REMEMBER THE DTM FLOW…
1. Identify provocative movement
2. Consider involved neurology for potential neuropathic component
3. Assess for neural sensitivity
4. Apply treatment to improve mechanical interface of the involved neuro
5. Re-test provocative movement
6. Apply homecare and perform regularly until sensitivity to movement normalizes
Common Diagnosis
- Muscle tension headache
- Migraine headache
- Tinnitus
- Temporomandibular disorder (TMD)
- Greater occipital neuralgia
- Cervicalgia
- Whiplash disorder
- Cervical sprain/strain
Target Neurology
- Greater auricular n.
- Lesser occipital n.
- Transverse cervical n.
- Supraclavicular n.
- Greater occipital n.
When evaluating for the potential involvement of superficial neurology in pain syndromes, make sure to first establish the location of the primary pain and/or identify a painful movement or activity. This allows a quick audit of the effect of treatment after applying DTM.
Commonly, complaints of radiating headache pain that starts in the back of the head (occipital area) and moves toward the forehead or eye, will involve the course of the greater occipital nerve. Lateral neck and shoulder pain should warrant evaluation of Erb’s Point, especially along the course of the supraclavicular nerve.
Follow the basic principles listed above. If findings suggest improvement with the DTM process, apply several times daily until the symptoms resolve. Benefit tends to be cumulative, with longer periods of pain-free experience as the course of home treatment continues. The addition of movement either while applying the skin traction or just after is important to allow the body to experience the now novel movement in the absence of pain.
