Friday, February 6, 2009

Treatment Hyiod Dysfunctions


Introduction: The hyoid bone and related myofascial connections of the neck often are not evaluated as possible causes of head and neck pain or dysfunction. Hyoid bone syndrome involves nonspecific cervical pain and pain while swallowing, with radiating pain to the face, neck and shoulders.
This article provides information on hyoid dysfunction, anatomy, evaluation and manual treatment methods.

Examination: The working understanding of the anatomy of the anterior structures of the neck is necessary to evaluate patients for this syndrome (a review of that anatomy is provided). Patients with anterior neck symptoms or tension and reduced extension of the neck should be checked for hyoid dysfunction, using palpation on the supine patient. Once the hyoid is located, it is tested for mobility, asymmetry, discomfort and muscle tenderness in the anterior cervical triangles. Bimanual palpation of the suprahyoid muscles is also performed.

Treatment: The author discusses five common treatment methods: 1) sustained compression over trigger points until softening occurs; 2) deep massage stroking distal to proximal; 3) positional release to slacken hypertonic tissue; 4) direct myofascial release on the whole complex; and 5) indirect myofascial release. The author’s preferred treatment method follows this method, in order: find tender points on the suprasternal notch and treat; treat muscle hypertonicity with massage; and stretch the hyoid using direct myofascial release. He emphasizes minimizing repetitions and limiting methods to 1-2 treatments.

Note: This article delves directly into the practical aspects of evaluating and managing patients. Active practitioners will find it useful in day-to-day practice.

Such GW. Manual care of the hyoid complex. Topics in Clinical Chiropractic 2002:9(3), pp. 54-62. Reprints: www.infotrieve.com

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