Yola's Caring Touch Massage

10/26/2025

Classification of specific LBP with an emphasis on pain origin. Symptomatic IVD degeneration with discogenic LBP is characterized by inflammation, a high-intensity zone, neuroinflammation-induced innervation and vascularization, and central sensitization for the development of pain

10/26/2025

◾ The sclerotomal pain distribution pattern is a key component used to characterize referred leg pain associated with lumbar degenerative disc disease or discogenic pain

⚙️ Characteristics of Sclerotomal Pain Distribution

◾ Nature of Pain: Referred leg pain associated with lumbar discogenic disease is always somatic in nature and sclerotomal in distribution

◾ Location: When discogenic pain involves the legs, it is usually referred to the lower extremities, generally above the knees

◾ Pattern and Localization: This type of pain expands into wide areas and can be difficult to localize. However, while the boundaries of the pain are difficult to define, patients are typically able to confidently identify its center or core

◾ Sensation: Referred leg pain is often described by patients as a deep tissue pain resulting from a sensation of expanding pressure

◾ Clinical Presentation Context: The presence of referred leg pain in a sclerotomal distribution, coupled with axial midline low back pain, is part of the specific diagnostic criteria for lumbar discogenic disease

🔍 Distinction from Radicular Pain

◾ Origin:

Sclerotomal pain is somatic in origin

Radicular pain results from compression of nerve roots

◾ Distribution:

Sclerotomal pain follows a sclerotomal, non-dermatomal pattern

Radicular pain typically follows a dermatomal pattern

◾ Quality:

Sclerotomal pain is dull, aching, and gnawing in the low back, with deep tissue pain or expanding pressure in the leg

Radicular pain is a thin band of pain with a lancinating quality, often described as electric and shocking

◾ Neurological Signs:

Sclerotomal pain shows an absence of neurological radicular signs, such as motor, sensory, or reflex changes

Radicular pain is associated with possible motor, sensory, or reflex changes, and often presents with positive signs like straight leg raise or Lasegue’s sign

◾ Sclerotomal pain distribution patterns in referred leg pain of discogenic origin by vertebral level👇

09/28/2025

If you haven’t gone to Big E this year or want to go again, I have a free ticket, and today is the last day. I am in the office if anyone would like to grab it and go 🙂
Txt or call 413-530-8200 to double check if it is still available.

09/23/2025

09/15/2025

🔗📃 Cervicogenic Vertigo 👇

📌Summary :

Vertigo and dizziness are one of the commonest and least understood symptom.

Meniere’s disease, Benign Paroxysmal Positional Vertigo (BPPV), and cervicogenic dizziness are classified as separate entities.

132 patients with vertigo were examined for neck, shoulder, and muscle tightness/asymmetry.

Most patients with Meniere’s Disease (80–88%), BPPV (66–75%), and cervicogenic dizziness (90%) had neck pain/headache with neck tightness or asymmetry.

Vestibular dizziness of Meniere’s Disease, BPPV and Cervicogenic Dizziness may be spectrum of the same disease with underlying myofascial problems.

Meniere’s Disease needs to be revisited as Cervicogenic Hydrops.

>>>

📖 Introduction

Meniere’s Disease and BPPV are two leading causes of peripheral vestibular vertigo.

Cervicogenic dizziness is characterized by imbalance, unsteadiness, disorientation, neck pain, limited cervical ROM, and may be accompanied by headache.

Diagnosis of cervical vertigo is challenging and made after excluding other causes.

Study undertaken to examine association between cervical signs and vestibular vertigo (Meniere’s disease, BPPV, cervicogenic dizziness).

✅ Conclusion

Vestibular dizziness of Meniere’s Disease, BPPV, and Cervicogenic Dizziness may be spectrum of the same disease with underlying myofascial problems.

Meniere’s Disease needs to be revisited as Cervicogenic Endolymphatic Hydrops.

Most vestibular disorders have postural problems with neck pain, headache, neck tightness, shoulder asymmetry.

Postural problems with underlying myofascial issues cause inner ear affection and vestibular symptoms.

Structural Rehabilitation by Myofascial release therapy has potential to revolutionize treatment.

📌 Key Takeaways

▪ Strong association between vertigo syndromes (Meniere’s Disease, BPPV, Cervicogenic Dizziness) and neck pain, headache, muscle tightness, and postural asymmetry.
▪ 81.8% of patients across all groups had neck-related symptoms and signs.
▪ Meniere’s Disease may not be purely idiopathic but linked to cervical and myofascial problems → proposed as Cervicogenic Endolymphatic Hydrops.
▪ Vestibular vertigo and cervicogenic dizziness are likely a spectrum of the same disease with underlying myofascial pathology.
▪ Myofascial release manual therapy (“Structural Rehabilitation”) showed significant improvement in posture, neck alignment, and dizziness.

>>>

🩺 Clinical Implications

▪ Vertigo patients should be screened for cervical spine dysfunction, posture, and myofascial tightness.
▪ Neck and postural rehabilitation should be integrated into management, not only vestibular-focused therapy.
▪ Myofascial release therapy is valuable in treating dizziness and preventing recurrence.
▪ Rethinking Meniere’s Disease as cervicogenic in origin may improve long-term outcomes and reduce progression.
▪ Interdisciplinary care (ENT + physiotherapy/manual therapy) is crucial for comprehensive vertigo management.

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⚠️Disclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.

Link to Article 👇

09/15/2025

The vertebral column

09/11/2025

🩻 Stages of Bone Fracture Healing

🔴 Inflammatory Phase (up to 2 weeks)
🟥 After a bone fracture, an inflammatory response occurs that lasts for two weeks
🟥 This phase starts an intricate network of proinflammatory signals and growth factors
🟥 Polymorphonucleate (PMN) cells and macrophages are recruited to endocyte microdebris and micro-organisms derived from the fracture
🟥 The damage to the blood vessels results in edema

🟠 Endochondral Bone Formation (2–3 weeks after fracture)
🟧 During this process, the MSCs are recruited in the injured site and begin to differentiate into chondroblasts (condrogenesis)
🟧 Chondroblasts proliferate into chondrocytes, resulting in soft calluses
🟧 Chondrocytes synthesize and secrete the cartilage matrix, containing type II collagen and proteoglycans

🟡 Hard Callus Formation (3rd–6th week)
🟨 The cartilage undergoes hypertrophy and mineralization in a spatially organized way
🟨 New MSCs are recruited which differentiate into osteoblasts, leading to the formation of interwoven bone (hard callus)
🟨 Mineralized bone formation is induced by the signaling of factors such as BMP, TGF-β 2 and -β 3 in the cartilaginous callus

🟢 Bone Remodeling Phase (8 weeks up to 2 years)
🟩 Communication between osteoclasts and osteoblasts mediates the replacement of the braided bone with lamellar bone
🟩 This occurs through two key activities:
🟩 Removal of the bone (resorption) by the resulting osteoclasts of the hematopoietic line
🟩 Formation of the bone matrix by the mesenchymal line osteoblasts

09/11/2025

09/10/2025

HEALING OF MUSCLE {SPECIAL TYPE OF WOUND HEALING}

🦾 Skeletal Muscle

Cut → fibers retract

Held together by stromal connective tissue

Filled with fibrinous material + polymorphs + macrophages

Macrophages clear damaged fibers

📍 If muscle sheath intact:

Sarcolemma tubes containing histiocytes appear along endomysial tube

⏳ After 3 months → properly oriented muscle fiber

Example : Zenker’s degeneration of muscle in typhoid fever

📍 If muscle sheath damaged:

Disorganized

Multinucleate mass

Scar composed of fibrovascular tissue

Example :Volkmann’s ischaemic contracture

>>>

🌀 Smooth Muscle

Limited capacity

In large destructive lesions → permanent scar tissue

>>>

❤️ Cardiac Muscle

Healing → fibrous tissue

If endomysium of individual cardiac fiber intact → regeneration

📌 Clinical Relevance for Physiotherapy

Skeletal muscle injury (sports, trauma, surgery): outcome depends on sheath integrity → physiotherapy promotes proper alignment & prevents contracture

Smooth muscle injury: usually not physiotherapy-related, except in pelvic/uterine recovery

Cardiac muscle: rehabilitation focuses on cardiac function compensation (not regeneration) after infarction