This detailed article began as a presentation to our monthly study group by Dr. Craig Thorsen, DC of Grants Pass OR. Exercise rehabilitation is often more effective, if combined with manipulation and soft tissue therapies. We've focused on the lower back with our examples. Marc
This is Marc’s insightful article dealing with the effect of a weak upper trapezius on the shoulder and neck. This particular muscular issue is among the most missed on a diagnosis, as everyone believes the upper trapezius is hypertonic. If the symptomatic side has a dropped shoulder, look for this problem. Marc [...]
Here is the first of a 2 part article on sciatica and gluteal pain. Part 2 will be listed at the bottom of this blog. I want to thank many of my patients, who have helped me puzzle through all of the challenges associated with an ongoing “pain in the butt.” So many sufferers [...]
This abbreviated extract article from National Center for Biotechnology Information of a clinical study done in China is simple and fascinating. The goal of the study was to determine the natural path of proven discogenic pain, which in these patients was determined by discograms. This process is no longer routinely done in the US [...]
This is a very important article about cortisone injections and I don't know why it took me two years to find it. What it says is that cortisone shots are overused, and they often slow healing. Yes, the cortisone can give quick relief, but over several months, the patient who get the cortisone injections, [...]
Marc Heller, DC This article from Orthopaedic Today Europe, Issue 5 is a discussion of the viability of discography.The missing piece of the discussion, in my view, is factoring in the research that shows that discography damages discs. Unfortunately, we still do not have a definitive non-invasive way to test for discogenic pain.I prefer looking [...]
Big Brother (meaning the federal nutritional authorities) would like you to eat less salt, but the evidence is quite contradictory. I have always felt that salt intake is better done by taste than by some arbitrary rules. Generally, you would eat fewer prepared and junk foods, which are the sources of “stupid” salt as [...]
Another hidden source of lower back pain is irritation of the superior cluneal nerve, coming from dysfunction at the thoraco-lumbar junction. I have been working with the Maigne syndrome concept for at least 3 months, as of December 2011. It has made me see the integration of the thoraco-lumbar and the lower back and pelvis more clearly. If this concept is new to you, read my article first. Since writing the article, I have been observing my patients. Here are some thoughts. First, it is so wonderful to have a clear indicator. In this case, the clear indicator- Maigne’s gluteal point- is the hot spot, the knot, about 7-8 cm lateral to the midline, just below the iliac crest. If you don’t get rid of this knot, you have not succeeded.
A sixty-something-year-old male comes in with thoracic stiffness and lower back pain. The lower back pain would occur on various motions. He had previously been quite active, living on 3 acres and taking care of his property. He had been involved in a vehicle accident, rear ended, several months previous. His previous chiropractic care and massage had seemed to make him worse rather than better, he would spasm the day after the treatments. The key findings on exam included stiff hips, he couldn’t internally rotate beyond 10 degrees on both sides. He was very rigid throughout the thoracic spine. It was hard to elicit tenderness in the thoracic spine, as his muscles were so tight. His lumbar motion was fairly normal, with some pain at the extremes of motion.
We could do better. We meaning all of the therapists trying to help all of our patients. The world of hands on care is very subjective, and we are the seven blind men looking at the elephant. We tend to see and touch through our own limited training, and our current passions. I would like to see us have a bigger view, and see the patterns more clearly. I would like us to engage our patients, and teach each of them what they can do to help themselves.