resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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 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.
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.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
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.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
October, 2008, Vol. 08, Issue 10
Complex Regional Pain Syndrome
By Whitney Lowe, LMT
Pain resulting from nerve entrapment syndromes is a common reason for clients to seek the care of a massage practitioner. However, there are numerous neurological disorders that, at first glance, might appear to be nerve entrapment but are an entirely different pathological condition. Complex regional pain syndrome (CRPS) falls into that category.
A brief review of fundamental neuroanatomy is helpful to properly understand what occurs in CRPS. The autonomic nervous system has efferent fibers that control activity in various smooth muscles, glands and cardiac muscle. Within the autonomic system there are two divisions, the sympathetic and parasympathetic. The primary function of the sympathetic branch is to stimulate activity, while signals from the parasympathetic branch serve to inhibit activity. Of these two, the sympathetic branch is more involved in CRPS.
The sympathetic nervous system has a vital role in protective reflexes as the body responds to stress. It is in high gear during the "fight or flight" response. However, excess sympathetic system activity can generate and maintain pain states in different regions of the body. It is this excess sympathetic activity that causes the symptoms of CRPS. While there still is not a complete understanding of how excess sympathetic branch activity causes these pain conditions, it appears there is some spillover of noxious input from the sympathetic efferents into various nociceptors, especially in the extremities.
The term complex regional pain syndrome has only recently been added to the medical lexicon. It includes two separate conditions that have similar symptoms, but are different in cause. The two conditions were formerly called reflex sympathetic dystrophy (now called CRPS 1) and causalgia (now called CRPS 2).5 The primary difference between them is how they occur. In CRPS 1, symptoms commonly occur as a result of some traumatic incident, but there is no evidence of specific nerve damage. In CRPS 2, there also is some event that initiated excess sympathetic activity, but this condition also involves identifiable damage to the nerve. Most of the symptoms of CRPS 1 and 2 are similar and are listed below:
Symptoms of CRPS
Distinguishing CRPS from other neurological disorders is aided by detailed evaluation of several clinical features in addition to those listed above. The condition can affect either the upper or lower extremity, but is more common in the upper extremity, and the pain usually is aggravated with moving the affected limb. Various myofascial dysfunctions also might accompany the extremity pain.1 Women are affected more often than men by approximately a three-to-one ratio.2 Some degree of depression or psychological dysfunction is common with CRPS. However, it is unclear if this psychological dysfunction is a causative factor or a result of the condition, because depression and similar psychological manifestations are common in severe and chronic pain conditions.4
Treatment for CRPS varies widely, but physical therapy is a primary component of most treatment protocols. The goal of most physical therapy treatments is to desensitize the area and restore normal function of the affected extremity. Massage might play a fundamental role in this process. Because myofascial dysfunction often is a part of the array of symptoms, addressing the myofascial component might interrupt the cycle of pain and dysfunction. In many cases, if the myofascial pain condition was properly addressed, the whole syndrome may resolve.3 Massage is also likely to be helpful because it is effective at decreasing overall sympathetic system activity.
If you have a client demonstrating signs and symptoms that indicate the possibility of CRPS, it is important to have them properly evaluated by a physician. There are a number of other treatment strategies such as nerve blocks and medications that are effective in addressing the problem, and it might be important to start these treatments as early in the rehabilitation process as possible.
CRPS can be a debilitating condition. Because it occurs more often in the upper extremity, it might be easy to dismiss many of the symptoms as arising from a peripheral compression neuropathy such as carpal tunnel syndrome. However, awareness of the variety of symptoms associated with CRPS allows the practitioner to look at a bigger picture and catch this condition early on, if present, so it can be most effectively treated.
Click here for more information about Whitney Lowe, LMT.
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