Thoracic outlet syndrome

Thoracic outlet syndrome involves the compression of nerves and arteries as they pass between the anterior and middle scalene muscles in the neck.

The symptoms:

Thoracic outlet syndrome affects the nerves and the arteries passing into the hands and arms. If the compression is affecting the nervous system, then symptoms can include pain, numbness and tingling fingers, pain in the neck and shoulders, aching arms and hands or a weak grip.

If the compression is affecting the circulatory system, then you could see a discoloration of the hands or arms, a weak pulse or arm pain and swelling. These symptoms are caused by decreased blood flow into the arms through the subclavian vein and artery.

So what is going on?

The neck consists of seven vertebrae stacked one on top of the other. Small openings between the vertebrae allow for nerves to exit the spinal cord and into the body, in this case the arms. As the nerves leave the spinal cord, they form a web-like interchange, rather like criss crossing highways complete with exit ramps, called the brachial plexus. Two muscles extend down from the neck and attach to the first rib underneath the collar bone. These muscles, the anterior and middle scalenes, pass either side of the brachial plexus. The image shows the proximity of the scalene muscles to the brachial plexus and blood vessels

What causes it?

Muscles can become stressed and tense from continuous punishment. An example of this could be stress caused by a high paced desk job, where the person slumps into bad posture as the day goes by. It could also be caused by repetitive lifting of the arms and over-use of the wrists and arms, such as swimmers, rock climbers or weightlifters. It could also come about through trauma, such as a car accident causing damage to the clavicle.

What can be done?

The scalene muscles can be released using pressure techniques to the muscles in the neck. Often times, there will be a trigger point, a hard muscular knot, just under the clavicle, at the base of the front of the neck. This can be released using pressure into the trigger point until the point looses sensitivity. Mobilisation techniques can be used to restore movement to the neck, freeing the neck and allowing you to turn the head further than previously allowed. There may be cases where thoracic outlet syndrome is not caused by muscular tension. This may require surgery to alleviate. 

The thoracic spine

The thoracic spine is the middle section of the spine comprising of 12 vertebrae. It starts at the base of the neck, marked by a protruding vertebra, and meeting the lumbar spine just under the ribs.

There are 12 ribs, which attach to each of the thoracic vertebrae in the back and to the breast bone, or sternum in the front. Ribs 11 and 12 however, do not attach to the sternum, and are called floating ribs.

As with the cervical and lumbar sections of the spine, nerves emerge from the thoracic spine and proceed to various parts of the body depending on where in the thoracic spine they emerge. Most of the nerves run along the ribs of the rib cage. The nerves which emerge from the very top of the thoracic spine don’t, they supply the upper and lower parts of the arm, but more about them in later articles.

So what can go wrong with the thoracic spine:

The thoracic spine is fairly robust, but despite this, you could suffer anything from crush fractures resulting from a fall, to arthritis, slipped discs and dislocated ribs.

In this article I will focus on the most common complaint, muscle spasm caused by bad posture.

Enter the trapezius. The trapezius muscle is a large muscle which is shaped like a large kite. It attaches to the thoracic spine and up to the neck and out to the shoulders. It is coloured red in the diagram.

The muscle can be divided into three major sections, the upper, middle and lower trapezius.

The upper region of the muscle is responsible for lifting the shoulder blades, while the middle and lower regions pull the shoulders back and depress the shoulder blades downwards.

Now, your boss has been on your case for that report which is due by 5, and you have discovered that it needs a major re-write. You are stressed and you’re hunching. This pushes the neck forward and puts the upper fibres of the trapezius in a bad postural position. Do this over months, and the trapezius will form protective spasm, which hurt.

It isn’t just office workers who are affected, but sports people like cyclists who are hunched over handlebars all day or hair dressers who spend most of their days with their hands in the air.

Tense trapezius muscles can form tight bands of muscle in the shoulder and mid-back, causing pain. The middle fibres of the trapezius can also form trigger points, which refer their pain elsewhere, most often as a headache.

The good news is that this kind of thing is easily treated with specifically targeted deep tissue work and mobilisation of the thoracic spine.

Jacque Cilliers. Adv Dip. MT. (MSM)

For appointments: 0845 458 5376

https://www.facebook.com/jacquecilliersmassage

http://www.jointsolutionsuk.com/

Herniated Discs

Herniated discs are often referred to as slipped discs. This isn’t entirely accurate. The disc doesn’t slip out of alignment with the spine, like a block in a Jenga tower, the spine is too stable. Briefly, there are three major ligaments running down the length of the spine which prohibit forward movement of the disc, added to this, there are various tendons, ligaments and muscles either side of the spine which stop it from slipping to the side either.  

I was taught that the discs of the spine are like rolled up belts, made of cartilage. Each disc has a soft core called the nucleus.  

Now cartilage, or the belt in our example, is tough stuff, but doesn’t handle compression very well. When compressed, cartilage tends to crack. So let’s place a large brick on the front of the belt. The force of the brick pushes down on the belt and forces the soft middle against the back of the belt. As this is repeated over many years, due to bad posture or bending, cracks start to appear in the belt, until finally the belt gives way and the middle pushes out. This is a herniated disc.

The body reacts to a herniation by causing inflammation, and inflammation causes pain and stiffness. The herniation itself can press up against nerves which pass in the vicinity of the herniation. This causes pain, numbness or tingling sensations down the path of the nerve. The most common location for a disc herniation is the L5/S1 region, at the base of the spine. The nerve emerging from the L5/S1 level of the spine is one of five roots contributing to the sciatic nerve, and compression of this nerve causes sciatica.

Symptoms:

As mentioned, symptoms include pain and inflammation around the area where the herniation occurred. You will most likely experience sciatica, or pain down the back of the leg. The sciatic pain may increase when you cough, sneeze or pass a stool. These symptoms may come on quickly, due to an injury, or they may come on slowly over time.

Treatment:

I will always treat what I find. The most common course of treatment would be to reduce the inflammation around the herniated disc. This includes treating those muscles which have become tense and spasmodic. I treat the disc directly by gently moving the spine in a way which widens the gap through which the nerves pass, reducing the pressure on the nerve and reducing the sciatic pain.

Treatment can take time, but it is worth it. You can manage herniated disc symptoms.

Jacque Cilliers Adv Dip. MT. (MSM)

For appointments: 0845 4585 376

https://www.facebook.com/jacquecilliersmassage

http://www.jointsolutionsuk.com/

more about sciatica: http://www.jointsolutionsuk.com/index.php/sciatica/ 

Sacroiliac joint dysfunction

The sacroiliac joint is the joint between the sacrum and the ilium. The sacrum is the triangular shaped bone at the base of the spine and the ilium, the winged shaped bones of the waist. The joint is marked by the presence of dimples at the base of the spine, called the posterior superior iliac spines, or PSIS for short. The picture shows the sacroiliac joint circled in red.

The sacroiliac joint is a slightly movable joint and, unlike the elbow, is designed to slide. The sliding action helps to absorb the impacts of running and walking, and other less energetic movements like sitting, or bending forward.

The joint may not look like much, and may not move a lot, but it is an important joint in the body, and like many joint in the body, it can inflame too. Inflammation of the sacroiliac joint is called sacroiliitis. A typical symptom of sacroiliitis is pain around the dimples in the lower back, or the joint itself. However, the sacroiliac joint is closely associated with other muscles in the back including the gluteus maximus, piriformis, muscles in the lower back and muscles which flex the hip. These muscles will react by becoming tense, causing pain in the lower back and buttocks. Changes in the way you walk can cause the muscles of the leg to become tense too. If piriformis is affected, then you could experience piriformis syndrome, which was discussed in my previous article, resulting in sciatica. Nerves leaving the spine, at the L2 to S3 level, pass close to the sacroiliac joint. Inflammation at the joint can play on these nerves causing pain to be felt in the buttock, thigh and hip.

As you can see, symptoms can be complex and varied. I always get asked what happened first, did the sacroiliac dysfunction cause the other muscles to react, or did tension in the other muscles cause the sacroiliac joint to inflame in compensation. It is generally hard to say, but what is certain is that sacroiliac joint dysfunction usually exists alongside other problems. For this reason I will treat what I find.

During a consultation I will test the sacroiliac joint for dysfunction, the lower back and piriformis for tension.

Treatment will typically include soft tissue work to release tension in the lower back and piriformis. I use mobilisation techniques to release the muscles around the joint and help it to move again. When I mobilise, or move, the sacroiliac joint, you might hear a pop or click as the ilium and sacrum slide over one another, restoring movement to the joint.  

Jacque Cilliers Adv Dip. MT. (MSM)

For appointments: 0845 4585 376

https://www.facebook.com/jacquecilliersmassage

http://www.jointsolutionsuk.com/

Piriformis sydrome

Piriformis syndrome

Piriformis syndrome occurs when the Piriformis muscle inflames and places pressure on the sciatic nerve as it runs from the sacrum and into the leg.

The Piriformis muscle is a pear shaped muscle found in, well, in the bum. It attaches to the sacrum and extends across, and under the gluteus maximus, to the greater trochanter of the femur. The sciatic nerve passes directly under this muscle as it leaves the sacrum and travels through the buttocks and into the leg. The image shows the location of the Piriformis and its attachment points, as well as the relative position of the sciatic nerve. Therefore, if this muscle gets damaged or inflamed, it will press on the sciatic nerve, causing pain in the buttocks and down the path of the sciatic nerve, which is down the back of the leg. Pain down the back of your leg is called sciatica.

The Piriformis has two functions, depending on what you are doing with your legs at the time. If you are standing, Piriformis is used to turn the entire leg outwards, pointing your toes to the side. If you are sitting, then it is used to open your leg outwards.

How do you get Piriformis syndrome?

One of the most common causes is sitting at a desk, or driving for long periods of time. This causes the muscles which bend the legs at the hip (flexors) to shorten or become tense. As a compensatory measure, the opposing muscles (the extensors) become tense too. The tension in the extensors can cause the Piriformis to spasm, causing pain

Overusing the Piriformis muscle can cause it to become damaged and tension will arise from this. Exercises like cycling, or other seated sports like rowing, can cause damage by using the muscle to much, also known as a muscle strain.

Another common cause of Piriformis syndrome arises from a stiffening or looseness of the sacro-illiac joint. The sacro-illiac joint is a joint between the sacrum and the ilium in the pelvis. This problem will be discussed further in later articles.

Lower back problems can also cause Piriformis syndrome. This is another compensatory reaction which occurs when the Piriformis tenses to protect against pain in the lower back and decreased, or altered gait.

Do I need to worry?

Not with Piriformis syndrome no. It is a muscle imbalance which can be corrected fairly easily with some deep tissue work and exercises.

Sciatica can, however, be caused by a herniated disc. This will also be covered in later articles. If you are suffering from sciatica, you should see an osteopath, physiotherapist or chiropractor for professional treatment. Sciatica can be treated.

For more information on sciatica: http://www.jointsolutionsuk.com/index.php/sciatica/

Jacque Cilliers Adv Dip. MT. (MSM)

For appointments: 0845 4585 376

https://www.facebook.com/jacquecilliersmassage

http://www.jointsolutionsuk.com/ 

Benefits of Movement

Benefits of Movement:
I saw this from a website that I subscribe to (bonfire health) and I liked it so I am going to share it with you:
Critical Concepts:  Lack of movement promotes stress.

There are many well-understood benefits of movement and activity, including improved cardiovascular health, weight loss, lean muscle mass and strength, balance, tone and appearance.  Science is now grasping the depth of the role of exercise in the realm of prevention of chronic diseases such as diabetes, CVD and obesity.  The latest research is now painting a broader picture for the benefits of movement in the realm of neurology, development and optimal health.
The primary purpose of movement and activity is to develop and condition the brain (Dr. John J. Ratey, Spark).
Our nervous system is an incredibly complex network of communication fibers and junctions that allow us to relate and adapt to our internal and external environments.  The nervous system, made up of the brain, the spinal cord and miles of nerves, depends on movement to restore the body to homeostasis – or a state of general balance and equilibrium.
This resting state is critical to health and healing.  Our lives have become frantic.  We rush through our days, seemingly never having enough time to complete tasks, slow down to eat, or relax and unwind.  So often we are stressed out in traffic or sitting in front of a computer or on the phone.  Most people spend far too much time in the “Go State” – fight or flight.  This constant Sympathetic Stress State keeps stress hormones coursing through our veins, wreaking havoc on our health.
One vital function of movement is its ability to “re-set” our nervous system from a “stress state” to a “rest and repair” state.
The cerebellum is the area of the brain that monitors movement.  The “body sense” that is derived from movement is called proprioception.  This body sense provides more data to our brain than all of our other incoming senses combined.  It is described by Nobel Prize Winner Roger Sperry as a brain nutrient.  The information is derived from the compression of spring-like mechanoreceptors in your joints.  When you move, they send signals to your brain.
This cerebella stimulation from movement of our joints will actually drive the body away from a stress state and back toward a rest and repair state.  This critical homeostatic mechanism is responsible for returning your body to a state of equilibrium.  In other words, movement reduces stress.
Lack of movement promotes stress.
If you live a sedentary life, you miss out on this effective “stress-buster.”  People who exercise regularly report less stress in their lives and experience fewer stress-related health problems.  Exercise has the additional benefits of increasing neurotransmitters (brain chemicals) that promote happiness, better sleep and increased sex drive.
Poor posture and fixed positions can create stress in the body.  Toxic and deficient movement patterns promote core weakness, muscle strain, inflammation and structural dysfunction.  When joints do not move properly, they create irritation to the nervous system that acts a lot like “static” or noise in our communication network.  This noxious stimulation or nociception changes the brain’s function and influences the body’s chemistry.  This type of joint dysfunction and associated nerve irritation is called “subluxation.”
Subluxations can occur in any joint, but the most devastating are found in the joints of the spine.  These spinal misalignments can be caused by trauma or bad habits (or both), and their ill effects on your health can be profound.  A distinctive quality of subluxation is joint fixation.  When a joint is fixed or “stuck” and not moving through its normal range of motion, a host of problems can arise.  Joint decay and degeneration (arthritis) occurs when a joint is not moving properly.  If a joint is fixated, proprioception (Body Sense) is reduced and nociception (noise) is increased – both of which promote stress in the body.
Healthy people practice regular spinal hygiene by utilizing the Life Extension Exercises.  A Bonfire best practice is to implement these into your daily routine to combat stationary work and postural stress.  Best results are achieved if you do this one-minute routine at least once every two hours at the computer or work station.  Nudge yourself into better habits by auditing your workstation for postural stress (read more here).  Make it a regular habit to get up and walk during your day.  It is very unnatural for you to sit for extended periods of time – no matter how important the project.  Dr. James Chestnut suggests a brilliant nudge: position yourself perfectly while sitting at the wheel in your car and then adjust your mirrors.  If you slouch during your drive, the mirrors will remind you to sit up.
A vital behavior for optimal health and function is to have your spine and nervous system evaluated regularly by a qualified chiropractor.  These doctors have a unique training and specialization in locating and correcting spinal misalignments that contribute to spinal stress.  This safe and effective method has been practiced widely for over one hundred years, and is now the second largest form of health care in the world.
Your brain and body expect and require movement for health – for life.  Get to it.
Summary Checklist

• Add activity every day in every way
• Calculate Energy Balance
• Add Functional Training
• Use variety in your workouts
• Focus on the Intensity of your workouts
• Gradually progress to a higher intensity
• Adopt the Buddy System
• Get your Spine checked by a chiropractor

Newer Rheumatoid Arthritis Drugs Don't Raise Cancer Risk: Study

Newer Rheumatoid Arthritis Drugs Don't Raise Cancer Risk: Study: Title: Newer Rheumatoid Arthritis Drugs Don't Raise Cancer Risk: Study
Category: Health News
Created: 9/6/2012 4:06:00 PM
Last Editorial Review: 9/7/2012 12:00:00 AM