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What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
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.