Massage and TCM for Frozen Shoulder Syndrome FSS

Frozen Shoulder Syndrome (FSS) also known as adhesive capsulitis, rarely is a result from an underlying illness or pathology. It is fairly common affecting 2-5% of the population and is considered a medical enigma, once cured rarely comes back to the same side. It is often misdiagnosed and Western Medicine defines it as “a stiff shoulder with less than 50% of normal range of active and passive motion in any direction.

 The initial phase maybe characterized by an exquisite sharp catching spasm either spontaneously or due to trauma and pain at night, by phase II the night pain has gone away but ROM has decreased further.

The shoulder ball and socket joint is surrounded by a fluid filled bag containing 35-70ml of synovial fluid. During FSS the capsule thickens and becomes tight, fluid levels drop to 5-10ml of fluid, this is a 75% decrease in fluid. Stiff bands of tissue (referred to as adhesions) may start to develop in and around the capsule due to inflammation. Inflammation may start in the groove behind the biceps tendon, (long head of the biceps also known as the rotator interval).

The stiffness is due to an over reaction of the body to the inflammation. The body then switches off the muscles of the rotator cuff in a coordinated fashion. Without treatment this condition will last an average of 30 months (3yrs). This is fascinating as the body will eventually recover if you are too lazy for the possible treatments that will be discussed later.

The stages are as follows: I) pre-freezing 0-4 weeks II) Freezing 1-8 months

III) Frozen 9-16 months IV)Thawing 12-40 months

FSS is more common in diabetics as 10-20% of the population are affected as opposed to 2-5%, this is due to the accumulation of sugar and alcohol in the tissues and specifically collagen. It is also more common in women than men 60%-40% and of course more common in women going through menopause.

A major factor causing FSS according to Janet Travell, author of “Myofascial Pain and Dysfunction: The Trigger Point Manual” are trigger points in the subscapularis muscle. The subscapularis muscle is one of the four muscles that comprise the rotator cuff. This muscle attaches to the inner surface of the scapula and to the front of the humerus, mainly responsible for holding the humerus in place during arm movements.

Trigger points are sensitive nodules in musculature that cause referred pain. Research shows that the pain referral pattern for the subscapularis is as follows: Pain concentrates on the back of the deltoid, extends back over scapula, then down the back or side of upper arm, pain skips forearm but appears again as a band around the wrist with more intense pain on the back of the wrist.

During phase I a person can reach up but experiences pain reaching backwards so FSS can be referred to as pitchers arm. This article goes into healing with acupuncture and it refers to SI-3 located on the side of the hand, this point is used to alleviate shoulder and upper back pain around scapula. It also stresses having good posture and not slouching or collapsing forward.

Traditional Chinese Medicine

The Chinese term for FSS is “wushi jian”, 50yr shoulder referring to the typical age of onset of the disorder. The Chinese Medicine patterns of FSS are as follows:

• wind-cold-dampness invading
• kidney and liver deficiency 
• and Qi and blood stagnation. 

The meridians associated with the pain referral path of FSS correlate to the Fire Element. Indicating that the fire meridians are weak and not able to warm the shoulder area enough. The invading wind is related to the Wood Element, so these are two elements that you could start looking at while evaluating your client. An herbal formula would contain herbs to vitalize and nourish the blood while dispelling wind and warming the meridians.

One of the earliest Chinese reports of acupuncture for FSS was published in 1991. Zhang Maohai focused on on Pt (yang ling guan) GB-34 located on the leg, needled on the affected side only. He used a deep insertion needling technique (2.0-2.5 cun deep). Followed by rotating and thrusting to get the Qi reaction, needle in the Pt for 30min and maneuvering the needle every 3-5 mins while patient was attempting to move the shoulder joint. The selection of this point is interesting, traditionally GB-34 is indicated for treatment of lower limb disorders, but effects of this Pt are also thought to extend upward along the GB meridian which traverses the costal region of the shoulder. GB-34 is indicated for soothing and moistening the sinews.

Another distal Pt for FSS is ST-38, Tiao kou, located 8 sun below ST-35, one finger width lateral from the anterior border of the tibia. ST-38 is indicated for shoulder pain and specifically adhesive capsulitis. The local Pts proven to be effective for FSS are SI-9 through SI-15, a key point being bing feng SI-12, found at the attachment zone for the shoulder capsule. These points are located over the entire scapula and costal region.

Shoulder issues and specifically FSS will be a common syndrome that clients will come to Massage Therapists with. Alaska Institute of Oriental Medicine, Acupuncture and Massage Therapy teaches a massage treatment for FSS that involves acupressure points.

The protocol is as follows and can be incorporated into a full body massage or just a spot treatment for the affected shoulder.

MASSAGE ACUPRESSURE PROTOCOL:
Warm up the affected arm and hand then treat the Large Intestine (LI) pain pathway: LI-11 located at the elbow crease 8x, move down to the belly of the brachioradialis LI-10 8x, move down 1 cun to the flat tendon LI-9 8x, then down to LI-4 at the thumb crease mountain 8x. Do this pattern 3x then connect LI-11 with LI-4 8x. Then work directly over the scapula on the affected side with the Small Intestine acupressure points SI-9-SI-15 8x each 3x through.

The information presented in this article should provide you with some good guidelines to get you started on your own research.

References:

1) Frozenshoulder.com Neil-Asher technique

2) Acutakehealth.com "The Cure for Frozen Shoulder That No One Talks About" by Sara Calabro

3) "Treatment of Frozen Shoulder Using TCM" by Subhuti Dharmanada, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

4) Alaska Institute of Oriental Medicine, Acupuncture & Massage Therapy, Cynthia McMullen, TCM Instructor

Massage & TCM for Asthma

Asthma is a chronic lung disease which makes lungs have inflamed and narrowed passageways. It can also be life threatening. According to Western medicine, Asthma cannot be cured, but it can be controlled. Recurring periods of wheezing, chest tightness, shortness of breath, and coughing are caused by it. Usually the coughing is worse in the evenings and/or early morning. Asthma can affect people of all ages, but most often begins in childhood. There are over 25 million people affected by asthma in the United States with 7 million of them being children. There is no cure for asthma, but it can be managed with diet, exercise and avoiding the factors that trigger symptoms.

Genetics, allergies, respiratory infections, as well as environmental are all factors that play a role in the development of asthma. People can be born with asthma. If a parent has it, their children are likely to develop it as well. Certain respiratory infections in young children (and in utero) can cause long-term damage to the lungs and result in asthma. Because the immune system is just developing, children are more susceptible to the role the environment plays with asthma as well. Asthma can develop from contact with allergens, irritants, and exposure to viral infections.

Asthma is diagnosed by the doctor asking for a complete history on symptoms such as coughing, wheezing, periods of chest tightness, colds that took more than 10 days to get over, as well as asking about family history and what things seem to trigger the symptoms or make them worse. The doctor will listen to the lungs and also do a test called Spirometry which checks the airways. This test measures how much air and how fast air can be blown out of the lungs after taking a deep breath. The results of the test will be lower than normal if the lungs are inflamed and narrowed or if the muscles in the lungs are tight after the test is completed. Medicine may be given during the test to see if lung function improves.

When a person with normal functioning lungs breathes, the airways are unrestricted and open. There is nothing irritating them, so the air is able to flow freely. A person with asthma has more difficulty breathing because the airways are swollen and sensitive. When a trigger is exposed (such as animal dander, cigarette smoke, colder weather, dust, chemicals, etc), the airway reacts and the muscles around them tighten. This narrows the airway and causes less air to flow into the lungs. The swelling can get worse, making it even harder to breathe. The airways then fill with mucus and air cannot leave the lungs.

A person may experience breathlessness, coughing, chest tightness and wheezing as they are trying to force air out of the lungs. Medicines that can provide short term emergency relief are called bronchodilator inhalers - such as Albuterol or Ventolin. A bronchodilator is a substance that dilates the bronchi and bronchioles which decreases the resistance in the airways and increases airflow to the lungs. This is only short term relief. Long term relief will come in the form of medicines such as corticosteroids, which reduce the swelling of the airways and makes asthma attacks less likely to occur.

In Traditional Chinese Medicine, asthma is called “"xiao chuan", which means wheezing and difficulty breathing. They are both two different symptoms and have two different treatments. It is believed to be caused by deficiencies in the lungs, spleen and kidney from birth or from living an unhealthy lifestyle along. In someone with a family history of asthma there is more kidney organ weakness. With others that have a diagnosis of asthma, they also have digestion problems which can include ear infections, upper respiratory infections and asthma.

The production and storage of phlegm in the lungs is from stagnation of water circulation, which is caused by the imbalance of yin and yang in the lungs, spleen and/or kidneys. Excess phlegm in the lungs is the main cause for asthma attacks. Diet, emotional disturbances, illness, external pathogenic factors (such as cigarette smoke, pollen, etc) as well as heat and cold can be triggers for an asthma attack as well.

There are four patterns of asthma. They are cold type, hot type, lung & spleen Qi deficiency type, and kidney deficiency type.

1.      Cold Type – A feeling of fullness in the chest, watery thin sputum, shortness of breath, not thirsty.

2.      Hot Type – Wheezing, coughing, thick yellow sputum, redness of face, thirsty.

Treatments for these are the use of herbs taken orally, food therapy (specific recipes that are eaten for each type of pattern), auriculotherapy, cupping and acupuncture, with the preferred points being LU-5 through LU-9 for asthma treatments. Intense exercise is not recommended as exercise should be performed at a slower pace, such as with Tai-Chi and Qi-Gong.

Massage is also very beneficial to asthmatics, since it increases pulmonary function. It is contraindicated when the client is experiencing symptoms of an asthma attack.

Good asthma control can prevent chronic and troublesome symptoms, reduce the need for quick relief medicines, help maintain good lung function, maintain a normal activity level, and prevent serious asthma attacks. Avoiding triggers or anything that can worsen asthma is important. Knowing the normal range for peak flow meter readings (a device that shows how well the air is moving out of a person’s lungs) and recording them, is also helpful. Doing these activities along with a healthy diet, can help people with asthma live normal, active, healthy lives.

Food Therapy – Recipes

Ginger Rice Soup: (Cold Type Asthma)
Fresh ginger: 9 grams Cut into very small pieces.
Apricot kernel:  6
Sweet rice: 50 grams
Cook sweet rice and apricot kernels together in water at low temperature; when the rice is very soft, the soup is done. Add ginger to the boiling soup before serving.
Take as breakfast and part of dinner.

Single herbal tea: (Hot Type Asthma)
Kuan dong hua (Coltsfoot Flower) or Kuan dong ye (leaves): one teaspoon –Boil in one cup of water for 30 minutes. Add a little honey to taste.
Niu xin cao: (Cyathula Officinalis):  mix one teaspoon with one cup of boiling water for 10 minutes.  Drink as tea with honey.

White Fungus Mushroom Soup: (Asthma w/Lung & Spleen Deficiency)
White fungus mushroom: soak in warm water for 30 minutes, then tear it into small pieces
Rock sugar: 60 grams
Chicken egg: one (egg white only)
First, cook the mushroom and sugar in water until the mushroom is soft, then filter the mushroom out while the soup is still boiling. Gradually add the egg white into the soup, stirring the soup at the same time. Then serve.

Sources

National Heart, Lung, Blood Institute - http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/treatment.html

 American Lung Association - http://www.lung.org/lung-disease/asthma/learning-more-about-asthma/

 Acufinder – https://www.acufinder.com/Acupuncture+Information/Detail/Treatment+of+Asthma+with+Herbs+and+Acupuncture

 TCM Treatment –  http://www.tcmtreatment.com/images/diseases/bronchial-asthma.htm

 Yang Shen - http://yang-sheng.com/?p=7575

Gastroparesis and Massage

Gastroparesis literally means stomach paralysis. It is a condition where the stomach takes too long to or cannot empty. The muscles of the stomach and intestines are not working normally and affect about 5 million people.

Can massage help? Yes it can, I have read a few blogs and I have a client with Gastroparsis. I was already including an abdominal digestive massage for my client, to which she noticed the difference right away. Then I read the blogs raving over the digestive massage. J I have also added essential oils and tuning forks to certain acupressure points during the massage to help enhance the flow and hopefully increase the effectiveness of the massage to reduce the symptoms of abdominal pain and bloating, nausea, and the emotional pain that goes along with that.

Causes of Gastroparesis are unknown, usually is a secondary cause in systemic diseases below

-          uncontrolled diabetes,

-          Hypothroid

-          Injury to or pinched vagus nerve

-          Viral Nerve

-          Medications, narcotics or anti depressants

-          Nervous systems disorders like Parkinsons or Stroke

-          Multiple Sclerosis

-          Depression (referenced only in TCM)

-          And other rare conditions such as - Amyloidosis, scleroderma

-          Can also be caused by viral infection

Symptoms

-     Heartburn or “GERD”,

-     Nausea,

-     Vomiting undigested food,  

-     Feeling full quickly when eating,

-     Abdominal bloating and pain,
Poor appetite and weight loss,

-     Unstable blood sugar levels

-     Brain “fog”.

Complications

• Food that stays in stomach to long can ferment lead to growth of bad bacteria
• Food in the stomach can harden and solidify into a “Bezoar”, which can cause obstruction in the stomach limiting the food to pass into the small intestine
• People with diabetes and Gastroparesis have more difficulty controlling blood sugar.

Diagnosis  

• Blood tests  to test blood sugar levels
• Barin X ray
• Radioisotope gastric- emptying scan - Radioactive substances swallowed  

• Gastric Manometry –  a tube is sent down the esophagus to the stomach and meaures the speed of digest
• Electrogastrography -  Speed of digest through electrolosis
• The smart pill  - speed of travel through the digestive system
• Ultrasound
• Upper endoscopy – a thin tube down the esophagus that examines the stomach lining.

Treatment is very limited and there is no known cure in western medicine. Gastroperisis is normally associated with other diseases and considered as a complication of such, like diabetes and hypothyroidism.

Suggested options of treatment would be to look at diet. Fats cause delay in metabolism as with high fiber vegetables, for example cabbage and broccoli. On the other hand liquids and warm substances speed up metabolism. Small frequent meals with soups or smoothies would be the best for people with Gastropersis. You can add the higher fats into the smoothes and the higher fiber vegetables into well cooked soups! I have heard and read “become friends with soups and smoothies”

The third option for treatment is to medicate to “turn on” the stomach churn (muscle) and speed up metabolism.

Last and final option is surgery which includes procedures to empty and lastly to bypass the non-empting stomach.

Traditional Chinese Medicine (TCM) sees this condition as a Wood/Earth disharmony. Wood and Earth are two of five Elements looked at in TCM. Gastroparesis is sometimes diagnosed as Food Stagnation. I have also found that the stomach is not only where food is digested but also ideas, thoughts and emotions. This follows what the Chinese believe.

The Chinese Liver is responsible for the smooth flow of everything in your body, including your emotions and digestion. So when that flow of anything is impaired the Chinese Spleen, responsible for digestion of anything is weakened and therefore compromised.

So what came first the chicken or the egg? Does it matter? NO!! In TCM the general disharmony is harmonized therefore resolving all symptoms!!  To compliment this theory the Chinese see the Liver as the seat of the emotion “anger”. Western psychology and Chinese theory suggests depression is anger turned inward therefore flow is restricted!!

TCM treatment

An herbal formula can be prescribed for Gastroparesis is Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia with Poria Decoction)   

Formula Action

-          Harmonizes the Stomach

-          Stops Vomiting

-          Dispels Phlegm

-          Regulates water circulation

-          Disperses Stagnation

   

Acupuncture or acupressure is also helpful with dispersing stagnation and harmonizing flow. 

These points are suggested CV 14 (disperses phlegm), 

                                      CV 12 (Alarm-Mu point for stomach) 

                                      St 36 (Rectifies stomach and spleen and other intestinal conditions)

                                      St 25(Alarm-mu point for large intestine)  

Diet on the TCM side would consider foods that calm the wood element down and then help strengthen the Earth element all dependant on the clients condition at the time.

And once all Five Elements are back in balance condition should rectify itself with client able to function a healthy normal life!! :-) 

References

Webmd.com

Gicare.com/diseases/gastroparesis

Blog. Adventures with Gastroparsesis

Blog. Dr Shan Kong acupuncture

acupuntureinthepark.com/health-conditions

americandragon.com

http://www.motilitysociety.org/clinician/manuscripts/trtment_of_gastroparesis.pdf                

Massage for Machado-Joseph Disease

By Starla Brewer, student

Simply put hereditary ataxia is defined as the inability to maintain muscle control and smooth movement as a result of some kind of genetic abnormality. However few things are this simple and Machado Joseph Disease is one of them. Machado Joseph disease is something my husband’s family has dealt with for many years and I have researched diligently over the course of 15 years. When I was given the assignment to choose a pathology and write a blog about the effects of massage therapy on that pathology I knew immediately what my subject matter would be. I thought with all of the advancements in the past 5 years since the last time (and death of my husband’s last remaining sibling we had contact with) I had done any real research. I also thought with the fast growing interest in complementary medicine modalities and insurance companies now paying for treatments such as massage therapy and acupuncture I would find some information. How sorely wrong I was! Yes, great advances have been made in diagnosis and identifying the cause of this as well as all other forms of hereditary ataxias including DNA testing. 

Machado-Joseph Disease- also known as Type 3 spinocerebellar ataxia is a dominantly inherited progressive, often fatal form of ataxia. People with MJD have difficulty with speech and eventually swallowing. Their gait is a lurching staggering with lack of balance that makes them appear to be drunk. Some can develop symptoms resembling those of Parkinson’s disease. The symptoms of MJD can have a very wide range due to the repeated expansion of the the ATXN3 gene. MJB is one of about 30 autosomal dominant inherited ataxias. There are three subtypes of these ataxias listed as fallows in article Machado-Joseph Disease: from first descriptions to new perspectives By: Conceição Bettencourt and Manuela Lima at Orphanet Journal of Rare Diseases. “these subtypes can be divided into three major categories: 1) "polyglutamine" ataxias, caused by CAG repeat expansions that encode a pure repeat of the amino acid glutamine in the corresponding protein; 2) non-coding repeat ataxias, caused by repeat expansions falling outside of the protein-coding region of the respective disease genes; and 3) ataxias caused by conventional mutations in specific genes (deletion, missense, nonsense, and splice site mutations)”.  While onset, life expectancy, neuroligcal signs and the degree of incapacity can very widely they all have in common the degeneration of the cerebellum and resulting loss of muscle control. With only 1-5:100,000 people having one of these ataxias there have been few treatment studies done. The focus has been identification and diagnosis testing leaving very little information about treatment. For this reason I am addressing them as a whole.

Until recently western medicine has done very little to address treatment. Typical treatment plans have been focused on drugs to reduce spasticity and rigidity of muscles, with supportive care using assistive devises such as canes, walkers and wheelchairs and occasionally physical therapy. A case report published in the International Journal of Therapeutic Massage & Bodywork titled Gait Characteristics, Range of Motion, and Spasticity Changes in Response to Massage in a Person with Incomplete Spinal Cord Injury: Case Report drew the fallowing conclusion “Positive changes in gait speed, stride length, and swing and stance phase percentages were observed in one person with incomplete AIS(D) SCI after specific application of MT. Further study is war- ranted to determine the extent to which massage may affect musculoskeletal and neural impairments that limit gait in people with incomplete SCI, and the methods or routines that, when applied, will yield the most benefit. “. I have talked to family members with MJD and people with these ataxias in forums. Many have been told nothing of massage or that massage would be ineffective or have other pathologies that make massage contra indicated. Those that have tried massage focus only on a general relaxation and pain management. Of those who reported using massage to relax the results varied widely. Most felt a short lived relief of muscle rigidity and spasms lasting up to 72 hours after the massage. One said they found a 30 minute head and neck massage seemed to improve their balance and ability to focus on muscle control.

 Thomas L. Clouse M.D. who has Spinocerebellar Ataxia (SCA-14) has come up with some very promising results using exercise and positive thought processes. And offer the most advice I have found thus far with detailed descriptions of how people with ataxia can’t slow dow the progression of the disease but, can maintain mobility and a higher quality of life longer. I am going to continue researching this topic and will update when more information of how massage can affect those with hereditary ataxias. 

SOURCES:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123549/

http://treato.com/Ataxia,Massage/?pix=2

http://www.ninds.nih.gov/disorders/machado_joseph/machado_joseph.htm

http://rarediseases.org/rare-disease-information/rare-diseases/byID/110/viewFullReport

http://www.disabled-world.com/disability/types/sca.php

http://www.ncbi.nlm.nih.gov/books/NBK1138/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3088529/

http://walkingwithataxia.com/MY%20JOURNEY.htm

Huntington's Disease

Western medicine describes Huntington’s disease (HD) as a defect of chromosome 4 that affects a persons’ ability to feel, think, and move. Caused by a degeneration of nerve cells in the brain, symptoms vary from person to person depending on what starts degenerating first. The defect that causes all of this damage is found in DNA called the CAG, with any slight mutation, it causes it to repeat more than necessary. On average, a persons’ CAG repeats around twenty times, with HD, repeats can happen more than double the average number.
An inherited or familial disease, it is passed down through generation to generation. Depending on whether the gene passed down was dominant or recessive, you have a fifty percent chance of getting HD along with a fifty present chance of passing it down to your children. HD can also happen sporadically during sperm development causing the mutation that will give the person Huntington’s down the road.
First named Chorea which is one of many symptoms of HD, later to be studied and described by George Huntington of which the disease is named after. Symptoms most commonly start becoming noticeable in adulthood, however; cases of early onset symptoms appearing in childhood to teen years have happened.

The wide array of symptoms includes:

-Behavioral disturbances

-Hallucinations

-Irritability

-Moodiness/ mood swings

-Restlessness/ fidgeting

-Paranoia

-Psychosis

-Abnormal and unusual uncontrolled movements (Chorea) including:

·       Facial grimaces, head turning, eye shifting/position, quick/sudden/jerky/slow movements of fingers, feet, arms, legs, face, and torso

·       Unsteady gait/clumsiness/lack or balance/stumbling/uncoordinated

-Dementia

-Disorientation/confusion

-Loss of judgment

-Loss of memory

-Personality change

-Speech change/impairment

-Anxiety/stress/tension

-Difficulty swallowing/eating

-Rigidity

-Tremors

-Apathetic

-Passive

-Depressed

-Angry/hostile outbursts

-Trouble with driving/learning new things/answering questions/making decisions

-Difficulty changing clothes

-Changes in handwriting

-Problems with walking/ falls a lot

Symptoms start out slow then progressively get worse over time.

Diagnosis maybe be difficult, numerous steps must be taken before being clinically diagnosed such as: medical and family history will be evaluated, testing intellect and emotion stability, testing movement/balance/and coordination along with strength, sensation, and reflexes. Blood tests will be drawn to examine chromosomes in blood. Brain scans will also be taken such as; CT, MRI, and occasionally PET scan.
There is no known cure for HD only medications that help and/or slow symptoms from progressing. Life expectancy when symptoms start to arise is around ten to thirty years. Cause of death can range from infection, injury, and suicide.
Little research has been done whether traditional Chinese medicine helps with HD, although; I was able to find a case study of a professor who suffered from HD and received acupuncture. After examining his medical history, pulse, and tongue; the acupuncturist diagnosed him with quote “Qi and blood stagnation, internal wind, spleen and kidney deficiency.”  Treatments happened two times a week and after five weeks of treatment there was a noticeable difference in being able to walk better, dress dependently, and an increased ability to read more. Key points were found on scalp along with other points along body.

Resources:

"50/50: A Huntington's Disease Documentary with Shana Martin." YouTube. YouTube, n.d. Web. 20 June 2014.

"Acupuncture for Huntington's Disease." Gancaonet RSS 20. N.p., n.d. Web. 20 June 2014.

Board, A.D.A.M. Editorial. "Huntington's Disease." Huntington Disease. U.S. National Library of Medicine, 28 May 2013. Web. 19 June 2014.

"CBS Special on Huntington's Disease/Chris Furbee." YouTube. YouTube, n.d. Web. 20 June 2014.

"Huntington's Disease: Read About Treatment Options." MedicineNet. Medicinenet.com, 15 Apr. 2014. Web. 19 June 2014.

" ." Huntington's Disease Society of America. N.p., 2014. Web. 20 June 2014.

Massage and Scoliosis

An abnormal curvature of a person's spine is classified as scoliosis. This spinal deformity reportedly affects over six million people around the US. About 80% of all cases show and develop during infancy and adolescents (between the ages of 4-15) which is when our spines experience the most growth. Adults can be diagnosed with scoliosis but most health care professionals believe it was just missed during childhood. As the research continues, there are some theories as to how this deformity is caused including: connective tissue disorders, nervous system abnormalities, hormonal imbalances, genetic factors, or consistent physical or emotional stress. Sometimes scoliosis can have an adult onset originating from a car accident or other physical traumas or stress to the body.

This condition can be in a correctable/functional or permanent state. Functional Scoliosis is a structurally fine spine that appears curved from other structural issues within the body such as: different leg lengths or inflammatory conditions including appendicitis. Any child or adult can develop functional scoliosis by leaning more on one leg than the other while standing if it becomes a true habit.

Though Scoliosis is said to be idiopathic (not having a known cause), manual therapists that are trained structurally have found that many idiopathic scoliosis cases which were labeled as permanent were actually caused by an unleved/unbalanced sacral or cranial base. Today, termed idiopathic scoliosis cases are popping up less and less. Resent studies are showing that lowered bone density is playing a large part in these deformities.

These uncomfortable curves can develop either in the thoracic or lumbar spine, although thoracic abnormalities are more likely to progress than in the lumbar region. An irregular 10 degree misalignment of the spine is considered a mild case. Once the curve has reached 70 degrees off the optimal straight alignment, it can cause the rib cage to push up against the heart and lungs. This can make it very difficult to breath and makes the hearts job intensely difficult. These curves cause one side of the spine's muscles to shorten and the opposite side to become elongated and weakened. This can bring on back pain, sciatic, and headaches.

Western medicine has three choices of action to take: Observation, Orthopedic bracing, and/or surgery. Observation is used for mild cases and is the simple act of watching to make sure the deformities don't progress. Orthopedic bracing is the updated version of the non-removable torso cast that used to be implemented. The brace is the most common treatment and doesn't improve the state of the curve but keeps it from worsening. This is mostly applied during the child's spinal growth phase and can only be removed for one hour each day or night. Surgery is used to stabilize the spine in severe cases. Small pieces of bone are removed from the patient's pelvis, placed between their vertebrae, and held in place by metal rods, hooks, and wires until the bones fuse together.

MASSAGE CHOICES
Alternative approaches are not quite as invasive or uncomfortable! Cranial-Sacral Therapy can be very helpful in restoring some mobilization of the body and bringing balance back to the spine. This therapy is a gentle manipulation and mobilization of the fascia with gentle traction along with it. Deep Tissue massage and Tui Na with assisted stretching can relieve muscular pain and enhance circulation. By elongating the shortened side of the spine with deep techniques, it can relax the spine and take away some of the strained or pulling feel in the back. Deep work on the overstretched side of the spine covering the ribs is contraindicated.

By: Madison Nicolet-Lloyd

Resources:

http://www.integrativehealthcare.org/mt/archives/2008/04/two_massage_the.html

http://erikdalton.com/media/published-articles/scoliosis-and-massage-therapy/