by Shawn Kirby L.Ac.

Friends, do you ever see patients complaining of migraines, chronic head and neck pain and low back pain? Do you sometimes find that these problems are difficult to treat, leaving you feeling down in the dumps? Well folks, have I got a proposition for you!

How would you like to be able to treat these conditions in 30 seconds flat and without ever having to leave the comfort of your office chair? Does that sound too good to be true? Friends, I assure you, this is no joke. This is the real McCoy! Armed with this simple diagnostic technique, you too can astound your friends and colleagues, amaze even the toughest patient and ascend to the rank of medical genius almost overnight!

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Ok, ok, enough with the hyperbole. In all seriousness though, I would like to share with you a little nugget that has been a huge boon to my success in treating pain. It’s simple, extremely effective and has the potential to dramatically improve recalcitrant conditions that can be difficult to treat.

Let’s say a guy walks into your office complaining of neck pain and headaches radiating out from the occiput. This has been happening for years and nothing he has tried has made much difference. What do you do?

Well, you could start out by taking a detailed history, examining his tongue and taking his pulse, and arrive at a TCM pattern discrimination. Using correct treatment principles, you could then formulate and prescribe an herbal decoction. You might also palpate, looking for ashi points and attempt to diagnose the offending meridian. Using all of this diagnostic information you could then utilize such techniques as retention needling, moxa, cupping, bleeding, etc. And, of course, you should do all of that. However, the first thing that I would do is to ask to see the man’s wallet.

No, you’re not checking to see if the guy will be able to pay his bill following treatment. You’re checking to see if he carries a big fat tri-fold wallet in his back pocket because if he does, you’ve most likely found the problem.

Homo sapiens is somewhat unique in the animal kingdom, in that our spinal column is orientated in a vertical, as opposed to a horizontal, position in relation to gravity’s pull. As omnivores, Paleolithic humans were both predator and prey simultaneously. Consequently, our forebears evolved unique strategies for adapting to both scenarios, which are still part of our genetic make-up today.

Prey animals tend to have their eyes located on the sides of their heads. This gives them a nearly 360 degree visual field to help alert them to potential predators coming their way. Predators, on the other hand, have both eyes front, giving them better depth perception. Depth perception is vital when landing a killer bite or blow. (Try picking up a piece of rice with chopsticks while you have one eye closed and you’ll see what I mean.) Stereo vision and its accompanying depth perception, along with the opposable thumb, made Homo sapiens an unparalleled killing machine for a creature of relatively small strength and size.

However, our ancestors also had to worry about enormous predators that could take them down without much of a struggle. The need to be visually aware of the surrounding environment was then compensated for by evolving a vertically oriented spine coupled with highly mobile cervical vertebrae. This mobile platform for the visual field made all the difference for our species’ survival. It’s also causing all of the trouble for your patient with the headaches.

While the human cervical spine can move all over the place, in order for us to perform the complicated task of staying upright on nothing more than our size ten clodhoppers our heads need to spend most of their time at home base. In this case, home base is level with the visual horizon, and at a right angle to gravity’s pull. Our upright spine is kept that way through a complex interaction with our visual field, our inner ear and the proprioceptive nervous system. If your head strays too far from this home base for too long, the body reacts violently. This is, of course, what happens when you get sea-sick.

It follows, therefore, that if you put a two-inch thick bolster under half of your rear-end that your body will compensate for this rather quickly by putting your head back into alignment with the horizon to keep you from barfing. Having to stay contorted in a small, yet very unnatural side bend while sitting for long periods of time (also not big on the to-do list of your average hunter-gatherer) will eventually put a strain on the spine. This strain usually manifests in of the spine’s two weak areas – either the C1/C2 complex or the L5/S1 junction. And, voila, you have a guy with neck pain and headaches that no one can fix.

Now, I know what you’re thinking – it has to be more complicated than that, right? Not really. At last count I have successfully cured (as in no more pain and no recurrence without any additional medicinal treatment or maintenance work) two cases of recalcitrant migraines and dozens of cases of neck and back pain by doing nothing more than convincing a guy to switch to a money clip in his front jeans pocket.

And, just in case you were starting to think that this is just a silly problem that only middle-aged men who insist on carrying a huge leather wallet full of receipts can have, let’s talk about a few other potential problems. Ladies and gentleman of the jury, I submit to you exhibit A, the high-heeled shoe, exhibit B, the low rise, too tight, boot cut jean, and exhibit C, your mom’s fifty pound purse.

Some of you are probably asking, “But what does any of this have to do with TCM?” Well, before I sign off, here’s a little head-scratcher for you. Let’s say, for sake of argument, that we accept as true the osteopathic doctrine that form and function (i.e. anatomy and physiology) are one and the same. Starting off with this premise, let’s think about the spine. Using our knowledge of anatomy we take into account that there are three main types of vertebrae, the lumbar, the thoracic and the cervical. While the cervical spine, as already discussed, is highly mobile and capable of moving in almost any direction, the rest of the spine is less mobile in order to enhance stability. The lumbar vertebrae, as you recall, are capable of forward and back bending as well as side bending, while the thoracic vertebrae mainly twist (A gross generalization, of course, but enough to illustrate my point.) Taking this into account, we might consider the junction where the spine moves from lumbar to thoracic vertebrae as another potential junction where a bend might take place and another problem could arise. We might then look at the organ structures that would be most effected by a long-term postural abnormality. These would most likely be the liver, spleen, stomach and pancreas. Might it be possible that the ubiquitous Liver-Spleen Disharmony could potentially be exacerbated, or even caused, by a structural abnormality resulting from sitting all day on a huge lump of calf skin and cash?

All theorizing aside, the next time you have a pain patient that doesn’t seem to be responding to normal treatment, ask to see that wallet. You won’t regret it.