resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Head and Shoulder Pain from the Splenius Cervicis
When clients report symptoms of pain in the head or eye, it is always of serious concern and they should seek medical care to determine the cause(s) and treatment options. Physicians and other healthcare providers are excellent referral sources to your practice, since a percentage of their patients are suffering with many issues that may include myofascial pain. Let's examine the splenius cervicis muscle, its anatomy, the location of myofascial trigger Points (TrPs), the associated pain referral patterns of each TrP, some treatment and self-care tips.
The splenius cervicis along with the splenius capitis muscle are the most superficial of all the extensors in the cervical region. The deepest of the extensor muscles are very short in length and attach to the next vertebra. In contrast, the splenius cervicis is long and crosses many vertebrae. Below the splenius cervicis attaches to the spinous process of the third through sixth thoracic vertebrae and the fascia over them. Above it attaches to the posterior tubercle of the transverse process of the upper two to four vertebrae. (See photo 1A)
Unilateral contraction of the splenius cervicis muscle produces extension, lateral flexion and rotation of the neck, turning the face toward the same side. Bilateral contraction produces extension of the neck.
Clients typically report a "stiff neck," limited cervical range of motion and/or pain in the shoulder, neck, head and or eye. Drs. Simons and Travell et, al, identified two (upper and lower) myofascial trigger points in the splenius cervicis muscle. In photo 1, "X" indicates the common location of trigger points. Solid red areas identify essential pain zones, the regions of referred pain that is present in nearly every person with active trigger points. The dotted red regions indicate spillover pain zones or the regions of referred pain on some, but not all, patients with active trigger points.
The splenius cervicis Upper TrP is located, as the name implies, in the superior portion of the muscle in the musculotendinous junctions. It can "refer a diffuse pain through the inside of the head that focuses strongly behind the eye on the same side, and sometimes refers into the ipsilateral occiput."1 (See photo 1A, B) The splenius cervicis Lower TrP is classified as a central TrP and located in middle of the muscle belly. It "refers pain upward and to the base of the neck."1 (See photo 1A, C)
During this technique, many posterior neck muscles are treated. Palpation of boney landmarks will help you determine your location. A combination of subjective complaints, objective findings, precise palpation and knowledge of TrP pain patterns will help you determine if the splenius cervicis muscle is involved. A few other muscles in the region that should also be assessed include: trapezius, levator scapulae, sub occipitals and scalenes.
The client is supine on a table. The therapist is seated at the end of table with the shoulder of the treating hand aligned with client's head, neck and body. The thumb of the treating hand is positioned at the base of the occiput, with the pad of the thumb palpating the posterior aspect of the transverse process. Avoid intruding on the nerve root by never treating the lateral aspect of the transverse processes. The therapist's non-treating hand will support the client's head while creating extension of the cervical spine. (See photo 2A)
While lowering the head toward the table, glide the thumb inferiorly, applying pressure anteromedially, to treat the posterior aspect of the transverse process, repeat three or four times. Turn the head 45 degrees away from the treating side and repeat the above step three or four times. Examine the same region using cross fiber movement will help to thoroughly check for TrPs. (See photo 2B)
In photo 3, the non-treating hand continues to support and control movement of the head and neck. The fingers of the treating hand cup the cervical spine as the thumb is positioned anterior to the upper trapezius. The thumb is pointing toward the client's feet with the pad of the thumb facing medially. It is important for the thumb to always remain posterior to the transverse processes to avoid pressing on the brachial nerves. Rotate the client's head toward the treating side with the side of the patient's head now resting on the therapist's forearm. Apply pressure with pad of thumb pointing 45-degrees anteromedially.
When you palpate an active TrP in a client, they recognize the referred phenomena. If the referred pain does not release after applying sustained pressure for a maximum of eight seconds, then release and check the spot later with less pressure.
Keep in mind that trigger points can form for a number of reasons. Examples include direct trauma during a motor vehicle accident, to sustained stress from poor posture, to improper biomechanics, to poor ergonomics at work and throughout the day. Discuss their activities of daily living. Do they drive for hours everyday? If so, the seat, stirring wheel and mirrors likely need to be properly positioned. Do they work on computer all day? If so, does the monitor, keyboard or chair need adjustments? At home, do they rest on the couch with their neck in extreme flexion?
Empower your clients with self-care tips they can utilize between treatments. Show them how to stretch. Give them the locations, times and tips to perform simple stretches throughout their day in the kitchen, bathroom, while walking the dog, at the beginning and end of everyday. They will feel better and appreciate your efforts.
Pain in the head or neck can create a great deal of anxiety for anyone. Sometimes a little therapy and a few lifestyle changes can make all the difference. Clients want to know what caused the pain and if there is anything they can do to prevent it in the future. If you provide effective solutions, people will refer their family, friends and co-workers. While many muscles could be involved, remember the splenius cervicis can cause pain from head to shoulder.