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Basics of manual therapy. Treatment of the spine using manual therapy Course of manual therapy how many days

“I must note that, as such, correction of the spine using manual action has been known since ancient times. Almost every nation had its own masters of medicine who tried to help people suffering from diseases of the musculoskeletal system. Often, troops on military campaigns were accompanied by chiropractors or directly by doctors who, among other medical skills, had experience in setting joints and treating bone fractures.

Spinal correction methods in the past were mainly developed through practice, trial and error. Therefore, they can rightly be called “a matter of chance.” In addition, it must be taken into account that in the process of learning about the actual result of treatment of the musculoskeletal system, it was necessary to talk only when correcting obvious pathologies, for example, the presence of a dislocation of the shoulder joint, jaw, bones of the arms or legs.

However, as such, manual correction for hidden diseases of the same spine was carried out almost “blindly” and was focused on temporary pain relief, without taking into account and understanding the true reasons that caused this disease. This is natural, since even today, scientists studying at the molecular level the development of processes in the cells and tissues of the spine already know a lot, but not everything. What then can we say about the time when doctors had primitive knowledge even in the field of anatomy? Therefore, the experience of ancient doctors involved in manual correction of the spine was based mainly on observations: it helped - good, it didn’t help - they tried it differently. Often the same methods were used on patients with the same symptoms and location of pain. However, as stated in the article , The cause of pain can be completely different. If it is not established, then instead of treatment it is quite possible to provide the patient with a truly “disservice”. This is how, in different countries, through trials, taking into account experience and errors, various methods of manual correction of the spine were identified over time, which temporarily eliminated pain syndromes, allowing the patient to remain able to work for some time.

Starting from the 19th century, various schools began to open one after another in the United States, where they taught essentially old methods of treating the spine using manual influence, but with an attempt to illuminate the meaning of these manipulations in the light of the then newfangled scientific interpretation...

It should be noted that schools were mainly built on a business basis, where, along with the study of anatomy, they taught courses in “business practice,” that is, they taught how to “sell” their “skills” profitably. The training course usually lasted two weeks. The courses recruited lovers of alternative medicine who were able to pay for this training. Naturally, there was no talk of any medical professionalism there. The increased number of graduates of these schools and their activities contributed to a decrease in the authority and fees of representatives of official medicine. Therefore, initially both directions [ approx. “long-lever” and “short-lever” schools of manual therapy] were in a very difficult relationship with official medicine. Instead of scientific discussions, judicial and civil trials were conducted.

In the modern world, although the attitude of official medicine towards manual methods of treatment (lat. manus- hand, Greek. therapy― treatment), but still the traditional foundations laid back in those days have been preserved to this day. The main one is to relieve the patient of pain, which is what chiropractors of various directions mainly appeal to in their defense today...”

“Moreover, chiropractic, osteopathy, craniosacral therapy, PIR (post-isometric relaxation) and others, including some traditional methods and methods of “treating” the spine, are essentially aimed at disrupting adaptive mechanisms. In case of degenerative-dystrophic processes in the intervertebral discs, the use of such methods inevitably leads to a more rapid progression of this pathology.”

“In this regard, I would like to ask the relevant questions directly to the patient. Do you really care if the doctor knows what he's doing to your spine? Does the doctor know what will happen to your health after his manipulations in a month, in a year? Or do you really not care what happens to you later and what price you will have to pay for temporary pain relief?

A number of patients, due to the lack of timely information, have already answered these questions with their sad experiences and poor health. I invite you to familiarize yourself with some materials from my documentary medical archive.

MRI No. 69 shows smoothing of the physiological lordosis of the lumbar spine, protrusion in the L5-S1 segment compensated by spondylosis, and epiduritis at the same level.

On MRI No. 70 of the same patient, the condition is observed after four sessions of manual therapy, in the L5-S1 segment - a sequestered herniation of the intervertebral disc with caudal migration of the sequester, absolute stenosis of the spinal canal, flattened physiological lordosis, epiduritis.

This story began with the fact that due to the development of protrusion and epiduritis, the patient developed pain in the lumbar spine. On the advice of friends, he turned to a manual therapy center. The doctor at this center (chiropractor), having examined him and listened to his complaints, sent him for an MRI examination (No. 69). Based on the examination results, the same doctor prescribed 12 manual therapy sessions for the patient. After the fourth session, the patient began to experience sharp pain in the leg and numbness. We did a repeat MRI (No. 70). The chiropractor reviewed the results and referred the patient to neurosurgery (but that’s another story).

On the first MRI No. 69, in addition to protrusion, the presence of epiduritis was clearly visible. Consequently, this patient required drug therapy under the supervision of a neurologist, to whom the patient should have been referred after an MRI examination. In this case, it was absolutely impossible to treat using traction or manual therapy methods. After all, when using these methods, the result could be easily predicted! Again, this is an indicative case when “specialists” send a person for an MRI, but evaluate the images unprofessionally. Otherwise, they could make a rudimentary forecast of the consequences of their “treatment.” By the way, most of these “specialists” provide only one-time assistance and do not monitor the patient’s health over both the immediate and long-term periods of time (months, years) after their treatment.

As for this case, I don’t think that these specialists did these manipulations intentionally, for the sake of profiting from the health of this person. Most likely due to ignorance of the basics of vertebrology and, accordingly, the choice of treatment method. This has led to the fact that now the patient’s life has become significantly more complicated, and his health after such “help” has worsened disproportionately. “Ne noceas, si juvare non potes” - "Do no harm if you cannot help".

The following incident demonstrates how some of the original traditions of the American school of “folk manualists of the 19th century” are still alive.

This patient, having decided to get rid of back pain, turned to a “chiropractor” for help. But, as it turned out later, there was, as they say, only one name from the chiropractor. This “specialist”, American model of the 19th century, felt the patient and said that the disc had fallen out and that he would now set it. Having placed the patient on the floor (on his stomach), he began to raise his legs one by one, simultaneously pressing on the lower back, then, laying him on his side, he performed a “twisting”. Thus, having performed several manipulations from the “set” of conventional manual therapy, I moved on to “my own developments.” He asked the patient to sit on the floor and stretch his legs forward and bend his lower back back. Then he began to press on his shoulders with sharp, strong thrusts. Then, asking the patient to stand up and, wrapping his arms under his arms, he lifted him up and shook him vigorously. After these manipulations, this “specialist” announced in a businesslike manner that the patient should come the next day for another similar session.

After the second session, the patient's pain intensified. He went to the local hospital. The local traumatologist referred the patient for an MRI. But contrary to common sense, the patient went with the results of the examination (MRI No. 71) not to a traumatologist, but again to the same “bone crusher.” He, having carefully looked at the pictures, said that “everything is clear” to him, the herniated intervertebral disc “fell out inward, into the stomach” and that “usually one or two sessions are enough, but this is a serious matter and it is simply necessary to carry out one more, or maybe two session." The patient, in his naivety, agreed. Everything was repeated as the first two times, only this “specialist” significantly increased the force of his influence when he sat him on the floor and began to push him on his shoulders, obviously so that the disc would definitely “come out of the stomach and go where it should.” This is called: “you have strength, you don’t need intelligence.” After several such shocks, the patient felt a sharp pain (“like an electric shock”) that passed from the tailbone to the head, and his legs went numb. A few days later, this patient developed pelvic disorders. We did a repeat MRI No. 72. The result is more than depressing: a compression fracture of the L2 vertebral body, a sequestered herniated intervertebral disc in the L5-S1 segment, absolute stenosis of the spinal canal.

MRI No. 71 shows smoothing of physiological lordosis, intervertebral disc herniation in the L5-S1 segment, spondylosis at the same level, multiple Schmorl’s hernias, stenosis.

On MRI No. 72, in addition to all of the above, there is also a compression fracture of the L2 vertebral body and a sequestered herniated intervertebral disc in the L5-S1 segment, absolute stenosis of the spinal canal.

MRI No. 73 shows an enlarged fragment of MRI No. 71 at the level of the L1-L2 segment, where there is an injury to the endplate of the L2 vertebra, as a result of the first two sessions with this “specialist”.

MRI No. 74 shows an enlarged fragment of MRI No. 72 at the level of the L1-L2 segment, which clearly shows the consequences of the third session of “disc reduction”, and as a result - a pompression “break” of the L2 vertebral body and its end plate (hyaline) and internal rupture intervertebral disc.

The reason for this tragedy is elementary illiteracy, not only of that “aboriginal specialist” of the 19th century, but also of the patient himself. After all, sometimes even basic knowledge or at least the presence of common sense on one of the parties can protect a person from making a fatal mistake that entails serious consequences.

So if you see a promising advertisement that says that specialists are engaged in non-surgical treatment of hernias, then you need to understand that they are treating, but are they curing? That's the question. And in order to ensure the sincerity of the intentions of the specialists of such medical centers, it is necessary first of all to familiarize yourself not only with reviews of the subjective feelings of their patients, but also with the objective results of the examination recorded on MRI images, for example, before and after treatment of their patients with similar diseases, as well as, if possible, the results of long-term consequences of such treatment.

Typical injuries as a consequence of manual methods of influencing the spine are hemarthrosis (from the Greek. haima- "blood", arthron- “joint”) of the facet joints, that is, hemorrhage into the cavity of the facet joints.

On MRI No. 86, there is a hemorrhage (a dark spot on the MRI) in the cavity of the left facet joint - as a consequence of treatment by a chiropractor who tried to “set the prolapsed disc.”

MRI No. 87 shows hemorrhages in the cavity of both facet joints. This case is associated with another patient, another chiropractor, but with the same disappointing result - hemorrhage again!

Unfortunately, such complications after manual therapy are quite common. Their reason is banal - just an attempt by a chiropractor to eliminate the so-called subluxation or “functional block” in the patient. Often the result of such exposure is hemorrhage into the cavity of the injured facet joints. Let me remind you that the inner layer of the articular capsule of the facet joints has many synovial villi rich in blood vessels. After an injury, when blood fills the joint cavity, the patient experiences pain, limitation and painful movements until the patient loses the ability to move independently.

It seems like it’s already the 21st century, but such unfortunate incidents that harm the patient’s health still occur. What is the reason? It’s not for nothing that I mentioned that the theory of “subluxation” of the school of chiropractors of the 19th century is alive and they are still trying to build a theory of manual therapy on it. But these attempts are unsuccessful and will remain so in the future, since this is tantamount to “building a house on sand.”

So what exactly is the “root of evil”? If you read several different manuals on manual therapy, you will notice that almost all of these books emphasize that during the manipulation to eliminate subluxation there must be a crunch (click), this supposedly indicates the correctness of the manipulation. So the chiropractors twist until it cracks.”

We will consider the nature of the occurrence of such a crunch in more detail. The main conclusion about the true reason for the occurrence of such a crunch during the manipulations of a chiropractor:

“...water hammer with a characteristic sound, formed after appropriate manipulations by a chiropractor, gives rise to microtraumatization of the joint capsule with microtears, areas of overextension, microcracks (including areas of hemorrhage, which are clearly visible in the laboratory under a microscope on the corresponding samples of this tissue). And with significant hemorrhages, this can already be observed during a diagnostic examination (MRI).”

“...Why, during the manipulation of a chiropractor after a crunch (in most cases), the patient experiences extraordinary lightness, almost euphoria, after which “the pain goes away,” “the mood improves,” and so on. The answer is simple: the culprits of such a sudden rush of “pain relief” are mainly endorphins And enkephalins- biologically active chemical compounds with a morphine-like effect, which are produced, including under stress, and are natural opioid peptides, in other words, “natural drugs”. But we will also consider this issue in more detail in our future publications.

So the manipulations of a chiropractor, which cause a crunch in your spine, are far from a safe procedure for the body. Remember this when on your life path you meet a “19th-century chiropractor” and tell you that your “discs have thus returned to place,” “the joints have been restored,” and “subluxation has been eliminated.”

Manual therapy is a set of special techniques that are aimed at treating diseases of the spine and neck. It is important to know who can use this treatment and for whom it is prohibited. Therefore, today we will tell you what this therapy is for osteochondrosis of the cervical spine, we will describe the techniques and results of this treatment method.

This method of treatment appeared a long time ago, so there are a huge variety of techniques. They are used depending on the age of the patient and the stage of osteochondrosis.

Proper therapy can improve the condition of tissues and joints. Manual therapy improves blood circulation and allows you to completely cure osteochondrosis of the cervical spine.

Here are the main methods of this treatment:

Manipulation. The doctor performs forced actions to restore joint function. Usually the procedure is accompanied by a strong crunching sound, which frightens patients very much. Many patients consider manipulation the most unpleasant method of treatment.
Relaxing massage. The specialist works on the cervical spine to warm up and stretch the muscles. Thanks to this procedure, the tension completely goes away and the pain goes away.
Mobilization. It is believed that this is the most pleasant and painless method of manual therapy. The doctor works on the cervical spine with relaxation techniques and traction. After the procedure, the spasm goes away and the muscles completely relax. Mobilization perfectly improves blood circulation and thereby the tissues in the cervical region are fed with beneficial vitamins from the body.

A set of procedures is often used for the successful treatment of cervical osteochondrosis. However, these methods are not suitable for everyone. Here is the main list of contraindications for manual therapy:

The procedure is prohibited for Arthrosis! We advise you to read more about this disease.
During pregnancy, even in the first months, such therapy is not recommended.
Benign and malignant tumors.
Recent injuries to the spine and other joints.
Infectious diseases in the final stages.
Intervertebral hernia.
It is forbidden to undergo manual therapy after drinking alcohol.
For any blood diseases.
At the time of flu and inflammatory processes.
For polyarthritis.
Patients with disc myelopathy are not recommended to attend the procedure.
After spinal surgery.

In any case, even if you do not have the above diseases, you still need to consult a doctor before the procedure session.

Sometimes osteochondrosis at a certain stage cannot be treated with manual therapy. The specialist will ask you to undergo certain examinations and tests. Only after this can manual therapy be allowed or canceled.

What results does therapy give?

Experts consider manual therapy to be very effective in the fight against cervical osteochondrosis. Typically, the course of treatment lasts from two weeks to three months. To really achieve a successful result, you need to contact a good, proven specialist. After all, it all depends on the skill of your doctor. Here are the positive results that a course of manual therapy leads to:

All tension is relieved from the muscles of the neck and back.
Numbness of the limbs disappears completely.
Restores movement of the shoulders and neck without attacks of pain.
Tinnitus, which most often accompanies cervical osteochondrosis, disappears.
The pain syndrome goes away completely.
The affected tissues in the neck area are restored.
Dizziness and headaches go away, which you can read more about.

In fact, a full course of manual therapy completely eliminates all symptoms of the disease. Remember that many symptoms will begin to go away immediately. But this does not mean that it is time to stop the course of therapy. The main thing is to complete all procedures to get rid of osteochondrosis forever.

Complications after manual therapy

Side effects may occur in every patient.

However, the more experienced your doctor, the less likely you are to get any complications. Usually, consequences occur if therapy was started during some other disease in the body. Here is a list of the main side effects:

Ischemic stroke.
Rib fractures.
Rupture of muscles and ligaments.
Confusion of the vertebrae, or, in extreme cases, blocking them.
Hypermobility in the spinal region.
Incarcerated intervertebral hernia.

Manual therapy for osteochondrosis of the cervical spine is prescribed individually to each patient. It is impossible to say with certainty how many procedures will need to be performed. The doctor first looks at the stage of osteochondrosis, at the general condition of the patient, and only after that prescribes the number of sessions.

Treatment of one spinal segment usually lasts 3 sessions. There are seven such vertebrae in the cervical region. Osteochondrosis can affect several segments at once, so the number of procedures is prescribed depending on this factor.

The manual therapy procedure is performed at intervals of 2-7 days. You shouldn't go to this type of treatment every day. After all, muscles and ligaments must get used to the new position after the procedure. Typically this addiction lasts for 48 hours.

Each specialist carries out this procedure in his own way. But most often the session takes place in the following sequence:

The doctor identified the first problem area in the cervical spine.
It is influenced by massage or post-isometric relaxation. At this stage, the specialist relaxes the muscles as much as possible and removes tension.
After this, the patient must turn in the desired direction, which is determined by the doctor. Next, the specialist fixes the displaced segment of the spine with one hand, and with the other hand presses on the entire body. It will play the role of a lever with the help of which the vertebrae are restored to the correct place.
Immediately after the “reduction” of the vertebrae, the patient feels relief. The doctor should work on the adjacent neck muscles for some time and complete the session. After the procedure, the specialist must give a number of tips to the patient. This could be exercises that you can do at home or advice on a proper diet.

Conclusion

Now you know that manual therapy helps cure osteochondrosis of the cervical spine. The main thing is to find a good specialist who will select the right treatment methods specifically for your case.

You have become acquainted with contraindications in which therapy will only cause complications. And you also know what positive results the sessions will give. Pay attention to your health, follow all doctor's advice and attend the procedure regularly. Then the trouble in the form of cervical osteochondrosis will easily pass.

The history of manual therapy dates back perhaps thousands of years, since this medical practice has been known since time immemorial.

At the moment, experts do not deny the effectiveness of the technique in relation to various diseases of the spinal column, therefore they quite often include it in treatment regimens for ailments associated with degenerative changes, disruption of the normal anatomical position of the vertebrae, prolapse of intervertebral hernias, and the like.

Experts recognize the effectiveness of manual therapy

This interest in this type of treatment is explained by the fact that manual therapy of the spine has the highest percentage of complete recovery. At the same time, the method is a frequent cause of complications. What is manual therapy? What are the pros and cons of manual therapy today?

Using the technique of manual manipulation of the spine, in just a few sessions you can get rid of persistent pain in the back, discomfort in the spine when performing movements, pain due to diseases of the joints of degenerative origin, and much more.

Manual therapy effectively relieves back pain

According to numerous reviews of manual therapy, this method allows you to eliminate functional blockages of nerve fibers caused by displacement of the vertebrae, relieve spasm from the muscle tissue of the back, restore normal blood supply to the affected areas of the spine, and the like.

What kind of treatment is this?

What is manual therapy: the benefits and harms of the technique? What is the essence of manual influence on the body? Similar questions concern many patients who are faced with the need to try this treatment method on themselves.

“Manual” or manual treatment is a set of therapeutic techniques based on techniques of manual influence on the structural elements of the musculoskeletal system, which makes it possible to identify and treat a huge number of pathological conditions in this area.

The main advantage of such a correction is that it is natural and safe compared to other similar methods, for example, massage.

If we consider how massage differs from manual therapy, the key argument here is the wider range of effects on the spine and the effectiveness of manual treatment compared to other options for similar treatment. In addition, in recent years the technique has been widely used in pediatrics. Manual therapy for children (including manual therapy for infants) is successfully used in treatment regimens for childhood spinal diseases, asthma, as rehabilitation and elimination of the consequences of injuries.

You will learn more about the manual therapy method from the video:

Vertebrologists often practice manual therapy during pregnancy, when, as a result of increased loads on the spinal column, a woman begins to experience back pain associated with weakening of the muscles and ligaments of the back, as well as old mechanical damage.

Sometimes doctors have to combine two issues such as manual therapy and HIV infection.

Manual therapy is most often prescribed for. It is in this segment that severe pain occurs, which is accompanied by nausea, dizziness, fainting, and the like. Manual therapy for cervical osteochondrosis is a real chance to overcome chronic pain in the neck.

Manual therapy for low back pain is a common practice for many diseases of this segment of the spinal column. The most common option is manual therapy, the effectiveness of which is about 65%.

So, there are the following indications for manual therapy:

Main types of manual treatment

Varieties of manual practice are divided into several classes, based on the direction of influence and depending on therapeutic goals:

manipulative influence(treatment of diseases of the spine, ribs, pelvic bones, limbs);
visceral manual therapy, which deals with the treatment of internal organs (similar manual therapy of internal organs is used in relation to patients suffering from pathologies of the intestines, heart, lungs, and pelvic organs);
craniocervical manual therapy, aimed at correcting headaches and problems with the bones of the skull (manual therapy for headaches is a common method of preventing cranialgic attacks, the main cause of which lies in the obstruction of the patency of the cervical vessels);
self-medication or manual therapy to oneself, when the patient independently performs manual manipulations;
myofascial manual therapy techniques, the action of which is aimed at strengthening muscles and ligaments, relieving muscle spasms, etc.;
complex of manual therapy methods for joint pathology;
gentle manual therapy or kinesiology, the therapeutic effect of which occurs as a result of a complex effect on three components of human health: the musculoskeletal system, metabolic processes and emotional background.

It is difficult to find a doctor who is fluent in absolutely all manual techniques.

But we can confidently say that a specialist who has thoroughly studied at least one option of manual influence will definitely help the patient cope with the problem that worries him.

Rules for the procedure

Before visiting a specialist for the first time, many patients are interested in how long a manual therapy session lasts. On average, the procedure takes about 30 minutes. This time is absolutely enough to carry out all the necessary manipulations to correct the pathological condition. The therapeutic effect should appear after 1-2 sessions. Therefore, when asking the question how many manual therapy sessions should be done, an experienced specialist will answer - about 7-10, but no more than 15 per year.

Watch the video to see how a manual therapy session goes:

How often can spinal manual therapy be done?

Doctors recommend not to rush to complete the full course of manual treatment and maintain reasonable pauses between sessions, which are about 2-6 days, depending on the severity of the pathological process, individual characteristics and age of the patient.

Contraindications to the technique

Despite the fact that manual therapy methods are effective in relation to a huge number of musculoskeletal diseases, this treatment option has its contraindications for use:

malignant tumors of the spinal column, skin and visceral organs;
inflammatory processes of the spine in the active phase;
vertebrae;
some congenital pathologies of the musculoskeletal system and genetic developmental defects associated with increased bone fragility;
conditions after surgical interventions;
acute pathological conditions of the spinal cord;
diseases of the digestive tract in the acute phase;
open form of tuberculosis.

A negative effect from manual therapy can also occur after a manual therapy session for a patient who has relative contraindications, for example, old injuries. The doctor must take into account such contraindications to manual therapy when prescribing a course of treatment, which will avoid the occurrence of undesirable consequences and complications of the underlying pathological process.

If the doctor does not take into account contraindications for manual therapy, serious complications may occur.

Possible consequences

In most clinical cases, the sensations after manual therapy are always positive, and a person can say with confidence that this technique has allowed him to improve his health. But sometimes it happens that after a manual therapy session your back hurts, you feel dizzy, or your overall body temperature rises. Why is this happening? What are these symptoms associated with?

As you know, each body is individual, and therefore reacts completely differently to treatment.

Often, the consequences of manual therapy make themselves felt after the first session of manual manipulation, and patients begin to complain about the appearance of unpleasant sensations, which they associate with the side effects of the treatment.

Sometimes people complain that they feel dizzy after chiropractic treatment. A similar reaction occurs in approximately 1 in 1000 patients who have used the services of a chiropractor. This side effect is temporary and most likely associated with blood redistribution. Therefore, if you experience a headache or dizziness after manual therapy, you should seek clarification from a specialist.

Fever after manual therapy is an extremely rare symptom. It appears predominantly in patients suffering from chronic inflammatory processes, which are activated and aggravated by manual influence. In any case, if after manual therapy you feel worse and your general health has deteriorated, you should visit a doctor as soon as possible to clarify the nature of the ailment.

The cervical region experiences high stress every day. When turning, sudden movements, uncomfortable posture, stooping, or prolonged tilting of the head, microcracks occur, discs bulge, arteries and nerve roots are pinched. The consequence of negative processes is dizziness, back and neck pain, poor blood supply to the brain, a high risk of protrusions and hernias, cerebral disorders.

Manual therapy for osteochondrosis of the cervical spine is used less often than during the treatment of pathology in the lumbosacral and thoracic region, but you should not completely abandon the use of the technique. Doctors cautiously allow sessions, but only with the involvement of a highly qualified chiropractor. Before starting the course, you need to consult a vertebrologist, neurologist or orthopedist.

Features of the method

During the session, the manual therapy doctor carries out certain actions to return the vertebrae and discs to their normal position, eliminate muscle spasms, and normalize the mobility of the affected structures. The doctor does not use medications or special devices: the basis of the influence is the hands of a specialist.

During the treatment process, the patient often experiences discomfort, pain, and a characteristic crunching sound (“acoustic phenomenon”) is heard. If the rules are followed, the optimal effect on the vertebrae and muscles is followed by relief, nutrition and blood supply to the affected discs improves, congestion disappears, clicks and crunching are no longer bothersome.

On a note:

The doctor must have knowledge of human anatomy and physiology, and know the points that need to be influenced to relax the muscles and realign the vertebrae. In no case should you influence cartilaginous and bone structures in the absence of medical education and knowledge in the specialty “manual therapy”;
The cervical spine is quite fragile, the spinal canal is narrow. Incorrect application of force can leave a person disabled, cause an ischemic stroke, or lead to death due to a fracture of the cervical vertebrae or spinal cord damage.

The benefits of the treatment procedure

Manual therapy, carried out taking into account the characteristics of the disease in a particular patient, gives a positive result. After a course of therapy, discomfort disappears, cervical mobility improves, headaches go away, etc.

Manual therapy has a complex effect:

antispasmodic effect;
normalization of blood circulation and nutrition of the discs and brain;
analgesic effect;
elimination of “clamps” that interfere with the normal functioning of the spine.

Manual therapy removes “blocks”, prevents congestion, and removes excess pressure on the discs, but osteochondrosis cannot be completely cured using this method. A complex effect on the affected intervertebral discs is required to restore the elasticity and functionality of the spacer between adjacent vertebrae. In addition to manual therapy, when treating diseases of the spine, the patient must receive, do special,. In severe cases, an orthopedic device for the neck helps.

Indications for use

Manual therapy of the spine is effective for mild to moderate pain in the neck, shoulder girdle, and moderate functional blockade. Sessions are carried out during a period of remission, in the absence of pronounced signs of exacerbation and inflammatory processes.

Contraindications

There are restrictions for manual therapy sessions:

cancer;
“fresh” intervertebral hernia;
inflammatory processes in vertebral structures and neighboring tissues;
recent spinal column injuries;
high blood pressure;
spinal instability.

Therapy results

Compliance with the rules, taking into account individual characteristics, adherence to the frequency and duration of the course gives positive results:

headaches disappear or occur less often;
no tinnitus;
mobility of the cervical spine is normalized;
hypertonicity of the muscles of the shoulder girdle and neck disappears;
the functions of affected tissues and joints are normalized;
pain decreases or disappears;
sensitivity returns to the upper limbs, shoulder girdle, fingers;
dizziness does not appear.

Important! If complications occur or there are no positive changes, you need to abandon manual therapy sessions and once again visit a vertebrologist, neurologist or orthopedist to adjust the therapy and select other treatment methods. There are many other methods of influencing weakened discs and vertebrae with cervical osteochondrosis.

How does a manual therapy session work?

The procedure is approximately the same, but each specialist can adjust the course of the session depending on the degree of osteochondrosis, the patient’s reaction, and associated factors. Before starting the course, the doctor must inform the patient about what will happen in the office so that the person does not worry and knows how to react to the specialist’s actions.

Manual therapy, in contrast, involves a more pronounced effect on bone and cartilage structures, pain and cracking of joints are possible. The patient should be aware of the features of the method in order to prevent excessive nervousness and anxiety during the procedure.

General information about a session with a chiropractor:

the doctor talks with the patient, clarifies his state of health and current complaints;
the patient sits or lies, the doctor may ask you to change body position for certain types of exposure;
After identifying the problem area, the specialist performs post-isometric relaxation or massage of the affected areas of the cervical-collar area to relax the ligaments and muscle tissue. Without this stage it is impossible to achieve a positive result: only completely relaxed tissues are able to perceive a specific impact. Tension of muscles and ligaments increases the pain syndrome, interferes with the session and the work of the chiropractor;
then the patient, at the doctor’s request, turns at a certain angle in the desired direction. It is important to strictly follow the doctor’s instructions in order to eliminate negative reactions of bone and cartilaginous elements;
With the fingers of one hand, the chiropractor fixes the blocked segment, with the second he gently presses on another part of the body, which plays the role of a lever;
if the effect is carried out according to the rules, then the person soon feels the disappearance of pain and noticeable relief appears;
The final stage of the session is working out the neck and shoulder muscles, hand massage. After the procedure, the chiropractor recommends not to overload your back and stop carrying heavy objects. A mandatory element of the treatment of osteochondrosis is therapeutic exercises. The doctor suggests simple exercises that the patient should regularly do at home;
The patient comes to the next session at the appointed time. It is not advisable to skip procedures: the effect of manual therapy sessions is lower than with regular visits to a specialist;
in the intervals between visits to a specialist, the patient, as prescribed by a neurologist, orthopedic traumatologist or vertebrologist, visits the physical room, undergoes physiotherapy, massage, takes NSAIDs, drugs to eliminate muscle spasms, analgesics, B vitamins. Only with a combination of several elements of therapy can cervical osteochondrosis be dealt with .

Go to the address and read the information on how to perform therapeutic exercises for osteochondrosis of the cervical-thoracic spine at home.

Duration of treatment

With complex therapy of cervical osteochondrosis, the course of manual therapy lasts from two to three weeks to 2-3 months. Sessions take place 2 times a week, but the frequency of procedures can be adjusted depending on the severity of the disease and the individual characteristics of the patient. The average interval between visits to a chiropractor is from 1 to 7 days.

Many patients are interested in why it is impossible to speed up treatment by going to a chiropractor every day. The explanation is simple: after eliminating the “block” in the spinal segment of the ligament, the muscles must adapt to the new position and tighten to properly fix the vertebra. This period lasts from 40 to 48 hours.

If one segment is affected, then it takes three sessions to restore it; if there are changes in other vertebrae (there are 7 in total in the cervical area), then the duration of therapy increases.

As treatment progresses, the chiropractor must ask the patient whether there are changes in sensations, whether negative signs in the cervical area disappear, or whether there are signs of worsening of the condition. The doctor notes all complaints and positive aspects in the patient’s card.

Possible complications

The vertebrae of the cervical area are smaller and thinner, the slightest deviation from the treatment regimen or improper influence on the bone structures provokes serious disorders. It is important to remember that damage to the vertebral artery and sensitive nerve roots can provoke oxygen starvation of the brain with serious consequences.

Other serious consequences are possible:

development of ischemic stroke;
strangulated hernia;
fractures of bone processes, ribs, and other solid structures;
development of a dangerous condition - hypermobility (excessive mobility) of the spine;
muscle and ligament rupture;
displacement or blocking of the vertebrae.

You can avoid unpleasant consequences by contacting a highly qualified chiropractor. It is important to check the availability of a diploma, find out patient reviews of the manual therapy clinic, and find out whether the doctor is taking advanced training courses. Precautions will not hurt: There are known cases of death due to a fracture of the cervical vertebrae or ischemic stroke when the session was performed incorrectly by charlatans or doctors without the appropriate specialization.

For osteochondrosis and other diseases of the joints and spine, manual therapy gives a positive result, but many traditional medicine doctors do not recommend attending sessions if discs are damaged in the cervical area. High professionalism and understanding of the line between benefit and harm for the fragile vertebrae of the upper spine are required in order to avoid serious complications. If the sessions are conducted by an experienced chiropractor, then the benefits of the procedures appear in most cases.

Video about the features of manual therapy sessions for cervical osteochondrosis and pathologies of the cervical spine:

Manual therapy is an area of medicine that is becoming more popular every year. However, not everyone fully understands what the features of this type of treatment are, how it differs from massage, and what diseases can be treated with manual therapy. Answer all these and many other questions in an exclusive interview with the portal FashionTime answered by the clinic's chiropractor GMS doctor Andrey Ivanovich Oros.

What are the main problems that manual therapy solves? By what means? How do they differ from standard practice?

Manual therapy is a branch of medicine in which the doctor performs manipulations with various tissues of the body, parts of the body, and the impact on them relieves pain syndromes. That is, thanks to manual therapy, pain is relieved, the mobility of tissues and joints is improved, and preventive measures are carried out - for example, slowing down the aging process of tissues due to a large volume of movement.

If we go deeper into history, the basis of manual therapy is rachitherapy - oriental techniques for influencing the spine. Manual therapy consists of subsections: soft tissue techniques (when a chiropractor works with muscles, skin, subcutaneous fat), joint techniques (when he works with joints) and specific techniques that came to us from the science of osteopathy. In addition, techniques for working with the bones of the skull, cervical spine and sacrum and visceral manual therapy techniques have been added - this is work with internal organs. There are also techniques of body-oriented manual therapy - that is, when, working with his hands, the doctor works on relaxation.

- When did manual therapy begin to actively develop?

In 85-86 years of the last century. Karel Levit's first books were published, and he immediately had students. But then there was such mixed manual therapy - rather harsh and manipulative techniques. So, everyone was waiting for a “manipulation click”, there were even ways to create it on purpose, but in fact, many manipulations in joints occur without any sound phenomenon at all.

- For whom is manual therapy most relevant?

First of all, for residents of big cities. In villages it is less relevant, since people are constantly moving there. Thanks to this, their muscles work, there is no isometric tension, static deformations, or static overloads. In big cities, in addition to bustle and speed, stress has become a sign of the times. We have biomechanical (static), chemical (what we breathe) and psycho-emotional stress. And a chiropractor solves these problems. The nervous system cannot develop in isolation from the muscles; any stress reaction is registered in them. Correct work with these muscles is a release of tension and a reflex response to the brain - calming, relaxation, stress relief.

- Should a chiropractor have a medical education or license?

Manual therapy can be professionally practiced by doctors of two specialties - a traumatologist-orthopedist and a neurologist. After receiving one of these specialties, the doctor must undergo five months of training in manual therapy and receive a certificate. That is, the chiropractor must show you: first, a medical diploma, second, one of the specializations: traumatologist or neurologist, and third, a currently valid certificate, which is issued for five years. Almost all chiropractors receive additional training because osteopathic medicine does not go through an official registry, and therefore when cranial therapy techniques, visceral techniques are needed, you study separately. Another very important point: a chiropractor must have knowledge of individual therapeutic exercises and exercise therapy. He should give exercises to patients.

What side effects can occur after manual therapy sessions? Can manual therapy not help, but harm the patient?

In any specialty you can do harm. Manual therapy can cause harm if a thorough diagnosis is not carried out. It is based on an incorrect diagnosis and rigid implementation of techniques.

It is advisable that the patient comes to the chiropractor no more than twice a week, a maximum of three times, but the third time should be only soft tissue, that is, work only with muscles, without manipulation. According to the rules, for a course of 10-12 sessions there should be no more than two or three manipulations, and sometimes they are not needed at all. The course does not have to be 10 days. Let it be better to have 10 sessions twice a week. Against this background, in addition to working with your hands, you are obliged to teach the patient exercises to stabilize the body, give the safest exercises that do not wear out the spine, but load the most important muscles. Be sure to work on the patient's weight. It is very good if a chiropractor has knowledge of nutrition, because he can tell you how to eat properly. You also need to understand what aerobic and anaerobic exercise is in order to advise how best to exercise for the diseases that the patient has.

Should you visit a chiropractor as a preventative measure or only when necessary? If so, how often?

I have a lot of patients on preventative care. I usually work out with them once or twice a week. It's a matter of money. We don’t have social programs in this area. In our country, manual therapy has been legalized by order, the number of offices per thousand people is written, but in fact, it is still a rather chaotic industry.

How long does a manual therapy session usually last?

A normal chiropractor will not do two clicks in 10-15 minutes - and that’s it! Typically a session lasts 45 minutes - 1 hour. At the same time, it begins gradually, the tissues are prepared, and are gradually brought into a certain state. When a chiropractor works on-line, a patient, for example, comes with a complaint of pain in the cervical spine, and he works only with the cervical spine. It is correct and useful for the patient to work out all the links in the kinematic chain: the thoracic, lumbar, and pelvis. And only when all these zones have relaxed can you move on to the neck.

- What are the indications and contraindications for manual therapy?

Indications are all manifestations of osteochondrosis, pain syndromes in the back, in the muscles, in the collar area, in the lumbar, in the thoracic region, post-traumatic pain syndromes, contractures (impaired range of motion in the joints). Indications also include static deformities, scoliosis, kyphosis, flat feet, varus deformity, muscle-tonic syndrome associated with static overload. There is also a term that we have collected in the clinic - “office worker stress” - complex psycho-emotional and static stress that accumulates due to working at the computer and strong pressure, which leads to the fact that a person tenses up and the muscles then do not relax. Another indication is to test the patient before playing sports.

As for contraindications, firstly, it is an acute injury, a fracture. Secondly, severe vascular problems, heart rhythm decompensation, heart attack, stroke, hemorrhage, blood clotting disorders. Contraindications also include oncology, tumors, metastases that are located in the bones, working with which can cause a fracture, severe osteoporosis, when the patient has a very fragile bone. At the same time, there are absolute contraindications, and there are relative ones. In principle, it is possible to work with both osteoporosis and oncology, but using certain techniques, with a certain rhythm and a certain sequence.

- Can children visit a chiropractor? What age restrictions are there?

Chiropractors work with children from a very early age, using very gentle techniques on the cervical region, with the bones of the skull, massage techniques, traction, and muscle relaxation. Usually in such cases the specialist only deals with children. Most often these are women, since they have softer hands and small children are less afraid of them. But in general there are no age restrictions. Older people can also visit a chiropractor. Soft tissue techniques are used here, mainly relieving muscle-tonic syndromes, gentle stretching, and working with joints.

- Do people with good athletic training, yoga and Pilates lovers find it easier during manual therapy sessions?

My patients who do yoga and Pilates find manual therapy much more pleasant for the reason that, firstly, their joints are developed, and secondly, while doing all this, they feel the need to work in a passive barrier. The range of motion in a joint consists of three elements: there is an anatomical zone, there is an active zone, and there is a passive zone. Your muscle works in the active zone, you go to train and work in this zone, but you cannot get into the passive zone, it can only be influenced from the outside. This is a doctor's area. Patients who are actively involved in sports have a need to get into this passive barrier, because they themselves understand that during exercise it is not always possible to get there. And when the doctor begins to work in this range, they experience great pleasure.

But at the same time, sessions with a chiropractor cannot replace sports activities or somehow compensate for their absence?

Never. A person must lead an active lifestyle so that nature can heal him, and a chiropractor must help if any problem, decompensation, injury, disease arises. The biggest deception is if even one chiropractor says that he will give you such techniques that you don’t need to go to the gym after that.