resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
June, 2005, Vol. 05, Issue 06
Cubital Tunnel Syndrome
By Whitney Lowe, LMT
Nerve compression problems are a frequent cause for pain and dysfunction in the upper extremity, particularly in the occupational environment. Although not as present in the popular literature as carpal tunnel syndrome, cubital tunnel syndrome is a common nerve compression pathology.In fact, it is the second most common peripheral compression neuropathy.1 It occurs when the ulnar nerve is compressed between the two heads of the flexor carpi ulnaris on the posterior elbow within a region called the cubital tunnel.
The cubital tunnel is located on the posterior elbow and is bordered by the two heads of the flexor carpi ulnaris (FCU) muscle. One head of the FCU muscle comes from the common flexor tendon attachments at the medial epicondyle of the humerus. The other comes off the medial aspect of the olecranon process. The two heads eventually join to form the belly of the FCU.
The nerve eventually passes between these two heads (Figure 1). Space within the cubital tunnel may decrease as much as 55 percent during elbow flexion, making nerve compression more likely.1 In addition, during flexion the ulnar nerve is increasingly pulled taut which may also aggravate symptoms. Subluxation (shifting position) of the ulnar nerve as the elbow moves into flexion could produce symptoms in this region as well.2
Cubital tunnel syndrome may occur as a result of direct compression of the elbow (either acute or chronic), excessive cubital valgus, bone spurs, synovial ganglions, fibrous bands within the muscle, or mechanical compression of the nerve during elbow flexion. The most frequent cause of cubital tunnel syndrome is hypertonicity of the FCU. The ulnar nerve may also be sensitive to compression if there are more proximal ulnar nerve compression pathologies such as thoracic outlet syndrome.3
Cubital tunnel syndrome usually produces a variety of sensory symptoms, including pain, burning, tingling or paresthesia. Motor symptoms such as weakness or atrophy may be seen as well. Weakness usually affects the intrinsic muscles of the hand more than other muscles in the forearm innervated by the ulnar nerve.
The client may report an acute compression injury to the posterior elbow that started the symptoms, such as striking the elbow on a hard object. This condition should not be confused with hitting one's funny bone. In this instance, the blow causes nerve compression between the medial epicondyle of the humerus and the olecranon process of the ulna just before it enters the cubital tunnel.
Cubital tunnel syndrome is more likely to occur as a chronic condition and is seen more often in men than women. The practitioner should identify actions that involved repetitive or static flexion of the elbow prior to the onset of symptoms. Prolonged compression of the elbow region, such as leaning on the elbows for long periods, should be identified. Symptoms are often aggravated at night if the client spends long periods with the elbow in a flexed position.
The client usually reports pain, aching, burning sensations or paresthesia in the ulnar nerve distribution of the hand (Figure 2). Weakness or atrophy are likely to affect the adductor pollicis muscle, which is an important muscle in grasping objects. Consequently, the client may report difficulty holding objects or having a degree of clumsiness when attempting to perform precise tasks. Atrophy of this muscle may be apparent with a decrease in the size of the muscle mass between the thumb and fingers compared to the unaffected side. Other instrinsic hand muscles innervated by the ulnar nerve are those of the hypothenar eminence (the fleshy bundle of muscles near the base of the hand on the ulnar side). Atrophy in these muscles may be evident with a decrease in size compared to the unaffected side.
Pressing directly over the cubital tunnel is likely to elicit the client's symptoms. Palpate the region when the elbow is in neutral, as well as full flexion. If the symptoms are exaggerated during flexion, this may be an indicator of cubital tunnel compression. There may also be anatomic obstructions in the cubital tunnel, such as bone spurs or synovial masses that are palpable. Tenderness or hypertonicity may be evident in the FCU muscle throughout the forearm.
Massage is helpful for cubital tunnel syndrome because a primary cause is muscular hypertonicity in the wrist flexor muscles. Techniques such as deep stripping to the flexor carpi ulnaris may help decrease compression on the ulnar nerve. Particular caution should be observed in applying pressure to the flexor carpi ulnaris near the region of ulnar nerve entrapment so as not to aggravate the pathology.
Click here for more information about Whitney Lowe, LMT.
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