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Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
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.
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