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Author: Tim Bertelsman, DC, DACO

Deep Neck Flexor Weakness and Cervicogenic Headache

Deep Neck Flexor Weakness and Cervicogenic Headache

Headaches affect almost half of the population. 15-25% of all headaches are referred from the cervical spine and are classified as “cervicogenic” (1,36). The pathophysiology of cervicogenic headache (CGH) is debatable, but the anatomical basis is thought to be a convergence of sensory neurons from the cervical spine and trigeminal nerve in the trigeminocervical nucleus located in the upper cervical spinal cord

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Carpal Tunnel vs. Pronator Teres

Carpal Tunnel vs. Pronator Teres

When a patient presents with numbness and tingling in their first 3 ½ fingers, most clinicians presume a diagnosis of carpal tunnel syndrome. Without confirming this source of median nerve compression we may be directing our treatment at the wrong culprit. Pronator Teres Syndrome describes the constellation of signs and symptoms that results from compression of the median nerve by the pronator teres muscle near the elbow. It is the second most frequent cause of median nerve compression with features similar to but discernable from its more common distal counterpart, carpal tunnel syndrome (1). Pronator Syndrome (PS) responsible for 9.2% of all cases of median nerve entrapment (2).

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Torticollis Patients

Torticollis Patients

Most chiropractors enjoy treating torticollis patients. We know that in a matter of hours to days that contorted patient, who is writhing painfully in your waiting room, will be telling everyone about the dramatic relief they experienced in your office. Unfortunately, unlike your excited patient, chiropractors have apparently told no one in the scientific community about these outcomes. A literature search for “acute torticollis” produces…well…almost nothing! Let’s change that- but first, some background information may be relevant.

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Lumbosacral Referral or Hip Osteoarthritis

Lumbosacral Referral or Hip Osteoarthritis

Lumbosacral problems are common, but so is hip osteoarthritis (OA). Estimates for the prevalence of hip OA vary from 3-33%. However, the diagnostic challenge with this commonality is the fact that referral zones for lumbar and sacroiliac disorders are very similar to those of hip OA, i.e. gluteal pain is common in both (10). This month, we will review diagnostic clues for hip osteoarthritis.

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Severs Disease

Severs Disease

Severs disease, or calcaneal apophysitis is a painful inflammation of the cartilaginous growth center at the site of insertion for the calcaneal tendon. This condition, first reported by Sever in 1912 (1), is a common cause of posterior heel pain in active adolescents.

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Tarsal Tunnel Syndrome and the Dorsiflexion-Eversion Test

Tarsal Tunnel Syndrome and the Dorsiflexion-Eversion Test

Tarsal tunnel syndrome, first described in 1962, is a relatively common compression neuropathy of the posterior tibial nerve as it passes through the tarsal tunnel. Tibial nerve compression results in pain and/or paresthesia radiating into the plantar arch and heel. Tarsal tunnel syndrome may be under-diagnosed as it sometimes mimics plantar fasciitis or heel spurs.

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