resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.