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What Are Dermatomes and Myotomes?

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dermatomes myotomes

The spinal cord and brain make up the central nervous system while the spinal nerves (branching to the spinal cord) and cranial nerves (branching to the brain) make up the peripheral nervous system. There are 31 sets of nerves that extend out of the spinal cord and are connected to it by the nerve root. Each nerve branches out about a half inch from the spinal cord before dividing into smaller branches. The dorsal rami are on the posterior side of the branch while the larger ventral rami are on the anterior side.

The dorsal rami provide nerve function for the skin of the trunk and posterior muscles. The ventral rami from T1 to T12 provide nerve function to the skin of the trunk as well as the lateral and anterior muscles. The anterior divisions that remain for plexuses, networks that provide nerve function to the body. Each plexus has specific areas on the body for skin sensitivity as well as certain muscles. Their point where they exit the spine determines how they are numbered. The four primary plexuses are:

  • Cervical plexus, C1 – C4, innervates the diaphragm, shoulder and neck
  • Brachial plexus, C5 – T1, innervates the upper limbs
  • Lumbar plexus, T12/L1 – L4, innervates the thigh
  • Sacral plexus, L4 – S4, innervates the leg and foot.

These spinal nerves have two sets of fibers: motor and sensory. Motor fibers facilitate movement and provide nerve function to the muscles. Sensory fibers facilitate sensitivities to touch, temperature and other stimuli. They provide nerve function to the skin.

What are Myotomes and Dermatomes?

A group of muscles that is innervated by the motor fibers that stem from a specific nerve root is called a myotome. An area of the skin that is innervated by the sensory fibers that stem from a specific nerve root is called a dermatome. These patterns of myotome and dermatome are almost always identical from person to person. There are occasionally variances, but that is rare. Often first identified by doctors specializing in dermatology and sometimes nerves and/or pain, this consistency allows doctors to treat patients. If a certain area is hurting, they know that it is attributed to a certain myotome or dermatome, whichever the case may be, and its corresponding nerve root. Problems with nerve damage is often the result of stretching the nerve or compressing it. When the nerves are injured in specific areas like the lumbosacral or brachial plexus, it presents as sensory and motor deficits in the limbs that correspond to them. Myotomes and dermatomes are used to assess the extent of damage.

How are Myotomes and Dermatomes used to Assess Nerve Damage?

When a doctor tests for nerve root damage in a patient, he or she will often test the myotomes or dermatomes for the nerves assigned to that location. A dermatome is tested for abnormal sensation, such as hypersensitivity or lack of sensitivity. This is done by using stimulus inducing tools such as a pen, paper clip, pinwheel, fingernails, cotton ball, or pads of the fingers. The patient is instructed to provide feedback regarding their response. Some of the abnormal sensation responses include:

  • Hypoesthesia (decreased sensation).
  • Hyperesthesia (excessive sensation).
  • Anesthesia (loss of sensation).
  • Paresthesia (numbness, tingling, burning sensation).

A myotome is tested for nerve damage in the muscles which presents as muscle weakness. This grading scale, which assigns a rating to the degree of muscle weakness, is often used:

  • 5 – Normal – Complete range of motion against gravity with full resistance
  • 4 – Good – Complete range of motion against gravity with some resistance
  • 3 – Fair – Complete range of motion against gravity with no resistance, active ROM
  • 2 – Poor – Complete range of motion with some assistance and gravity eliminated
  • 1 – Trace – Evidence of slight muscular contraction, no joint motion evident
  • 0 – Zero – No evidence of muscle contraction

During a typical chiropractic exam, your chiropractor will assess both dermatomes and myotomes for potential neurological problems. This gives him or her additional insight on how to treat your condition, whether it’s related to a subluxation of vertebral bodies or other other disease processes.

Why A Pinched Nerve Responds So Well To Chiropractic

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pinched nerve

A pinched nerve is a common complaint that can cause a wide variety of symptoms from pain to numbness. In many cases, the condition can be resolved quickly through chiropractic care; sometimes with just one session. However, chiropractic should be treated as an ongoing practice for better health and wellness. Not only can it help you better manage pain and resolve many health problems, it can also help prevent injuries and certain conditions from developing. This often means that seeking chiropractic for a pinched nerve is a wise decision and can bring a quick resolution.

What is a Pinched Nerve?

A pinched nerve is the result of excessive pressure being applied to a nerve. Which sometimes can be reversed through concussion recovery protocol. This pressure can come from muscles, bones, tendons, or cartilage and causes a disruption in the nerve’s ability to function. This causes a variety of symptoms including pain, numbness, tingling, and weakness.

In the spine, a herniated disc can put pressure on the nerve root, causing pain and discomfort. In the wrist, it can cause a condition known as carpal tunnel syndrome.

Why is a Pinched Nerve so Challenging?

The issue with a pinched nerve is finding the source. When a nerve is pinched, the pain and other symptoms may not be at the actual site. Instead, the pain and other sensations can travel to other parts of the body, including down the leg or through the arm. This can make it difficult to treat, but an experienced, knowledgeable chiropractor can assess the situation and treat the condition, bringing relief to the patient.

What are the Symptoms of a Pinched Nerve?

A pinched nerve can manifest with many different symptoms, often depending on its location in the body. They may worsen while the patient is sleeping. Some of the most common symptoms include:

  • Pain that is aching or sharp
  • Lower or mid back pain
  • Neck pain
  • Shoulder pain
  • General spinal pain
  • Pain that radiates down the leg or arm
  • Numbness or tingling in the legs, arms, fingers, or toes
  • Burning sensation in the legs, arms, fingers, or toes
  • Muscle weakness in the legs or back
  • Headaches
  • Frequently feeling like a hand or food is “asleep”

When the nerve is not pinched for very long, it typically does not leave the patient with any permanent damage. When the pressure is relieved, normal function returns rather quickly. On the other hand, if the pressure is not relieved, it can cause permanent damage to the nerve, leading to chronic pain.

What Causes a Pinched Nerve?

A pinched nerve can have a number of causes. Wrist or rheumatoid arthritis is a common cause, but others may include:

  • Injury
  • Repetitive motion that places stress on parts of the body
  • Obesity
  • Sports activities
  • Certain hobbies that require repetitive motion

What are the Treatments for a Pinched Nerve?

The first line of treatment for a pinched nerve is rest. Medications may be recommended or prescribed, such as NSAIDs and muscle relaxers, but remember every drug has side effects so make sure you talk to your medical doctor before moving forward.

Physical therapy is another common treatment. The patient is taught certain exercises that stretch and strengthen muscles around the pinched nerve so that it relieves pressure. They are also given self-management techniques that they can do at home to get relief. However, if the pinched nerve is do to a misalignment in the spine, it doesn’t matter how many exercises you do; they won’t fix the problem. In severe cases, surgery may be recommended. This is usually a last resort.

Does Chiropractic for a Pinched Nerve Really Work?

Chiropractic care is a very effective treatment for pinched nerve because it addresses the root cause and works toward fixing the problem through spinal manipulation and very specific chiropractic adjustments. By bringing the body into alignment, pressure on the nerves is relieved. This helps relieve the pain, but also facilitates healing allowing the patient to return to their normal daily activities and experience less down time.

Contact our office and schedule an appointment.  We are eager to help you start living your life again.

What Emerald Coast Chiropractic Patients Want To Know About Herniated Discs

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herniated disc

The spine is a very intricate structure and when one component fails to function properly it can affect the entire body, causing pain and loss of mobility. Tiny bones, called vertebrae, are stacked on each other to form the spine. They are joined in such a way to facilitate movement, flexibility, and a wide range of motion. There are small, fluid-filled discs that rest between each vertebra, providing a cushion between the bones. When one of these discs becomes damaged it can affect the surrounding nerves, causing pain and making movement difficult. A herniated disc is one of the most common spinal disc issues, and what kind of herniated disc treatment is employed will depend on the severity and its location.

What is a Herniated Disc?

A herniated disc is a common spinal condition that typically affects the cervical spine (neck region) or the lumbar spine (lower back), although it can occur in any part of the spine. Most often, a herniated disc occurs at the L4 – L5 and at the L5 – S1.  This is because this portion of the spine, the lumbar region, bears the bulk of the body’s weight.

It is often referred to as a ruptured disc or slipped disc and occurs when the disc moves or slips out of place. It can also be the result of a disc that has a small tear and is leaking the jelly-like substance that is inside. This can put pressure on the surrounding nerves, causing pain and discomfort.

What are the Progression and Symptoms of Herniated Disc?

There are four stages of a disc herniation:

  1. Disc protrusion
  2. Prolapsed disc
  3. Disc extrusion
  4. Sequestered disc

The first two stages are called incomplete herniations while the last two stages are called complete herniations.

Symptoms of a herniated disc may increase or worsen as the condition progresses although some patients do not experience any at all Typical symptoms include:

  • Pain in the affected area
  • Tingling
  • Numbness
  • Weakness
  • Leg or arm pain
  • Loss of reflex
  • Loss of mobility
  • Loss of flexibility
  • Decreased range of motion

What Causes Herniated Discs?

A herniated disc can have several causes. The most common are aging and degeneration, overuse, and normal wear and tear on the body.

A herniated disc resulting from an injury or trauma, such as a blow to the back, is less common, but it does happen. Because the back does bear most of the body’s weight, it can put a significant amount of pressure on the spine and discs. Over time, the discs may begin to weaken and a herniation can occur.

Injury or trauma that results in a herniation may include a car accident that involves sudden jerking, or incorrectly lifting heaving objects can put excessive pressure on the spine, causing it to herniate.

How is a Herniated Disc Diagnosed?

A physical examination is usually the first step in diagnosing a herniated disc. The physician or chiropractor will examine the spine while the patient is standing, then while they are lying down. Depending on the severity and location of the herniation, they may note a decrease in spinal curvature.

Radicular pain will also be assessed, when the spine is unmoving, while in motion, and when pressure is applied. Other tests may also be administered. X-rays may also be taken, but an MRI is usually more accurate and provides greater detail.

What are the Treatments for Herniated Discs?

Medications may be recommended or prescribed, including NSAIDs, narcotics, muscle relaxers, and anticonvulsants. Some doctors may advise cortisone injections to reduce inflammation. Physical therapy may be recommended as a stand-alone treatment or in conjunctions with other treatments. Surgery for herniated discs is rare and usually reserved for a last resort option.

Chiropractic has been very effective in helping patients manage their pain and regain their mobility so they can return to their normal life. Therefore, you should visit a physical therapy center first before you go down the road with drugs or surgery.

Contact our office and schedule an appointment.  We are eager to help you start living your life again.

How Emerald Coast Chiropractic Helps AC Joint Pain

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AC joint

When most people think of chiropractors, the first thing that comes to mind is back pain. However, chiropractic care can be used to treat a variety of conditions from joint pain to migraines. When a patient comes in with complaints of pain in the shoulder and restricted motion in the joint, one possible diagnosis may be acromicioclavicular (AC) joint injury. While it is often an injury that is common among athletes, it can happen to anyone. Fortunately, chiropractic is a very effective treatment.

What is an acromioclavicular joint injury?

There are two bones, the clavicle and acromion, that make up the AC joint. Four ligaments hold the joint together. When those ligaments are strained to stressed, it results in an AC joint injury, often causing at least some joint separation. AC injuries fall into one of two categories: overuse and traumatic.

Overuse injury occurs over a period of time and is caused by excessive stress on the joint that is repeated or consistent. This causes damage to the cartilage and can lead to AC joint arthritis.

Traumatic injury occurs when the damaged ligaments cause a disruption of the joint called a shoulder separation. This is different from a shoulder dislocation which involves the actual ball and socket shoulder joint.

What causes acromioclavicular joint injury?

The cause of an AC joint injury depends on the type of injury.

Overuse AC joint injuries is caused by overuse and is commonly seen in people who perform tasks that involve lifting heavy weight (including military or bench presses) or that perform physical labor that involves often stretching their arms over their heads.

Traumatic AC joint injuries are often caused by a fall. The person may fall and land on their shoulder or fall on their hand then they put it out to brace their fall. It is often seen in cyclists who are involved in crashes, football players when they are tackles, or a laborer who falls from a high place, such as a ladder. These injuries are graded from mild to severe, depending on how much the separation there is in the joint.

What are the symptoms of acromioclavicular joint pain?

A patient with AC joint pain may experience the following symptoms:

  • A bump that sits above the shoulder and is easily visible
  • A catching sensation or popping sound when the shoulder moves
  • Pain and swelling in the shoulder
  • Loss of range of motion of the shoulder
  • Loss or decrease in shoulder strength
  • Tenderness and swelling over the AC joint
  • Pain when lying on the affected side
  • Discomfort and pain in the shoulder when performing activities that place stress on the AC joint, including:
    • Carrying heavy objects at the side
    • Reaching across the body
    • Lifting objects overhead

What are the treatments for acromioclavicular joint pain?

Mild cases of traumatic AC joint injuries are often treated with physical therapy and chiropractic. Ice, rest, and immobilization can also be used to manage the pain.

Overuse AC joint injuries can also be treated with immobilization and ice as well as physical therapy and chiropractic. More severe cases may require surgery. Doctors may prescribe muscle relaxants, pain medication, or NSAIDs to help manage the pain.

Is chiropractic for acromioclavicular joint pain effective?

Chiropractic has been proven to be very effective for AC joint pain. The chiropractor performs what is called an AC adjustment which involves manipulation of the shoulder.

While it can be a little uncomfortable for the patient, it is one of the best ways to quickly decrease the pain. After the procedure, the chiropractor may recommend icing the area to minimize or prevent swelling and pain. Regular chiropractic care can ensure continued mobility and continued decrease in pain.

What Emerald Coast Chiropractic Patients Want To Know About Frozen Shoulder Syndrome

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frozen shoulder

The shoulder bears the brunt of a lot of work even in day to day activity. When something goes wrong, it can dramatically impact a person’s quality of life. The joint itself is quite complex with a wide range of motion and that ability can become compromised due to overuse, injury, or age. The goal of the chiropractor is to keep the shoulder moving naturally and ensuring that it is pain free. Frozen shoulder syndrome is one common condition that affects the shoulder, limiting mobility and causing pain. Chiropractic is an effective treatment that helps patients regain range of motion and decrease or eliminate their pain.

What is frozen shoulder?

Frozen shoulder, or adhesive capsulitis, is characterized by pain, stiffness, and limited range of motion of the shoulder joint. It can occur as a result of overuse or after an injury, but can also be caused by diabetes or other diseases or even stroke.

It happens when the tissues that surround the joint become stiff and scar tissue begins to form in the area. Shoulder movements become painful and difficult. It typically has a gradual onset, then goes away just as slowly. It can take a year or longer for the condition to subside.

What are the symptoms of frozen shoulder?

There are three stages of frozen shoulder and from onset to resolution. It develops gradually and subsides just as slowly with each stage lasting several months.

  • Stage 1 – Freezing Stage – The shoulder experiences pain during movement and the range of motion begins to decrease.
  • Stage 2 – Frozen Stage – The shoulder is stiffer but the pain may begin to decrease. However, using becomes increasingly difficult.
  • Stage 3 – Thawing Stage – The shoulder begins to “loosen” and the range of motion begins to return.

Some patients may experience worsening pain at night which can lead to sleep problems.

What causes frozen shoulder?

Frozen shoulder often develops when the patient ceases normal use of the joint due to injury, pain, or a chronic health condition. There is no single cause of frozen shoulder; it can be caused by any problem involving the shoulder that prevents the patient from maintaining full range of motion.

It can also happen when the capsule that encases the connective tissue of the shoulder becomes thick and tight. The movement of the shoulder joint is restricted, impacting its ability to move.

People who are 40 and older tend to be more at risk for frozen shoulder, and it occurs more often in women.

Patients who have had prolonged mobility of the shoulder or their shoulder has been completely immobilized are also at risk. These mobility issues may result from conditions including:

  • Broken arm
  • Surgery recovery
  • Rotator cuff injury
  • Stroke

Certain diseases can also place patients in the high-risk category for frozen shoulder. Some diseases that may increase that risk include:

  • Cardiovascular disease
  • Diabetes
  • Parkinson’s disease
  • Underactive thyroid
  • Tuberculosis
  • Overactive thyroid

How can chiropractic help frozen shoulder?

The primary treatment for frozen shoulder involves pain management and preserving the shoulder’s range of motion. Over the counter pain relievers like NSAIDs and aspirin are often the first line of treatment. Physical therapy may also be used.

In situations where the symptoms persist, more aggressive treatment may be necessary. Doctors may recommend invasive remedies such as surgery and steroid injections.

However, chiropractic can treat the condition from onset through resolution. Even in instances where the symptoms persist, chiropractic can still be very effective. In fact, it can be as effective as more aggressive measures without drugs or invasive procedures. Regular chiropractic care can help return range of motion to the shoulder and return the patient’s quality of life.