| In my San Antonio, Texas based Massage | | | | |
| Therapy and Bodywork practice I'm often asked | | | | NERVE COMPRESSIONS and ENTRAPMENTS are types |
| by clients how it is that I assess clients | | | | of nerve impingement. These are areas of |
| and approach my work. There are a number of | | | | abnormal pressure on nerves which can cause |
| methods I use but when it comes to | | | | pain, numbness and tingling, or muscle |
| musculoskeletal pain one set of guidelines | | | | weakness. A Nerve Compression occurs when a |
| are "The 7 Perpetuating Factors of Pain". | | | | hard tissue such as a vertebrae or vertebral |
| These factors were originally presented to me | | | | disc directly presses on a nerve. A more |
| during my training in Neuromuscular Therapy | | | | common occurance is a Nerve Entrapment. Nerve |
| and Medical Massage and are based on the work | | | | Entrapments occur when a soft tissue such as |
| of Drs. Janet Travell and David Simons (and | | | | muscle, tendon, ligament, or fascia |
| others). By keeping these factors in mind | | | | abnormally press on a nerve. An example of a |
| during assessments and treatment a Massage | | | | nerve compression would be sciatica. Examples |
| Therapist's potential to help relieve the | | | | of a nerve entrapment include Carpal Tunnel |
| client's pain increases tremendously. The | | | | Syndrome and the lesser known Piriformis |
| factors are: | | | | Syndrome, but encompass a wide variety of |
| | | | painful conditions. |
| 1) Ischemia | | | | |
| | | | POSTURAL DISTORTIONS are another factor |
| 2) Trigger Points | | | | contributing to musculoskeletal pain. |
| | | | Distortions such as the head being to far |
| 3) Nerve Compression or Entrapment | | | | forward, leg length discrepancies, or an |
| | | | elevated shoulder cause muscular imbalances |
| 4) Postural Distortion | | | | and joint abnormalities which lead to pain. |
| | | | |
| 5) Biomechanical Dysfunction | | | | BIOMECHANICAL DYSFUNCTIONS include joints |
| | | | that are either excessively mobile |
| 6) Stress | | | | (hypermobile) or have an abnormally limited |
| | | | range of motion. These Biomechanical |
| 7) Nutrition | | | | Dysfunctions cause pain in the joints |
| | | | themselves and contribute to some of the |
| Each of these factors plays a part in a | | | | other perpetuating factors including postural |
| person's musculoskeletal pain. Any one of | | | | distortion, ischemia, and trigger points. |
| these factors can be the sole cause of pain, | | | | |
| but usually a person will have more than one | | | | STRESS may be the most common of all |
| factor at work - sometimes all of them. | | | | perpetuating factors of pain. A person |
| | | | experiencing physical, mental, emotional or |
| ISCHEMIA is a local deficiency of blood | | | | spiritual stress produces larger amounts of |
| supply and the oxygen transported by the | | | | stress hormones and usually has a nervous |
| blood. Ischemia can occur for a variety of | | | | system that's in overdrive - fight or flight |
| reasons including direct injury to tissues, | | | | syndrome. Stress leads to pain in so many |
| abnormally tight or overworked muscles, | | | | ways that it's impractical to list them here; |
| clothing or shoes that are too tight, or even | | | | however, stress can cause pretty much all of |
| off-the-shelf splints for tennis elbow. | | | | the other perpetuating factors. |
| Specialized nerve receptors in muscles report | | | | |
| pain in ischemic areas due to chemical | | | | NUTRITION is one factor often overlooked in |
| changes that occur. | | | | the treatment of musculoskeletal pain. |
| | | | Unfortunately, Massage Therapists are seldom |
| TRIGGER POINTS are hyperirritable spots in a | | | | trained, qualified, or legally able to |
| muscle associated with a palpable "knot" and | | | | provide nutritional advice. However, most |
| a taut band of tissue. Trigger Points are | | | | Massage Therapists, including myself, do know |
| painful on compression and can refer pain and | | | | healthcare professionals in their locale to |
| tenderness to other areas. Trigger Points are | | | | help with the nutritional side of treating |
| usually ischemic and often cause an entire | | | | pain. These professionals often find that |
| muscle to be too tight, weak, and more easily | | | | there are nutritional deficiencies just a |
| fatigued. Trigger Points can be caused by | | | | Drs. Travell and Simons did during their |
| overworking or overstressing muscles, direct | | | | research. |
| trauma to muscles, or even chills. | | | | |