resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
Advancing the "Whole Organ" Spine Model
Historically, the human spine has been organized by body region utilizing specific anatomical landmarks and transition zones.
Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
Helping Patients With Parkinson's Disease
Parkinson's disease (PD), a long-term degenerative disorder of the central nervous system that mainly affects motor function, has a slow onset over time.
House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
Waist Circumference: A Conversation Starter
New estimates suggest more than two-thirds of Americans are either overweight or obese. The medical significance of this statistic is astounding.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
News in Brief
The American Association of Acupuncture and Oriental Medicine (AAAOM) board members recently met with the Korean Customs Service, which is similar to the FDA, to discuss herbal safety and importation issues.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
February, 2014, Vol. 14, Issue 02
What Does an MRI Tell the Therapist? A Closer Look at Cervical Pain
By Debbie Roberts, LMT
There are more than six million car accidents every year in the United States alone. Worldwide, an estimated 1.2 million people were killed and fifty million injured from a car accident. There is a very big chance you will treat a whiplash injury over the course of your career.It is important not to treat these potentially serious trauma cases blindly. Even if you work in a chiropractic office ask to see their MRI report. The MRI and his prognosis for the case will give you a more precise treatment strategy. This will also help you determine how severe the injury is. You can divide a whiplash prognosis into three categories. Minor whiplash injuries usually resolve within one to two weeks. Moderate whiplash injuries with muscle spasm or ligament strains may take up to four to eight weeks to resolve. Severe whiplash injuries, or those that involve nerve damage or ligament or disc injury to the spine, may result in chronic or permanent disability. These injuries may require more drastic measures to resolve.
How many times has a patient said to you, "I feel like I am crazy?" Massage therapy is sometimes so much more than the physical portion of manual therapy. Massage therapy can be the gap of empathy, education and evaluation between the patient and their physician. Where does the process start? It starts with how well you assess and evaluate the situation. Evaluation takes a level of judgment, necessary to make sense of the clinical findings in order to correlate a relationship between the symptoms and the signs of dysfunction. This kind of thinking takes you away from treating symptom-based massage therapy into cause and affect therapy. Having real tangible evidence helps the therapist decide which techniques are necessary to help the client regain their previous level of health or even a better state of health.
Where is the easiest place to start? Start with the facts and not speculation. If the client has had a MRI, ask them to bring it to their first appointment. If you have never read a MRI report it can look and sound daunting, but it will actually help you make a more sound therapy session. The information this report can lend to you as a therapist is insight into what is really going on with the client. There may be certain range of motion movements you will not want to do with this client knowing their history. Also, now you will have a better idea on what you can expect from your treatment plan.
There are well over 100 types of massage and massage modalities to choose from these days so it is even more important to have a system on which to base the appropriate technique or tool from the tool box. I bring this up to help our community of massage therapists understand that although some techniques such as stretching, elongating fascia and helping with mobilization are good at times, certain directions of movements may not be appropriate after reading the clients MRI report. Holding ourselves accountable for knowing standard orthopedic joint range of motion measurements are critical in making sound stratagem for massage therapy. Just because you learned that a stretch in lateral side bending will lengthen the trapezius muscle, will that technique or modality be appropriate for this cervical patient? And without looking at their MRI report, you are trapped at speculating instead of correlating the facts.
It is not hard to read a MRI report of findings. You simply go to the end of the report and find the word IMPRESSION. This is where the basic conclusion of what the testing results showed. Taking the time to ask for the report and reading the report demonstrates to the patient you have knowledge and understanding as well as empathy. It also demonstrates you really want to know what to do and what not to do during their treatment session. Massage therapists have an opportunity to educate the client by showing charts of the muscles, joints and nerves involved that were indicated in the report. The patient doesn't understand why their muscles are still going into spasms one month, two months, even a year later, but you do. Giving the needed educational and emotional support when someone is in pain can immediately reduce their anxiety which in turn reduces their pain levels and an opportunity for healing can begin. When you take the time yourself to understand what a MRI report is saying, your treatment plan can be much more precise.
Here is the exercise for this article. I am going to give you the subjective information and the results of one of my cervical patients MRI report. Read the report all the way through. Jot down what you understand and then what you don't understand. Google it! Based on the subjective, how would you treat? Now, based on the facts how would you treat? Which technique or modality would you be comfortable using. Is there range of motion movements you would avoid? What muscles would you do manual muscle testing on?
Case Study Subjective
In total tears, over lunch my girlfriend relays she has been in neck and headache pain now for the past six months and can't workout. She had chiropractic care which included adjustments, ultrasound, hot/cold and electric stimulation which offered some relief.
Past Medical History
She had an accident one year prior to this car accident. She fell off of a ladder that tore her ACL, MCL, the medial meniscus and fractured her tibial plateau. She was found on the ground in a pool of blood.
Here is a beginning list of the muscles innervated at the different spinal roots. C5/6 innervate the Deltoid, Teres minor, Biceps, Brachioradialis, Subclavius, C4,5,6 Infraspinatus, Supraspinatus, C6/7 innervate Coracobrachialis, Pronator teres, Flexor Carpi Ulnaris, Triceps, C7 innervate the Latissimus dorsi. Let's look at a few terms that were in the report.
Spinal stenosis is an abnormal narrowing of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. There can be either sensory or muscular weakness. Cervical spinal stenosis is dangerous because it involves compression of the spinal cord.
A bulging disk extends outside the space it should normally occupy. The bulge typically affects a large portion of the disk, so it may look a little like a hamburger that's too big for its bun. The part of the disk that's bulging is typically the tough outer layer of cartilage. Usually bulging is considered part of the normal aging process of the disk and is common to see on MRIs of people in almost every age group.
A herniated disk, on the other hand, results when a crack in the tough outer layer of cartilage allows some of the softer inner cartilage to protrude out of the disk. The protrusion of inner cartilage in a herniated disk usually happens in one distinct area of the disk and not along a large component of the disk, which is more typical of a bulging disk. Herniated disks are also called ruptured disks or slipped disks. A herniated disc is more likely to cause pain.
Relief In The Findings
Because she didn't understand the report of findings, she was not making the necessary adjustments to her lifestyle to help with relief of long term pain and dysfunction. Her neck seems like a train wreck and is the third type of whiplash discussed previously. We treated her with ice and heat, performed soft tissue work to tolerance. No deep tissue was used. She was treated in supine, prone and side lying. Other treatments included some craniosacral therapy, light traction, and no range of motion movements instead the use of isometrics in all directions and again to tolerance. I managed to take her pain level from a 10 down to a 3 with soft tissue work, home contrast therapy, lying down as often as possible during the day while she was working. Also, she made modifications to her workout routine. The focus was not to let the pain cycle get started.
Understanding the MRI helped her make the necessary lifestyle corrections to allow the chiropractic and massage therapy to be successful. Although both kinds of care lowered her pain levels, it still remained a constant nagging dull ache with limitations to her standard of living. On the advisement of her lawyer she sought care from an orthopedist. The orthopedist recommended a series of facet injections to help break her pain cycle and he felt strongly that it would eliminate her pain. The injections were successful and this allowed her to resume closer to her previous way of living and working out. To make sure she doesn't get into that pain cycle again she presently maintains herself on as needed bases of both massage therapy and Chiropractic care.
Because the disc does not always protrude in the same direction in relation to the nerve root there is no way to know for sure which motions or positions will aggravate a nerve root compression. A safe rule of thumb is that if any motion or position or technique further aggravates the client's symptoms, it should be immediately stopped.
Click here for more information about Debbie Roberts, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.