients Say
When a patient presents to the office for care, they typically have a specific complaint – lower back pain, whiplash, sinus congestion, sciatica, etc. They are often not interested or engaged in what they consider "unrelated" personal health history.
Wellness: A New Buzzword at the Aging in America Conference
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Deciphering the New CMS-1500 Claim Form
Q: I am confused about how and when to use the new 1500 form, particularly block 14 and block 15. What is required and how do I properly fill out these fields? And do I actually have to use this new form or may I continue using the old version?
Halt Allergies With Moxibustion Therapy
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Medical Qigong for the Heart: Part I
According to the Center for Disease Control and Prevention, heart disease is the leading cause of death in the United States, affecting people of all ages and backgrounds. Coronary heart disease, in just the United States alone, costs close to 109 billion dollars a year.
New Leadership Era at the WFC
The World Federation of Chiropractic recently announced not only a new president, as is customary every two years, but also an incoming secretary-general, marking the first time since the WFC's inception in 1988 that someone other than David Chapman-Smith, Esq., will serve in that capacity.
Medial Knee Pain: 11 Potential Causes (and Corrections)
We have all seen patients with medial knee pain that either has no traumatic origin or lasts well beyond when it should be resolved. How can we help these patients? Here is an overview of clinical scenarios and how we can provide conservative care.
Employers Need Chiropractic First and Sooner
From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP).
The Search for the Origin of the Wiggle Technique
When Bob had adjusted me previously, most of the time I knew what he was doing. But this time, he had me lie on the treatment table in the usual side-posture position, and he "wiggled" my sacroiliac with the fingers of both hands, while stabilizing my pelvis with his forearm.
Replenishing and Restoring Jing
I learned an important principle from my great Taoist Master Sun Hak. He taught me that all people "leak" Jing, and that we can mitigate or stop this leaking, and as a result strengthen our life force, develop enhanced adaptability and lengthen our life.
The Boston Benevolent Chiropractic Clinic: Standing Up for the Needy
Our chiropractic assistant, Bridget, greeted an arriving patient at the Emmanuel Church in downtown Boston. She said, "Hi, Michael, good to see you. It's been awhile. Have a seat and Dr. Ken will see you soon."
CRREW Rallies for Ongoing Acupuncture Relief Effort in the Philippines
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Working With The Yuan-Source Level: Resonance and the Extraordinary Vessels
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News In Brief
Pacific College of Oriental Medicine obtains grant funding from NIH; Yo San University of Traditional Chinese Medicine Announces New President; Kentucky Gets Licensed; PCOM Receives Approval from WASC to Offer FPD.
Don't Trust What a Patient Says
When a patient presents to the office for care, they typically have a specific complaint in mind – lower back pain, whiplash, sinus congestion, sciatica, etc.
"Doctor ... Always Do the Right Thing"
So says "Da Mayor" in the iconic Spike Lee movie. As a fresh grad questioning in-network versus out-of-network, it struck me that some doctors have explicitly skirted the issue, while others have argued adamantly for the latter and "sticking it to the man."
We Get Letters & E-Mail
Imagine What More Could Be Achieved With Your Support; A Lesson in Hygiene: What Do You Do in Your Office? Open Letter to the Profession.
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D'Youville Vet Program Gets High Praise; A Moment of Silence for Dr. Paul Reginald ("Reg") Hug.
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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