A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
2018 Gallup-Palmer Report: Key Findings
The fourth annual Gallup – Palmer College report is out; here are some of the key findings excerpted directly from the executive summary regarding Americans' experiences with chiropractic care relative to the management of neck and back pain:
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
December, 2004, Vol. 04, Issue 12
By Whitney Lowe, LMT
Neck pain is a frequent reason for clients to see a massage therapist. In this issue, we'll examine torticollis, one cause of neck pain and disability that poses challenges in identification in the treatment room.Torticollis means literally, "twisted neck." A person with torticollis exhibits involuntary muscle contractions that lead to abnormal positions, and/or tremor or spasmodic movements of neck and head. Torticollis may manifest in different forms: congenital, spasmodic, or acute/acquired.
Congenital torticollis presents in infants and occurs at birth or shortly after. The condition may result from improper positioning in the uterus or birthing trauma. There are other roots of infant torticollis, such as structural or neurological. With treatment in the first year, this condition is usually resolved.
While considered rare, spasmodic torticollis, also known as cervical dystonia, may still affect close to 90,000 people in the United States. There are three variations named for the types of neuromuscular dysfunction: tonic (a sustained contraction), clonic (head shaking), and mixed (both). Spasmodic torticollis is a neurological condition that has no known cure and treatment is symptomatic. Clients who present with this condition should be instructed to contact one of several organizations that can provide support, information and resources to this population. Practitioners should also confirm the client has been diagnosed. In some cases, spasmodic torticollis is mistaken for muscular dystrophy, epilepsy or Parkinson's disease. There are significant distinctions between spasmodic and acquired or acute torticollis.
Acute or acquired (sometimes called "wry neck") is the most common form of torticollis characterized by constant muscle spasms in the neck. It appears in a broad spectrum of the population from children to adults. Acquired torticollis is caused by maintaining muscles in shortened positions for a prolonged period. The acute form might manifest as a result of a head or neck injury such as whiplash or concussion, in which symptoms may appear immediately or be delayed. Myofascial trigger points are another factor that either lead to the condition or perpetuate it. The condition seemingly appears "overnight" when, for example, a person has slept with his/her neck in an awkward position or a cold draft on their neck muscles. Other activities likely to produce acquired torticollis include holding the telephone between the head and shoulder, or playing an instrument, such as the violin, for long periods.
The sternocleidomastoid (SCM) muscle is most commonly involved in acute or acquired torticollis. Because it is a contralateral rotator, any position that rotates the head to the opposite side for long periods may lead to the condition. A history that includes the nature of the onset, the length of time the condition has been present, and physician diagnosis should allow distinction between the neurological spasmodic form and the muscular variation.
The practitioner will be able to palpate - and usually observe - shortening and hypertonicity in the muscle. Visual indicators are similar with each variation of torticollis. The head and neck are held in a non-neutral position, often with rotation to the opposite side. The SCM on the affected side is likely to be more prominent than on the opposite side. In the clonic variation of spasmodic torticollis, there will be some shaking of the head.
The muscles of the cervical region may feel tight due to local muscle spasm. In some cases, especially if the condition is chronic, a degree of fibrotic change may develop and there may be palpable contracture in the muscles. Active and passive motions that turn the head in the opposite direction of the contraction are likely painful and limited. There may be pain associated with further rotation to the contracted side depending on the severity of the condition and the percentage of muscle fibers recruited for the activity.
Acquired torticollis is not serious and symptoms generally resolve in a couple of weeks. This condition also responds well to massage; however, care should be used in treatment, as the muscles are often painful from spasm and trigger-point activity. In order to rule out more serious neurological or structural disorders, it is a wise idea to have the client evaluated by another health professional prior to treatment.
Click here for more information about Whitney Lowe, 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.