resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
December, 2011, Vol. 11, Issue 12
Back Pain: Signs and Symptoms of the Iliopsoas Muscle
By David Kent, LMT, NCTMB
Patients come to you concerned about their back pain, looking for answers and relief. The pain started when they tried to get out of bed or reached for the keys that fell onto the floor. Your ability to quickly assess your patient's symptoms and communicate your objective findings can determine if they schedule additional appointments, upgrade services or a treatment package, refer others and in some cases the amount of your tip.(Read "Practice Building: Getting Inside Your Patient's Head" MT, January 2011). The iliopsoas muscle can refer pain into the back that ranges from a mild ache to a severe debilitating level of intense pain. We will explore the signs and symptoms that indicate involvement of the iliopsoas muscle and ways to communicate your findings.
Patients will report pain and difficulty when attempting to stand erect after extended periods of hip flexion after driving or reading, seated at a desk or computer, sleeping in a hip flexed or side lying fetal position. The iliopsaos is the primary flexor of the thigh. So pain is often experienced from the iliopsoas when the patient contracts the muscle to perform hip flexion or a sit up movement when rising from a lying position.
Now, lets look at the function of this muscle from another perspective. When the thigh is in a fixed position, as when weight bearing, the iliopsoas acts as a trunk flexor. This is easily spotted during your postural and gait analysis. Postural analysis photos make it easy to document and educate patients of a shortened iliospoas muscle that is causing them to stand in a hip flexed position, bearing weight on the uninvolved side, while keeping the knee bent on the painful shorten side to shorten and reduce tension on the iliospoas (Image 1). The iliopsoas plays an import roll in maintaining upright posture when standing by preventing hyperextension of the hip joint. (Read "Getting Comfortable With Postural Analysis" MT, July 2008)
The iliopsoas is also active during gait. When the iliopsoas is shortened, patients will walk with a stooped posture, tilting their pelvis forward creating a hyperlordosis of the lumbar spine and limping when bearing weight on the involved side.
Proximally, the psoas major muscle attaches to the 12th thoracic and to all of the lumbar vertebral bodies and the corresponding intervertebral discs and the transverse processes of the lumbar vertebrae. The iliacus attaches proximally to iliac fossa, the sacrum and the anterior sacroiliac ligaments. Distally, the two tendons merge forming the iliopsoas tendon to attach onto the lesser trochanter of the femur. (Image 2)
One simple way to check the length of the iliopsoas is to have the patient sit on the edge to the therapy table, extending the hip of the iliopsoas being assessed, while flexing the opposite hip, bring the opposite knee and thight toward the chest to flatten the back, stabilize the pelvis and avoid creating a hyperlordosis of the lumbar spine. Using a photo, it is easy show the right iliopsoas length appears normal and how the shortened left hamstrings are limiting range of motion, preventing the left knee and thigh from moving closer to the chest. (Image 3)
Myofascial trigger points in the psoas muscle refer pain along the spine ipsilaterally from the lower thoracic to the sacral and upper gluteal regions. (Image 4) Patients will point moving their hand up and down or encircle one side of their back, near the spine. When trigger points are referring from both iliospoas muscles, patients will point moving their hand side to side. Iliacus produces the same back pain as psoas and referrers to the anterior thigh and groin.
While trigger points can arise in the iliopsoas from acute overload, they are usually associated with trigger points in other muscles. It will be important to assess and treat the lumbar paraspinal muscles, quadratus lumborum, tensor faciae latae, pectineus, rectus femoris, rectus abdominus (Read "Back Pain Caused by Rectus Abdominis Trigger Points" MT, June 2009), and the contralateral iliospoas muscle.
While it is easy to identify involvement of the iliopsoas, it is necessary to ruled out any precautions and or contraindications prior to performing any stretching or manual therapy. The iliopsoas is clinically important in relation to the kidneys, ureters, pancreas, appendix, sigmoid colon, lumbar lymph nodes and nerves. A clear understanding of the anatomy and proper hands-on training is necessary prior to treating this muscle. Many patients find yoga be a great way to provide self care for the iliopsoas muscle while lengthening and strengthening their entire body.
The treatment of back pain is common and hopefully easier now that you know many of the signs and symptoms of the iliopsoas muscle. Here are a few other articles I encourage you to read "Iliosacral Pain You Can't Touch" (MT, April 2011), "Back Pain: Often a Pain in the Gluteus Medius" (MT, March 2009), and "Pseudo-Sciatica and Gluteus Minimus Trigger Points" (MT, May 2011).
Click here for more information about David Kent, LMT, NCTMB.
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