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04 Jun 2015
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Dry Needling Support Models (3 of 4): Spinal Segmental Sensitization (SSS) and Pentad Model

Dry Needling Support Models (3 of 4): Spinal Segmental Sensitization (SSS) and Pentad Model

June 4, 2015 | 1 Comment | , , , , , , , , , , , , , ,

In our last two blogs, we went over models that help explain how Dry Needling works.  These two were the Radiculopathy and the Trigger Point Models.  The topic of this blog will involve the third model, or the Spinal Segmental Sensitization and Pentad Model.  As we have with the last two discussions, we will try to explain any difficult terminology or ideas.

Spinal Segmental Sensitization and Pentad Model

The Spinal Segmental Sensitization (SSS) and Pentad Model was proposed by the late Andrew Fischer, M.D. (Physiatrist…pain management and rehabilitation medical doctor).  This is a good time to discuss this model as it really incorporates both of the first two models.  Dr. Fischer proposed that the SSS is a ‘hyperactive’ state of the dorsal horn of the spinal cord that is caused by damaged tissue sending nociceptive (pain) input into the spinal cord.  This information then causes the over-sensitivity of the associated spinal level dermatome (skin), pain sensitivity of the associated spinal level sclerotome (bone, ligaments, joints), and Myofascial Trigger Points (MTrPs) in the associated spinal level muscles.  All this occurs because the nerve coming from the spine is over sensitized, and by being in this pathological state, it stimulates these changes listed above.  In effect, we have a pretty vicious cycle of pain and dysfunction. Continue Reading →

14 May 2015
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Dry Needling Support Models (2 of 4): The Trigger Point Model

Dry Needling Support Models (2 of 4): The Trigger Point Model

May 14, 2015 | 2 Comments | , , , , , , , , , , , , , , , , , , ,

In the last blog, we discussed the first model (The Radiculopathy Model) that helps explain why Dry Needling works.  Now we will continue with the second of four models.   This one is probably the most well-known one and there is a plethora of medical literature supporting it.  Again, we will try to explain any concepts that are a little difficult to understand.  These models really shed light into how our bodies work and they are great to learn about.

The Trigger Point Model

Myofascial Trigger Points (MTrPs, or TrPs for Trigger Points) are defined as ‘hyper-irritable spots in skeletal muscle that are associated with a hypersensitive palpable nodule in a taut band’ (Travell and Simons).  The resultant pain/discomfort that one gets due to such points is referred to as myofascial pain syndrome (MPS).  Simply put, MPS is defined as ‘sensory, motor, and autonomic symptoms caused by myofascial trigger points’ (Travell and Simons).  Sensory symptoms refer to what you feel, motor symptoms refer to how the muscles work, and autonomic symptoms refer to the things that you do not realize.  This seems a little odd, but consider what happens when you bang your arm really hard.  You will feel the pain (sensory), the muscle might be painful and not contract properly (motor), and your heart rate goes up as does your respiration due to the ‘adrenaline rush’ (autonomic) of the injury. Continue Reading →

11 May 2015
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Dry Needling Support Models (1 of 4): The Radiculopathy Model

Dry Needling Support Models (1 of 4): The Radiculopathy Model

May 11, 2015 | 4 Comments | , , , ,

We get a lot of questions about Dry Needling and the next few blogs will address several theories that support the treatment.  There is currently a good amount of medical literature supporting Dry Needling and this is great, but the theories behind Dry Needling are fascinating and interesting to discuss.

The 4 models are as following:

1.  The Radiculopathy Model
2.  The Trigger Point Model
3.  The Spinal Segmental Sensitization and Pentad Model
4.  The Central Model

Each of the next 4 blogs (including this one) will discuss one of these theories as it relates to Dry Needling.  We hope this gives you a better understanding as to why Dry Needling works so well.  We are aware that the models tend to use medical terminology and can be a little hard to follow, so we will try to explain things as we go to make the explanations easier to understand. Continue Reading →

12 Dec 2011
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Dr. Manison Gets Case Study Published on Cox Flexion/Distraction Technic For Cervical Spine Disc Herniation

Dr. Manison Gets Case Study Published on Cox Flexion/Distraction Technic For Cervical Spine Disc Herniation

December 12, 2011 | 0 Comments | , , , , ,

Dr. Manison was published in the Journal of Chiropractic Medicine (JCM), one of the two medically indexed chiropractic journals.  This is a huge accomplishment and he is very excited about this.  Writing the paper and going through the editing process took about 100 hours of time.  It was a very tough and humbling experience, and he is very happy with the end result.

Most clinicians, or field doctors, do not have the time or skill to write a paper for medical publication.  Dr. Manison feels that it is important to continue to work hard to be the best doctor he can be as well as give back to the field.  If there are no studies on the successes of chiropractic, it is hard to justify the care.  The more those in the chiropractic field publish the good work we do, the better.

Dr. Manison would like to thank his wife and editor extraordinaire, Jennifer Hepps, MD, for her help with the paper.  Dr. Hepps is very accomplished in her field and her insight and direction were critical to the success of his paper.  When they say behind every man there is a great woman, this is truly the case!

We would include the entire study here but are not allowed to do so…however, please click the link below to view the abstract.

Chiropractic management using Cox cervical flexion-distraction technique for a disk herniation with left foraminal narrowing in a 64-year-old man

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