Massage & Bodywork


Issue link:

Contents of this Issue


Page 90 of 117

88 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 7 technique MYOSKELETAL ALIGNMENT TECHNIQUES A crick in the neck is a common complaint among clients seeking manual therapy. This informal umbrella term can refer to symptoms that range from general cervical stiffness to complete immobility and unrelenting pain. When assessing cricks, therapists trained in myoskeletal alignment techniques (MAT) engage the client's nervous system through active and passive movements, observing for range-of-motion limitations and local or referred pain patterns (Image 1). Some clients might report general neck stiffness, whereas others may experience radiating pain that limits their ability to rotate the head in one or more directions. A thorough history intake usually reveals helpful clues to possible neck crick etiology, but not always. During the intake process, you may learn that many chronic pain clients carry a diagnosis of osteoarthritis and degenerative disc disease, and are convinced these abnormalities are responsible for their pain (Image 2). Although these medical terms do sound scary, they are, in fact, part of the normal aging progression of the human spine and, depending on how the brain perceives the threat, may or may not be actual pain generators. It's not unusual for clients diagnosed with a degenerating spine to tie the pathology to the pain, but this kind of mental connection often causes much unneeded worry and stress. When working with these clients, it is best not to dramatize, catastrophize, or blame their pain on the pathology. The therapist must try to avoid words or graphic images that may trigger fear and possibly induce the nocebo effect. The opposite of the placebo effect, the nocebo effect occurs when negative beliefs and expectations influence a situation in a negative way. This is not to say therapists should avoid the study of orthopedic terminology. In my opinion, the more the therapist knows, the safer the client and the practitioner. Without an understanding of terminology, it's difficult to visualize how neck cricks due to a degenerating spine can progress from protective muscle spasm to pain—and even more difficult to learn to derail the crick in its early stages. So, from one professional to another, let's discuss a common example of how a simple neck crick might progress from a spasm, to degeneration, to full-blown pain. STAGE 1: MECHANICAL COMPRESSION The client begins noticing neck stiffness and loss of range of motion, but no pain. As joint, ligament, and deep spinal groove muscles lose their ability to perform normal smooth gliding movements, Crick in the Neck From Pathology to Pain By Erik Dalton, PhD The therapist's left thumb and fingers palpate each cervical vertebra while the right hand flexes, extends, rotates, and sidebends the client's head and neck, examining for motion restrictions. Degenerative joint disease may or may not cause pain. Compressed disc Bulging disc Herniated disc Disc degeneration and bone spurring 1 2

Articles in this issue

Archives of this issue

view archives of Massage & Bodywork - NOVEMBER | DECEMBER 2017