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Segmental dysfunction
  1. Hywel Watkin
  1. Beech House Surgery, 69 Vale Street, Denbigh, Denbighshire LL16 3AU (UK)


    Spinal segmental dysfunction, although used in clinical practice by medical acupuncturists, musculoskeletal physicians, physiotherapists and osteopaths, is not a concept which is familiar to the majority of medical practitioners. The concept implies that a problem in the function of a spinal segment may cause symptoms without necessarily being caused by physical pathology.

    Studies of the dysfunctional spinal segment have shown that physical stress, emotional stress and visceral disease all cause a reaction at the dysfunctional segment more easily than at normal segments. In the same way that individuals may have asymptomatic latent trigger points which may later become symptomatic, so individuals may have asymptomatic dysfunction which later becomes symptomatic under the influence of appropriate stimuli.

    There is some evidence that the clinical features of segmental dysfunction may be mediated by the sympathetic nervous system. The detection of segmental dysfunction is a clinical skill worth developing and the properties of the dysfunctional segment are worthy of further research.

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