Clinical Tip of the Week

Clinical Tip of the Week 16: Always consider the segment

When treating pain anywhere in the body therapists are often trained to look in that exact spot in order to resolve it.

This strategy is often helpful  however in many cases the pain is the result or the victim of a problem elsewhere.

Always consider the spinal segment as a potential source of the problem.

Spinal soft tissue pathology, Disc pathology, facet joint pathology are all potentials for creating local and importantly referred pain and dysfunction.

The following is a Myotomal chart of the muscles which are innervated by specific spinal segments.

These are the motor nerves responsible for muscle activity.









How Does This Work

  1. If a patients presents with Quadricep dysfunction, referring to the chart it tells us that the motor nerves that innervate those structures come from the L 2 to L3 segments. Assess these segments to attempt to reproduce their exact pain. 

Plan your treatment to address the segmental components with:

Local soft tissue treatment, Muscle Energy Technique and

Assessing and addressing the causative factors eg reducing stress at those specific segments and as always, if you are not achieving the required result

Refer to others in your network eg Physiotherapists, Osteotherapists and Chiropractors whose treatments are spinal focussed and ensure they give great value to their patients not just quick 2 minute consultations.

Keep focused, keep purposeful and keep highly inquisitive as to the behaviour of what you are treating.

Please tell us what you think!!! Are these tips helping? Do you want more information? What information are you seeking?

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