Steveman30
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I'd like to share an easy and quick tech' for prolapsed and bulged disk that I learned from an Orthopedic surgeon and a Neurologist.
A very brief history so you see where I'm comin' from.
I work in a hard physical environment which deals daily with knee injuries, prolapsed disk and an assortment of other li'l problems. It has been in my best interest to learn how to both know a problem is in fact prolapsed disk and the general whereabouts of the epicenter(Hope I spelt that correctly) if you like.
Because I am on the front line so to speak being the first therapist on the job as the injury occurs, I can best have more than a fair idea how to proceed. Let me say, too often I have seen paramedics come to work at our place. Instant injuries happen, mainly pinched nerve or crucial ligament. This happens from overwork, fatigue and incorrect timing.
My first consideration is to ice the area. Ice is always good unless the person is also suffering from hypothermia. Then it's a bad thing. Doesn't happen inside a big heated house very often, luckily.
Next I begin working on the peripheral muscles so the problem is, even in my mind not spreading like wildfire.
Here is the test:
The first sign of prolapsed or bulged disk is conducted pain due to the nerves being entrapped. Acute pain is the precursory sign as the sensory pathway is closest (posterial) to the disk than the motor neuron. (anterial)
The person would be seriously in trouble if the motor neuron was damaged.
Prolapsed disk is more common in the lumbar spine, less common than the cervicle vertebrae. I have only seen one case in the thoracic as this is extremely rare.
Testing the cervical vertebrae:
I take the patients hands in mine and ask them to flex their arms using the biceps. I am feeling for an imbalance of strength between left and right arms. This tests C5/C6
Then I ask them to extend arms forward using the triceps. This is for C7.
C7/C8 is a rare injury but if suspect: Spread the patients hands and finger's wide and apply even pressure to the forefinger and the pinkie. If the patient resists in balance, this is not the problem.
So then I'm basically stumped coz I've tried it all. Then I send 'em off to an Orthopedic doctor or Neurologist. When in doubt, I pass it on... Safer that way.
Testing the lumbar:
First I will ask the patient to walk on his or her heels. Power is required from the lower leg flexors and these nerves are fed from L5.
For testing S1, I ask the person to walk on tip toes. This uses the lower leg extensors.
To test L3/L4, I ask the person to stand on one leg and give you his or her knee. Take and support behind the knee and ask the person to extend the lower leg forwards to test the Quadriceps.
These are very simplified and there are other tests like the Laséque, but I thought easy is easier to learn. Besides as massage therapist's we need not know more. Painful and serious problems like this are best passed on to specialists. Best we contain and refer to the right person.
Hope this can help someone.
Regards
Max
A very brief history so you see where I'm comin' from.
I work in a hard physical environment which deals daily with knee injuries, prolapsed disk and an assortment of other li'l problems. It has been in my best interest to learn how to both know a problem is in fact prolapsed disk and the general whereabouts of the epicenter(Hope I spelt that correctly) if you like.
Because I am on the front line so to speak being the first therapist on the job as the injury occurs, I can best have more than a fair idea how to proceed. Let me say, too often I have seen paramedics come to work at our place. Instant injuries happen, mainly pinched nerve or crucial ligament. This happens from overwork, fatigue and incorrect timing.
My first consideration is to ice the area. Ice is always good unless the person is also suffering from hypothermia. Then it's a bad thing. Doesn't happen inside a big heated house very often, luckily.
Next I begin working on the peripheral muscles so the problem is, even in my mind not spreading like wildfire.
Here is the test:
The first sign of prolapsed or bulged disk is conducted pain due to the nerves being entrapped. Acute pain is the precursory sign as the sensory pathway is closest (posterial) to the disk than the motor neuron. (anterial)
The person would be seriously in trouble if the motor neuron was damaged.
Prolapsed disk is more common in the lumbar spine, less common than the cervicle vertebrae. I have only seen one case in the thoracic as this is extremely rare.
Testing the cervical vertebrae:
I take the patients hands in mine and ask them to flex their arms using the biceps. I am feeling for an imbalance of strength between left and right arms. This tests C5/C6
Then I ask them to extend arms forward using the triceps. This is for C7.
C7/C8 is a rare injury but if suspect: Spread the patients hands and finger's wide and apply even pressure to the forefinger and the pinkie. If the patient resists in balance, this is not the problem.
So then I'm basically stumped coz I've tried it all. Then I send 'em off to an Orthopedic doctor or Neurologist. When in doubt, I pass it on... Safer that way.
Testing the lumbar:
First I will ask the patient to walk on his or her heels. Power is required from the lower leg flexors and these nerves are fed from L5.
For testing S1, I ask the person to walk on tip toes. This uses the lower leg extensors.
To test L3/L4, I ask the person to stand on one leg and give you his or her knee. Take and support behind the knee and ask the person to extend the lower leg forwards to test the Quadriceps.
These are very simplified and there are other tests like the Laséque, but I thought easy is easier to learn. Besides as massage therapist's we need not know more. Painful and serious problems like this are best passed on to specialists. Best we contain and refer to the right person.
Hope this can help someone.
Regards
Max