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AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
October, 2004, Vol. 04, Issue 10
Median Nerve Compression Pathologies
By Whitney Lowe, LMT
The most researched and well-defined upper extremity nerve-entrapment problem is carpal tunnel syndrome (CTS). CTS involves compression of the median nerve at the base of the hand in a region called the carpal tunnel.Because this condition is studied so often, we have a very good understanding of how it occurs; however, because it has become such a "popular" condition, clinical practitioners may be too eager to assume the presence of CTS simply because their patient/client experiences median nerve compression symptoms.
This article will look at the entire length of the median nerve where there are numerous locations that median nerve entrapment may occur. We will follow the nerve's course from the spinal cord to its termination in the hand and describe common locations of compression pathology. It is essential to thoroughly evaluate the problem before coming to a conclusion about the presence of the ever-popular CTS.
The median nerve carries both motor and sensory fibers. Therefore, compression of the nerve may create both sensory and motor deficit. The sensory symptoms are located primarily in the palm (See Figure 1). They include pain (often described as sharp, shooting, or electrical in nature), paresthesia ("pins and needles"sensations), and numbness. The median nerve and its branches innervate primarily the flexors of the wrist and fingers, as well as several muscles of the thumb. Motor problems from median nerve compression usually show up as weakness in grip strength or atrophy of the thenar eminence (fleshy part of the palm near the base of the thumb).
The first location where median nerve compression may occur is at the cervical nerve roots. The median nerve is derived from the C5-T1 nerve roots. Intervertebral discs, bone spurs, small tumors, or other obstructions may press on these nerve roots and produce symptoms that affect the median nerve. Since the nerve roots also contain fibers for other peripheral nerves, symptoms of compression at the nerve root level may extend outside the commonly mapped area for median nerve sensory involvement illustrated in Figure 1.
Thoracic outlet syndrome is not consistently defined in the medical literature, so there is a great deal of confusion about it. Fibers of the median nerve can get compressed against a pathological bony extension of the C7 transverse process, called a cervical rib. This is called true neurological thoracic outlet syndrome. Other thoracic outlet syndrome variations that may compress the median nerve include the region between the anterior and middle scalene muscles, between the clavicle and first rib, and underneath the pectoralis minor muscle.
Moving distally after leaving the axillary region, the next location where median nerve entrapment is likely, is just proximal to the elbow. This location is only a possible source of nerve entrapment in a small percentage of the population. A ligament called the ligament of Struthers is present in 1 percent to 3 percent of the population. It runs between the medial epicondyle and the shaft of the humerus, and has no function. The median nerve passes underneath it and can get compressed here although it is not very common.
While the biceps brachii attaches primarily to the radius, there is a fibrous attachment to the ulna through a slip of fascia called the lacertus fibrosus, which is also called the bicipital aponeurosis. The median nerve runs underneath the lacertus fibrosus at the elbow and can get compressed by it here. If symptoms are aggravated during strong elbow flexion movements (when the biceps brachii is contracting strongly) there is a good likelihood that compression exists here.
After leaving the elbow, the median nerve runs between the two heads of the pronator teres muscle. This is a common region of median nerve compression and is commonly mistaken for CTS. The sensory and motor signals are almost identical, making it difficult to distinguish these two regions of entrapment without more specific physical examination, such as orthopedic special tests and nerve conduction studies.
The last common location of median nerve entrapment is within the carpal tunnel. While this region is the most common site of median nerve entrapment, it is not the only one. There are a large percentage of failed carpal tunnel treatments; this could very well be due to improper identification of the precise location of median nerve entrapment.
Keep in mind that compression may occur at several sites simultaneously. Therefore, you may have a problem that is not in just one of these locations, but in two or more.
One of the great benefits for using massage to treat nerve compression problems is that massage treatments are frequently applied to the whole length of the nerve and can easily work on multiple sites of compression at the same time.
A summary of the locations for median nerve entrapment are:
Click here for more information about Whitney Lowe, LMT.
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