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Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
February, 2003, Vol. 03, Issue 02
The Ligamentum Nuchae
By Neal Cross, PhD, NCTMB
In a recent article published in Clinical Anatomy,1 Dean and Richard clarified some of the anatomical detail of the upper cervical connective tissue elements.I think their results are exciting for anyone utilizing craniosacral techniques and/or treating cervicogenic headache.
The ligamentum nuchae is that well-developed portion of the supraspinous ligament in the cervical region. It runs from the external occipital protuberance along the tips of the spinous processes of the cervical vertebrae, to the tip of the spinous process of the vertebra prominens (usually C7). The supraspinous ligament can be considered the superficial continuation of the interspinous ligament. This latter ligament runs between the adjacent vertebrae extending from the base to the tip of each spinous process. The ligamentum nuchae is formed primarily from the aponeurotic attachments of the adjacent and subjacent musculature. From superficial to deep, these muscles are the trapezius; rhomboideus minor; splenius capitis; and the serratus posterior superior.
Dean and Richard found direct fibrous attachments between the ligamentum nuchae and the spinal dura - between the occiput and C1, and between C1 and C2. They found attachments to the ligamentum flavum and the spinal dura between C2 and C3. These were not as prominent as the attachments at superior levels. They did not find any direct connections between the spinal dura and the rectus capitis posterior minor (RCPM), as had been previously reported.2 However, they did find a connective tissue band that ran from the deep surface of the RCPM to the posterior atlanto-occipital membrane. This thin membrane runs from the posterior margin of the foramen magnum to the upper border of the posterior arch of C1.
It is interesting to note that although most of the cranial dura are innervated by the trigeminal nerve (CNV), the infratentorial portion (the portion inferior to the cerebellar tent) is innervated by upper cervical nerves. It is tempting to speculate how working the suboccipital soft tissue elements might have a positive impact on relieving cervicogenic headaches. We may be able to effect this end by using several different techniques, including craniosacral, Swedish and counterstrain, among others.
Of further interest for consideration would be to review the anatomy of the transition of the dura from the cranium to the vertebral canal. The cranial dura is comprised of two layers: the outer or endosteal layer, and the inner or meningeal layer. These two layers are contiguous throughout most of the cranial cavities, except where they part to allow for the formation of the dural sinuses. The outer layer also ends at its attachment around the foramen magnum. However, at this latter point, the inner layer continues through the foramen magnum to become the spinal dura. The periosteum of the vertebral canal is the equivalent of the outer layer of cranial dura.
In summary, we see several cervical elements associated with the cranial dura mater by their connection to the spinal dura. The ligamentum nuchae directly attaches to the spinal dura, as does the ligamentum flavum, to a lesser degree. The upper cervical nerves serve the sensory innervation of both the cervical spinal dura and the cranial dura in the posterior cranial fossa. These same nerves supply the sensory elements of the muscles of the deep back and skin over the back. Although the trapezius is innervated by the accessory nerve, its sensory innervation derives from the upper cervical nerves.
A therapist could spend quite some time on the back of a client's neck, and achieve results well-worth the time spent.
Click here for previous articles by Neal Cross, PhD, NCTMB.
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