Two types of muscles exist in the body, and they are voluntary or the ones that we can move and involuntary or those that move on their own like the digestive and heart muscles. Both can be made stronger and more resilient through exercise and physical activity. We’re shall focus on the voluntary muscles that move and support the spine.
When there is a lack of muscle strength and flexibility it can create an environment for back pain. The muscles connect to the bones through the tendons. When contracted the signal concentrates through the tendon, and moves the bone/s. The tendons are attached to the bones. When the tendons get inflamed, tendonitis can occur even in the spine.
Muscle layers
Some go deeper while others are more superficial and at the surface. The deeper muscles are the ones that stabilize and secure the bones. The abdominal muscles along with the hips and legs can play a part in back pain/problems.
A doctor might have told you that to have a healthy spine. That is great news, however, we all need to build a strong core, which includes the abdominal muscles, to help stabilize the entire torso. There are four types of abdominal muscles.
The Corset
The deepest is the transversus abdominis, which wraps around your body just like a corset. These muscles contract if you place your hands on your waist and cough. On the sides of your body, there are two sets of oblique muscles. The internal obliques go deeper, while the external obliques are closer to the surface. The obliques enable us to twist and bend from side to side.
The Six-Pack
And of course, there is the rectus abdominis which we all know as the six-pack. These can be sculpted into the washboard abs but they do not help in stabilizing the spine/back. The job of the abs is to pull you forward like when doing sit-ups and crunches.
They do help compress the deeper ab muscles, but to stabilize the spine, you want to strengthen the deepest ab muscles. The corset, internal obliques, and back muscles are the ones you want to work. One of the most effective ab and back workouts is Pilates. It targets all abdominal and spine muscles in a gentle way.
Flexors
Within the body are two muscles on either side of the body, called the iliopsoas muscles, or the psoas (so-as). These are the hip and thigh flexors which lift the thighs like when�walking, going upstairs.
When in a stationary position, the psoas enables you to bend forward or flex the hips. When sitting, the psoas stabilizes the spine into an upright position. It is one of the largest and thickest muscles, and it extends from your lumbar vertebrae, crosses in front of each hip, and attaches on the inside top of the thigh bone. When we sit for long periods it constricts or shortens the psoas, which causes soreness/pain when you stand.
Layers
Spinal muscles are made up of layers. The deepest are small and are attached one vertebra to another. The deepest level are the interspinalis muscles, which connect the spinous processes; thank them for helping you stretch backward.
The transversospinalis group forms a chevron pattern along the back and helps with side bending, twisting, and assists in back bending. The next layer up is the erector spinae. The main job of this group is bending, but also assist with�bending to the side . When muscle spasms occur, it’s often the erector spinae muscles.
The next level consists of the rhomboids. These are situated between the shoulder blades. Exercise or physical therapy can realign the vertebrae if there is upper back, shoulder and neck pain. The wings on either side of the back are called latissmius dorsi. These stabilize the back and help in doing all kinds of activities, like pull-ups.
Next are the trapezius (traps) muscles that extend from your neck and midback to the shoulders. These muscles help move your neck and lift the shoulder blades. When there is tension, there is a tendency to lift our shoulders, which is what makes these muscles tight and sore. It�s never too late to increase strength and flexibility. Look at activities that you and your friends/family can enjoy and turn them into a regular thing.
Athletes and Custom Foot Orthotics
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A�chiropractor�is the ideal�medical professional to consult with for any unexplained pain in the musculoskeletal system. They are highly qualified professionals that their specialty is treating conditions like lower back pain and they are very affordable. If you or a loved one have pain give us a call. We�re here to help!
Here are a few questions that most new patients have along with the answers about chiropractic adjustments, how they work, what they do and what to expect when visiting a chiropractor.
How do adjustments work?
Chiropractic adjustments are painless, but there is soreness from the massage, the working out of trigger points, knots and from the realignment of the spine into its proper position. New chiropractic patients sometimes involuntarily stiffen or fight the adjustment and feel some discomfort. However, once they relax the treatment will go very smoothly.
If the patient has gone through recent trauma like a car accident or personal injury where whiplash or inflammation has set in then there will be some pain. This is completely normal. However,�once the adjustment has been completed patients report feeling relief, calmness, a sense of well-being, and improved mobility.
During an adjustment what is that pop?
When the vertebrae are realigned, there are small pockets of gas that get released from the joints, which is what makes that pop. It is the same sound heard when knuckles are popped. This pop does not happen with all patients. But it does not mean that the adjustments are working/not working. It is not necessary to have a pop to mean that the treatment is working.
Professional Vietnamese chiropractor doing pushing motion to adjust the spine of a male patient
How safe are these adjustments?
There are several research studies documenting the safety and effectiveness of chiropractic treatment. Chiropractic is far safer than taking medication/s or surgery. Complications from chiropractic are very rare.
Question Is self-adjustment possible?
Absolutely not, chiropractic adjustments and treatment need to be performed by a qualified professional. Remember this is your spine when it’s out of place you don’t want to try to shove it back into place. A medical practitioner that knows the body’s anatomy, especially the spine is who you want working on your spine. This is exactly what chiropractors are specifically trained to do.�
Can other professionals perform these adjustments?
Yes, there are osteopaths or doctors of osteopathic medicineDO’s that are trained to perform these techniques. But usually, they are chiropractors themselves or have chiropractic training but are not using that title in their practice. Chiropractors perform 97% of all adjustments in the country. Be mindful of pain therapists, massage therapists, or so-called healers that claim that they can perform spinal adjustments but do not have the credentials, qualifications, and experience.
What conditions do adjustments help with?
Chiropractic medicine involves precise restoring/realignment of the spine that will allow for correct function and proper movement. Chiropractic helps with:
Repetitive Movement Injuries like carpal tunnel, golfer/tennis elbow
Sciatica
Scoliosis
Sports injuries
Sprained�muscles, joints, and ligaments
Stiffness in the neck, shoulders, back, arms, hands, chest, abdomen, hips, legs, feet
Strained�muscles, joints, and ligaments
Tendonitis� inflammation of soft tissues
Trauma to the body like whiplash from an accident, sports injury, personal injury
Work injuries, falls, slips, lifting, twisting
Question What if surgery is needed?
New guidelines have been issued�and emphasize that the first response for conditions and injuries should be conservative care. Because of the opioid crisis, non-invasive/surgical treatment has been deemed the approach to take with pain meds and surgery as a last resort. However, chiropractors are trained to recognize an injury that they are not able to work on and will refer a patient to the appropriate medical specialist when necessary.
Lower Back Pain Chiropractic Treatment El Paso, TX
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A chiropractic adjustment�can be a great way to improve multiple areas of the body, along with improving overall health with non-invasive treatment. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers and premiere rehabilitation�providers to bring El Paso the top clinical treatments to our community.��Providing high non-invasive protocols is our priority. For any questions, you may have about treatments, please feel free to call Dr. Jimenez at 915-850-0900 or 915-412-6677.
Spinal Cord Injuries Are Not Only Caused by Trauma
When people think of spinal cord injury/s or SCI’s, traumatic events like a major auto accident, hard fall, severe sports injury or intense work injury come to mind. It is true that auto accidents are the leading cause, however, non-traumatic accidents and diseases like a spinal tumor can also cause spinal cord injuries.
These types of injuries involve damage to the spinal cord that can temporarily or permanently affect its functionality. Spinal cord injuries are divided into 2 categories: traumatic and non-traumatic. Even with non-traumatic injuries the impact or severity is not lessened and the aftermath can have a devastating effect on a person�s life.
Spinal Cord Injury Trauma
Vehicle crashes: Motor vehicle accidents are the leading cause of traumatic spinal cord injuries, and they account for 40% of all SCI’s.
Falls: Falls are the second cause of traumatic spinal cord injuries, and they account for 32% of injuries.
Violence: Violent acts, like gunshot wounds or a stabbing cause around 14% of spinal cord injuries.
Spinal cord injuries occur more in men than women with 80% of cases affecting men.
Although people of all ages can experience SCI, there are activities/events that increase the risk that affects different age groups more than others. An example is high-impact actions like motor vehicle accidents and sports injuries occur more in young adults. Conversely, spinal cord injuries caused by a fall happens more in adults over age 60.
Regardless, SCI occurs more in the neck or cervical spine. Around 60% of cases involve the neck, followed by the mid-back or thoracic spine that averages to around 32% of injuries. Although most people experience low-back pain, only 9% of spinal injuries occur in the low back and tailbone or lumbosacral spine.
Understanding SCI Trauma
Damage to the spinal cord not only affects the area where the point of impact occurred. The primary injury can also damage cells, dislocate the vertebrae and cause spinal compression. It can also trigger secondary injuries, that cause a series of biological changes. This can happen within weeks or months after the injury.
The secondary injury cascade processes:
Glial cells along with the nerve cells in the spinal cord begin to die. These cells provide nutrients and other support to the nerve cells in the central nervous system. This consists of the brain and spinal cord.
The blood vessels in the spinal cord lose their ability to function, and this reduces the blood supply to the cord. When the blood supply becomes inadequate it is called ischemia. Blood vessel injuries expose the cord to inflammatory cells that in turn cause swelling. When the spinal cord becomes inflamed the spinal cord gets more and more compressed. If this happens�the initial injury progressively worsens.
This changes the cord�s structure and its normal operation. The secondary injury cascade can interfere with the cord�s ability to heal itself. This means an individual could experience permanent nerve pain and dysfunction.
Non-traumatic SCI
Spinal cord damage does not only happen with traumatic events. An SCI can also be caused by non-traumatic diseases in the spine. Tumors are the leading cause, but infections and degenerative disc disease can also cause serious damage.
Non-traumatic SCI’s happen more than traumatic based ones. �The incidence of traumatic SCI in North America comes to around 54 cases per one million people. With the incidence of non-traumatic SCI is around 1,227 cases per million people.
Healthy Spinal Cord Injury Outcomes
Spine researchers are making great strides in developing optimal protective and regenerative treatments to improve spinal cord health after these injuries occur.
Currently, innovative medical, surgical, cell-based and alternative treatments are furthering the medical community�s understanding of SCI’s. This is dramatically improving the quality of life and creating positive futures for individuals who experience these injuries.
Car Accident Injury Rehabilitation | El Paso, Tx (2020)
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The muscles in the back keep the spine moving and functioning properly.�When the spine or�abdominal muscles are�weak this creates a higher probability of a back strain or injury. Having strong, healthy spine muscles are important because they function in maintaining correct posture, which in some cases, causes chronic back pain because of poor posture.
If�only one part of the body is�strengthened like the back is not enough. Therefore strengthening the rest of the body is a must. These include the body�s core and leg muscles. Total body strength will reduce back pain and can help perform regular activities, like�lifting heavy objects much easier, with more confidence and with a lesser probability of injury.
Q: Dr. Jimenez, I read one of your articles about physical therapy and spinal stenosis exercises that focus on stretches for relieving pain. I was wondering if it was also possible to do aerobic exercise with a spinal condition and can you recommend a safe cardiovascular program?
I’m a 65-year-old with spinal stenosis, and I want to stay in shape. I try to ride a stationary bike for 20 minutes at least 2 times a week, but with my low back pain, I don’t always finish the workout.
How else can I stay in shape
A: I do recommend aerobic exercise for everyone, but especially for people with spinal conditions.
Aerobic exercise increases the blood flow to the body’s tissues, and people with high levels of cardiovascular fitness generally do better dealing with spinal problems.
However, before anyone with a spine condition or any medical condition for that matter, starts a wellness and fitness program, they should check with their primary caregiver, to clear the individual as fit to exercise.
Example: Someone with cardiovascular (heart problems) can have restrictions when it comes to certain types of exercise.
A physical exam will make sure your body is ready for exercise.
Physiotherapist assisting a senior woman with exercise ball at a chiropractic rehabilitation clinic
Low-impact aerobic exercise is recommended�
Walking
Swimming
These are excellent examples of low-impact aerobic exercise. They increase heart rate and are easy on the body.
Riding a stationary bike is another recommended form of low-impact aerobic exercise.
It can be tiring, but if recommended by a caregiver/therapist, then realize they did so for a reason/s to get you healthy.
By biking, you are building up endurance, and that is exactly what you want, as it speeds up recovery.
Walking is a great exercise for spinal conditions. It is low-impact, and you can control the pace to fit your needs.��
Daily walks after lunch or after getting home are a great way to exercise.
If exercise does begin to increase back pain or another type of pain, tell your caregiver or physical therapist right away.
The phrase, no pain, no gain does not apply when there are spinal conditions. So do not try to push through the pain or think that the hurt is good.
Also, do not try to do take on too much right away. Even if you feel good, follow the fitness plan.
But if you want to mix it up, discuss with your chiropractor/physical therapist if adding walking and swimming to the plan will be beneficial, as well.
It can be tempting to not exercise with a spinal condition. But remember that if there is no movement at all, you could make the pain worse. Knowing what your body can handle and sticking to a workable schedule, these healthy steps will relieve you and help with your low back pain.
Chiropractic Care Sports Injury Rehabilitation El Paso, TX
Daniel Alvarado, the owner of Push-as-RX Fitness, discusses how he carries out his PUSHasRx Functional Fitness Workouts personal injury rehabilitation and athletic training program as a part of Dr. Alex Jimenez’s chiropractic rehabilitation plan.
Physical therapy (PT), also referred to as physiotherapy, is one of the allied health professions which, by utilizing mechanical force and motions (bio-mechanics or kinesiology), manual therapy, exercise therapy, and electrotherapy, remediates impairments and promotes mobility and purpose.
Physical therapy is used to enhance a patient’s quality of life through:
Examination
Diagnosis
Prognosis
Physical intervention
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Exercise is an essential part of good health. It can help with weight loss and plays a crucial role in preventing many chronic health conditions like hypertension, diabetes, and heart disease. Regular exercise has also been shown to help with depression and anxiety. It is what nature intended; as humans, we are supposed to be active. The more active you are, the better you will look and feel � and the healthier you will be.
Chiropractic can help with a wide variety of health conditions, particularly those involving the spine. Your chiropractor�s ability to adjust your spine makes it possible to correct many issues with the back and neck. Chiropractic also offers the advantage of being drug-free and non-invasive, so the side effects you need to worry about are minimal.
6 Spine Disorders that Chiropractic Helps
1. Degenerative Disc Disease
Most often, degenerative disc disease is a condition that strikes people as they get older. The discs that sit between your vertebrae are supposed to be relatively soft to provide cushion and flexibility to the spine. Unfortunately, years of use and various injuries can cause the discs to wear down. When they wear down it can lead to pressure on nerves and bone on bone contact.
2. Herniated Disc
Sometimes a disc can rupture, allowing the interior matter to protrude from the outer shell and press against nerves in the spine. The most common areas of the body to have a herniated disc are the lower back and the neck.
3. Sciatica
The sciatic nerve travels from the lower back and down the legs. The nerve can become irritated if there are issues with the lower back, such as degenerative disc disease, herniated disc or misalignment. Pressure on the nerve can cause symptoms like shooting pains, numbness, tingling, dull aching, and other discomforts.
4. Whiplash
Whiplash is most common in rear-end car accidents, where a car hits you from behind and causes your head to whip forward and backward. The force generated by the whipping motion can cause significant damage to your neck. Stiffness and pain are common symptoms. Whiplash should be treated as soon as possible following an accident.
5. Myofascial Pain
The fascia is the sheath-like material that surrounds your muscles. Adhesions can occur in the fascia due to overuse or injury. Sometimes the painful points can feel like hard knots under the skin. Myofascial pain often causes discomfort in other areas of the body that you would not assume are related to the problem area.
6. Back Sprains and Strains
There are many ways that the back can become sprained or strained. A sprain involves the ligaments that are attached to your bones, while a strain involves your muscles and/or tendons. Either condition can cause significant pain and a loss of mobility.
Chiropractic Can Help By
Your chiropractor will offer you different options for healing your spinal condition. These may include:
Adjustments
Many times the problems with your spine can be improved by realigning the vertebrae. Injuries and spinal conditions are often associated with misalignment�where the vertebrae are not sitting on top of one another as they should be. A chiropractic adjustment gently returns your vertebrae to alignment.
Massage Therapy
Massage is a great complementary therapy to chiropractic adjustments. It can help to relax muscles, eliminate adhesions and improve mobility. It can also help your spinal adjustments to stay in place as you go about your day to day life.
Ultrasound
Ultrasound treatments are an effective way to encourage your body�s own healing mechanisms without causing any unwanted side effects. The sound waves penetrate deep into the tissues to create heat energy, which encourages circulation and aids in healing.
Get Help with Your Spinal Disorder
If you are struggling with a spinal disorder like those mentioned above, we would love the opportunity to help. Our chiropractic team understands how to administer safe, effective treatments that are non-invasive and work together to improve healing outcomes.
Please contact us today to discuss your spinal condition and schedule an appointment.
Heel Spurs
Do you have a sharp pain in your heel? When you take a step, does it feel like a knife is stabbing your heel? If the answer is yes, then you might have a heel spur.
A heel spur is a degenerative outgrowth of bone on the calcaneus. While the heel spur itself is sometimes painless, the condition is commonly associated with Plantar Fasciitis.
Though adjustments may help reduce symptoms, they do not restore plantar aponeurosis laxity or the resultant excessive pronation.
Custom orthotics support all 3 arches, which help control pronation and protect against heel shock.
Your healthcare provider and custom orthotic’s center can offer a special cut out�at the site of the insertion of the plantar fascia to reduce pressure.
Conclusion
Heel spur pain can be reduced by seeing your movement patterns of the foot and ankle. While there is no cure for heel spurs, chiropractic foot adjustments, orthotics and home stretching can help.
El Paso, TX Chiropractic Heel Spur Treatment
Blanca, born and raised in El Paso, TX, has been suffering from heel spurs for approximately two years. As a registered nurse, her symptoms appreciably affected her ability to work and her general quality of life. Determined to improve her health, Blanca believed care. Once she began treatment with Dr. Alex Jimenez, however, Blanca experienced enormous relief from her heel spurs, nearly immediately. Blanca highly recommends chiropractic care with Dr. Alex Jimenez as the nonsurgical selection for the treatment of heel spurs. A heel spur is a calcium residue resulting in a bony protrusion on the bottom of the heel bone.
Although heel spurs are often painless, they can lead to heel pain. They are often associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) which runs across the bottom of the foot and connects the heel bone to the ball of the foot. Heel spurs are usually caused by strains on foot ligaments and tendons, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes.
Orthotics
Foot Dysfunction can very easily cause a domino effect that extends all the way to the back. The feet are the foundation of the body and when there is a problem with the way they function it can cause the entire body to shift out of alignment. Overpronation and oversupination can cause a variety of injuries and conditions that affect not only the feet and ankles, but also the knees,�hips, and back as well.
Functional Hallux Limitus
Functional hallux limitus is unfortunately still considered to be a rare health issue which often goes unaddressed. Outcomes for many different foot disorders will be jeopardized if treatment doesn�t address functional hallux limitus. Foot and postural abnormalities have a basis in poor function of stabilization and the windlass mechanism of the foot structure through the plantar fascia.
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Although many people try to treat their low back pain on their own first, one of the fastest and best ways to treat it is through custom orthotics, which actually optimize the performance of your entire body, not just your feet and lower back. For instance, overpronation of the foot causes a series of internal changes that extend up through the leg. The femur may rotate causing hip pain and inflammation of the sacroiliac joint which leads to back pain. Other misalignments in the body that are caused by foot problems can also lead to chronic lower back pain as well.
Sometimes there are abnormalities of the spine and it causes a misalignment of the natural curvatures or some curvatures may be exaggerated. These unnatural curvatures of the spine are characterized by three health conditions called lordosis, kyphosis, and scoliosis.
It is not intended to be naturally bent, twisted, or curved. The natural state of a healthy spine is somewhat straight with slight curves running front to back so that a side view would reveal them.
Viewing the spine from the back, you should see something completely different � a spine that runs straight down, top to bottom with no side to side curves. This doesn�t always happen though.
The spine is comprised of vertebrae, small bones that are stacked on top of each other with impact cushioning discs between each one. These bones act as joints, allowing the spine to bend and twist in a variety of ways.
They gently curve, sloping slightly inward at the small of the back, and again slightly at the neck. The pull of gravity, combined with body movement, can put a great deal of stress on the spine and these slight curves help absorb some of the impact.
Different conditions for different types of spinal curvatures
Each of these three spinal curvature disorders affects a certain area of the spine in a very specific way.
Hyper or Hypo Lordosis � This spinal curvature disorder affects the lower back, causing the spine to curve inwards or outwards significantly.
Hyper or Hypo Kyphosis � This spinal curvature disorder affects the upper back, causing the spine to bow, resulting in that area rounding or flattening abnormally.
Scoliosis � This spinal curvature disorder can affect the entire spine, causing it to curve sideways, forming a C or S shape.
What are the symptoms?
Each type of curvature exhibits its own set of symptoms. While some symptoms may overlap, many are unique to the specific curvature disorder.
Lordosis
A �swayback� appearance where the buttocks stick out or are more pronounced.
Discomfort in the back, typically in the lumbar region
When lying on a hard surface on the back, the lower back area does not touch the surface, even when attempting to tuck the pelvis and straighten the lower back.
Difficulty with certain movements
Back pain
Kyphosis
A curve or hump to the upper back
Upper back pain and fatigue after sitting or standing for long periods (Scheuermann�s kyphosis)
Leg or back fatigue
The head bends far forward instead of being more upright
Scoliosis
Hips or waist are uneven
One shoulder blade is higher than the other
The person leans to one side
What are the causes?
Many different health issues can cause the spine to become misaligned or to form a spinal curvature. Each of the spinal conditions mentioned is affected by different conditions and situations.
Lordosis
Osteoporosis
Achondroplasia
Discitis
Obesity
Spondylolisthesis
Kyphosis
Kyphosis
Arthritis
Tumors on or in the spine
Congenital kyphosis (abnormal development of the vertebrae while the person is in utero)
Spina bifida
Scheuermann’s disease
Spine infections
Osteoporosis
Habitual slouching or poor posture
Scoliosis is still a bit of a mystery to doctors. They are not certain what exactly causes the most common form of scoliosis that is typically seen in children and adolescents. Some of the causes that they have pinpointed include:
There are screenings available for both children and adults to identify any spinal curvatures in their early stages through your chiropractor. Early detection of these disorders is crucial in identifying them before they become too serious.
Personalized Spine & *SCIATICA TREATMENT* | El Paso, TX (2019)
The spinal cord and brain make up the central nervous system while the spinal nerves that branch to the spinal cord and cranial nerves that branch to the brain makes up the peripheral nervous system.
There are thirty-one 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 are 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.
This consistency allows doctors to treat nerve pain in patients. If a specific 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 are 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 the 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 examined 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:
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 them additional insight on how to treat your condition, whether it’s related to a subluxation of vertebral bodies or other, other disease processes.
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