resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
November, 2007, Vol. 07, Issue 11
Cervical Disc Herniation
By Whitney Lowe, LMT
One of the most important aspects of assessment in massage is to determine if it's appropriate to work on a specific condition. While massage is safe in most cases, there are some instances where harm can be done if inappropriate treatment is applied.A cervical disc herniation is just such a condition. It's important to identify this condition, as it also should be evaluated by another health professional to make sure massage is appropriate. However, if performed appropriately, there are some beneficial massage approaches.
A herniated disc (also called herniated nucleus pulposus or HNP) results from sudden or long-term compression loads on the spine. Herniations are more common in the lumbar region than in the cervical, but can still produce significant pain or disability when they occur. Cervical disc herniations produce pain or neurological dysfunction in the neck or upper extremities. They are relatively common and frequently occur in asymptomatic individuals, so presence of a herniated disc does not necessarily imply a pathological problem.1
The intervertebral disc is designed to absorb shock and cushion compressive forces transmitted through the skeletal structures of the body. The center of the disc is composed of an inner gel-like substance called the nucleus pulposus. The nucleus is surrounded by concentric layers of collagen that make up the outer disc boundary, called the annulus fibrosus (Figure 1). When compressive loads are placed on the disc, the nucleus presses against the walls of the annulus. As the pressure increases, annulus fibers begin to tear and the disc changes shape (Figure 2). The disc usually is pushed in a posterior-lateral direction. Unfortunately, the cervical nerve roots are very close to where the disc herniation occurs, so the herniation frequently presses on the nerve roots producing sensory or motor nerve dysfunction.
Cervical disc herniations are most common in the lower cervical spine. The nerve roots in this region make up the brachial plexus. The nerves of the brachial plexus eventually course down through the length of the upper extremity, so nerve compression symptoms commonly are felt down all or part of the upper extremity.
In some cases, the disc herniation is an acute injury with a sudden load on the cervical spine. For example, herniations develop when an individual hits their head on the bottom of a shallow swimming pool after diving in. In other situations, a disc herniation may develop from significant compressive loads over time, such as those that occur from chronic forward head posture.
The primary symptoms from cervical disc herniation include pain, paresthesia or weakness in the neck or upper extremities. Pain or paresthesia can occur throughout the entire upper extremity or only in part of it. Muscle weakness may be evident in any of the upper - extremity muscles innervated by fibers of the affected nerves. Because symptoms may occur in any region of the upper extremity, it can be challenging to distinguish a cervical disc herniation from other nerve compression pathologies that occur in the upper extremity, such as thoracic outlet or carpal tunnel syndromes.
Suggestions for Treatment
While surgery was once considered almost essential for this condition, it's not as common now. Research shows that disc herniation problems may heal spontaneously without surgery or other invasive procedures.2 Some rehabilitative exercises are suggested to encourage the disc to return to a normal position away from affected nerve roots.3 It's important to consult with a physician or other health professional for recommendations on treatment.
While massage is not absolutely contraindicated for disc herniations, treatment methods should be used cautiously. The transverse processes protect the nerve roots from further compression during most massage techniques, but symptoms could be aggravated by minor vertebral movements that occur from pressure applied to the region. Massage is helpful to decrease muscle tension in the area and may reduce compressive loading on the disc. However, this massage also should be performed carefully and only once the extent of the disorder has been clarified.
Click here for more information about Whitney Lowe, LMT.
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