resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
December, 2004, Vol. 04, Issue 12
By Whitney Lowe, LMT
Neck pain is a frequent reason for clients to see a massage therapist. In this issue, we'll examine torticollis, one cause of neck pain and disability that poses challenges in identification in the treatment room.Torticollis means literally, "twisted neck." A person with torticollis exhibits involuntary muscle contractions that lead to abnormal positions, and/or tremor or spasmodic movements of neck and head. Torticollis may manifest in different forms: congenital, spasmodic, or acute/acquired.
Congenital torticollis presents in infants and occurs at birth or shortly after. The condition may result from improper positioning in the uterus or birthing trauma. There are other roots of infant torticollis, such as structural or neurological. With treatment in the first year, this condition is usually resolved.
While considered rare, spasmodic torticollis, also known as cervical dystonia, may still affect close to 90,000 people in the United States. There are three variations named for the types of neuromuscular dysfunction: tonic (a sustained contraction), clonic (head shaking), and mixed (both). Spasmodic torticollis is a neurological condition that has no known cure and treatment is symptomatic. Clients who present with this condition should be instructed to contact one of several organizations that can provide support, information and resources to this population. Practitioners should also confirm the client has been diagnosed. In some cases, spasmodic torticollis is mistaken for muscular dystrophy, epilepsy or Parkinson's disease. There are significant distinctions between spasmodic and acquired or acute torticollis.
Acute or acquired (sometimes called "wry neck") is the most common form of torticollis characterized by constant muscle spasms in the neck. It appears in a broad spectrum of the population from children to adults. Acquired torticollis is caused by maintaining muscles in shortened positions for a prolonged period. The acute form might manifest as a result of a head or neck injury such as whiplash or concussion, in which symptoms may appear immediately or be delayed. Myofascial trigger points are another factor that either lead to the condition or perpetuate it. The condition seemingly appears "overnight" when, for example, a person has slept with his/her neck in an awkward position or a cold draft on their neck muscles. Other activities likely to produce acquired torticollis include holding the telephone between the head and shoulder, or playing an instrument, such as the violin, for long periods.
The sternocleidomastoid (SCM) muscle is most commonly involved in acute or acquired torticollis. Because it is a contralateral rotator, any position that rotates the head to the opposite side for long periods may lead to the condition. A history that includes the nature of the onset, the length of time the condition has been present, and physician diagnosis should allow distinction between the neurological spasmodic form and the muscular variation.
The practitioner will be able to palpate - and usually observe - shortening and hypertonicity in the muscle. Visual indicators are similar with each variation of torticollis. The head and neck are held in a non-neutral position, often with rotation to the opposite side. The SCM on the affected side is likely to be more prominent than on the opposite side. In the clonic variation of spasmodic torticollis, there will be some shaking of the head.
The muscles of the cervical region may feel tight due to local muscle spasm. In some cases, especially if the condition is chronic, a degree of fibrotic change may develop and there may be palpable contracture in the muscles. Active and passive motions that turn the head in the opposite direction of the contraction are likely painful and limited. There may be pain associated with further rotation to the contracted side depending on the severity of the condition and the percentage of muscle fibers recruited for the activity.
Acquired torticollis is not serious and symptoms generally resolve in a couple of weeks. This condition also responds well to massage; however, care should be used in treatment, as the muscles are often painful from spasm and trigger-point activity. In order to rule out more serious neurological or structural disorders, it is a wise idea to have the client evaluated by another health professional prior to treatment.
Click here for more information about Whitney Lowe, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.