resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
February, 2010, Vol. 10, Issue 02
Sources of Neck Pain
By Anita Boser, LMP, CHP
Clients usually think that pain is the "X" that marks the problem spot. As therapists, we know the source of pain is often somewhere else. In other words, "Where it is, is where it ain't," a colloquialism attributed to Ida P. Rolf. In the realm of a connective tissue matrix, internal pulls and compensations often create a symptom distant from the source of dysfunction.
As the pinnacle of the spinal cord, the neck has to accommodate for every weakness, imbalance and misalignment below, in addition to resolving direct trauma such as whiplash. There literally are thousands of sources of neck pain. In my practice, two are the most common: limited range of motion in the shoulder girdle and restrictions in the thorax.
Scapular Restrictions Limit Arm Flexion
When raising the arm overhead, the scapula must rotate 60 degrees to achieve full range (180 degrees of flexion). Not only does scapular rotation make full flexion possible, the glenoid cavity is then also in the proper position to provide support to the humerus. See Figure 1. The serratus anterior and upper and lower fibers of the trapezius contract to rotate the scapula. The costal fibers of the pectoralis major, the latissimus dorsi, and levator scapula also need to lengthen.
If the scapula can't fully rotate, the body will get the job done another way, usually by elevating the entire shoulder girdle. The levator then activates when it should release, and the scalene muscles often contract in an effort to assist. See Figure 2. The result is rigidity in the neck at the trapezius, levator and scalene cervical attachment sites, and often trigger points in the rotator cuff muscles which have to work through abnormal alignment.
Allow for Extension, Latissimus Dorsi
With your client on your table in a side-lying position, ask him to raise his upper arm in front of him and then up alongside his ear. Observe the rotation of the scapula. When the inferior angle stops moving anteriorly and superiorly assist the movement with a stroke to lengthen the latissimus and increase proper rotation of the scapula as you direct your client to rotate his elbow toward the ceiling. See Figure 3. (If the client's movement is very limited and/or his arm is weak, place a pillow under the upper arm to help support the weight.)
Scapula Coordination, Serratus Anterior
Turn your attention next to the serratus anterior. Have your client bend his elbow and place his hand on the table in front of his face or even under his head. With the back of your hand or soft fingertips, contact the fibers of the serratus on the lateral ribs. Ask your client to press into his entire hand so that the elbow moves slightly away from the shoulder joint. Feel for where the serratus is stuck or inhibited and use your touch to facilitate functional involvement. See Figure 4.
That's the Spot, Levator Scapula and Trapezius
Your client will certainly appreciate it if you address the adhesions that have most likely developed between the upper trapezius and the levator scapula. First release the superior edge of the trapezius from any underlying adhesions. Then, as your client extends his arm overhead again, release the levator, starting at its tendinous attachment to the scapular superior angle and directing it inferiorly. It also helps to work the length of the levator to its attachments on the transverse processes of the cervical spine, which are just posterior to the attachments of the scalene muscles, which will want some attention, too.
Thoracic Spine Immobility
While restrictions in the shoulder girdle place extra stress on the neck, lack of mobility in the thoracic spine often causes the cervical spine to exceed its range of motion. For example, if all of the motion to look over the shoulder, to side bend, or to look down comes from the neck, then the cervical spine muscles and ligaments get overworked and overstretched. The result is increasing stiffness as a means of protection.
Get in the Laminar Groove
The answer is to mobilize the thoracic spine and ribs, usually from T1 to T8. With your client in a sidelying position, you can use your knuckles to extricate the spinalis and paraspinal muscles at their attachments to the transverse and spinous processes. As you work, have your client make small unstructured movements under your hands. Use your pressure to stimulate the erectors and paraspinals and encourage more glide in the layers of tissue. Follow through to release restrictions in the myofascia between the ribs from their attachments to the transverse processes all the way to the sternum.
Shoulder restrictions and thoracic spine immobility are obviously not the only sources of neck pain, but adding these two assessments to your tool chest will expand your therapeutic potential and maybe even your reputation as a miracle worker.
Anita Boser graduated from the Institute of Structural Medicine and practices in Issaquah, Wash. She is the author of Relieve Stiffness and Feel Young Again With Undulation and Undulation Exercises. The exercises in this article are excerpted from her book. You can contact Anita at
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