Epi-Perineurial Anatomy, Innervation, And Axonal Nociceptive Mechanisms

Body workers from all disciplines appreciate that maneuvers that move nerves often reproduce radiating pain. This symptom reproduction has important implications for the diagnosis and management of radiating pain symptoms. In the presentation at Fascia 2007 from which this manuscript is derived, two videos that were obtained with high resolution diagnostic ultrasound were presented that clearly showed median nerve gliding during normal finger and wrist movements. The movements were independent of the movements of the other surrounding structures. Such movements of the interface between the nerve and the surrounding structures constitute but one mechanical stimulus that nerves are susceptible to. Nerves are also bent around various structures, and indented by external pressures. Nerves have many anatomical features that allow them to accommodate such movements and mechanical stimuli. The reader is directed to books by Shacklock (Shacklock 2005) and Butler (Butler 2000) for full descriptions of nerve biomechanics

Long Lasting Recruitment Of Immune cells And Altered Epiperineurial Thickness In Focal Nerve Inflammation Induced By Complete Freund\u27s Adjuvant

Immune-mediated nerve inflammation is involved in many painful states in humans, and causes axonal and behavioral changes in rats. While models of nerve inflammation have been characterized using electrophysiological and behavioral methods, the presence of immune cells has not been fully assessed. We inflamed rat sciatic nerves using complete Freund\u27s adjuvant and quantified the presence of ED-1 macrophages and TCR-αβ T-cells for up to 12 weeks. We report that these immune cells are prominent extraneurally up to 12 weeks following the induction of inflammation. This observation does not easily correlate with inflammation-induced axonal mechanical sensitivity, which peaks within 1 week and is resolved after 8 weeks

The Clinical Relevance Of Ectopic Axonal Sensitivity

Dr. Geoffrey Bove gives a presentation on the translation into clinical practice of his research on the effect of inflammation and altered axoplasmic flow on nociceptor axons.https://dune.une.edu/biomed_facpres/1002/thumbnail.jp

A Non-invasive Method To Evaluate Gastrointestinal Transit Behaviour In Rat

Introduction: Many factors alter gastrointestinal transit. Animal models are useful for preclinical studies of gastrointestinal transit, but terminal methods do not allow later study, and stressful assessment methods will likely alter the transit of the animal. To overcome these factors, we developed a new method to assay rat total gastrointestinal transit. Methods: Standard plastic cages with their bottoms cut off were placed on wire mesh floors. Custom apparatuses were built to contain fecal pellets as they fell through the floors. Webcams connected to a computer running a security program were placed to image the pellets at regular intervals. Custom food was obtained with and without blue pigment. After habituating to the cages and the non-pigmented food, the pigmented food was administered. The duration to the appearance of the first pigmented pellet was determined by reviewing the photographs. This duration represents the complete gastrointestinal behavior, including feeding. We compared 24-hour fecal pellet counts using images to counts by visual inspection, and also made hourly counts. After establishing baseline transit times and hourly fecal pellet discharge, rats were given buprenorphine, known to alter gastrointestinal transit. Transit times and hourly discharge were obtained again and compared to the baselines. Results: The methods were successful in determining transit times. Baseline measures were consistent between three groups of 8 rats. Visual and image-based counts were highly correlated. Transit times and hourly pellet discharge were reduced by buprenorphine. Discussion: The described method offers a relatively simple, inexpensive, and non-invasive means to measure rat gastrointestinal behaviour. The method has potential for any studies where altered total gastrointestinal transit is an experimental concern

[Correspondence] A lesson from classic British literature

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Family Physicians, Chiropractors, And Back Pain

In this article, major aspects of back care provided to patients by family physicians and chiropractors are reviewed, and the recent guidelines on spinal manipulation therapy are discussed. These guidelines should be useful for family physicians wishing to refer patients to chiropractors

Anatomy And Neurobiology Of Pain

This chapter examines some of the basic human anatomy and neurobiology related to the perception of pain. In this context we will discuss how the nervous, endocrine, and musculoskeletal/fascial systems all contribute to our experience of this important sensation. We will look at some of the pathologic changes that occur when short-term pain becomes a long-term problem, and how stress can exacerbate pain perception. Finally, we will discuss how manual therapies may access peripheral nervous system structures in order to address some of the factors that can contribute to chronic pain patterns

Lessons From The Conference: “Highlighting Massage Therapy In Complementary And Integrative Medicine”

A landmark conference, Highlighting Massage Therapy in Complimentary and Integrative Medicine, was held in Seattle, Washington, on May 13th–15th, 2010. The conference was designed to address the status of research related to massage therapy, as well as to have an open discussion regarding attitudes towards research and professional issues. Leaders from diverse manual therapy professions presented interesting and important data. The itinerary and summaries of the meeting can be found at http://www.massagetherapyfoundation.org/researchconference2010.html. In this brief report, rather than summarizing the presentations, we will share a combination of our observations and impressions, as well as suggestions for the direction of massage therapy research

A Pilot Study Of The Prevalence Of Leg Pain Among Women With Endometriosis

Radiating leg pain is a common symptom presenting in manual therapy practices. Although this symptom has been reported as a complication of endometriosis, its prevalence and characteristics have not been studied. We surveyed members of a national endometriosis support group with endometriosis using a self-administered, mailed questionnaire. The main outcome measures were the prevalence and characteristics of leg pain. Of 94 respondents, leg pain was reported by 48 women (51%), and was bilateral in 59% of these symptomatic women. The likelihood of experiencing leg pain was related to weight gain since age 18, age, and height. The most common treatments tried included exercise, over-the-counter medications, and massage therapy, all with variable results. These data support leg pain as a prevalent complication of endometriosis, and that the disease may affect multiple peripheral nerves. Manual therapists should remain aware to this possible etiology for radiating pain

Complementary And Integrative Approaches For Pain Management

Many people around the world use health care approaches that were developed outside conventional allopathic medicine. More than 30% of adults in the United States, with similar numbers in Europe, utilize complementary health approaches [20,47]. Chronic pain, particularly musculoskeletal pain, is one of the most common reasons for individuals to use complementary health care approaches. It is estimated that more than 40% of individuals with chronic musculoskeletal pain try some form of complementary therapy [21]. Chronic pain has become a health crisis in the United States and around the world. It is estimated that the prevalence of chronic pain (defined as chronic, recurrent, or long-lasting pain continuing for at least 6 months) is more than 30% in women and more than 25% in men [39]. Pain is most commonly treated using pharmacotherapy, but with the growing opioid epidemic, it is important to examine the use of nonpharmacological therapies to treat pain. Rather than giving an overview of all complementary practices, this course will focus on three nonpharmacological approaches to treating chronic pain that have shown significant clinical effects— cognitive-behavioral therapies, manual therapies, and yoga therapy—and discuss mechanisms that may underlie their effectiveness