Chiropractor - a doctor involved in the diagnosis and treatment of diseases primarily of the musculoskeletal system, as well as internal organs. The main working tool of a manual operator is his own hands.

On the one hand, the work of this specialist can be characterized as performing a deep massage, although at the same time it is believed that the technique of influence and healing techniques- it's more than a massage. The techniques used are carried out directly on bone skeleton, while a massage therapist has the right to work only with soft tissues. As a rule, such a profession is obtained by neurologists and surgeons who have undergone specialization in manual therapy.

Do not confuse a chiropractor with a chiropractor. The latter sets dislocated bones, while the chiropractor uses about 3 thousand methods aimed at restoring the correct position of certain organs relative to each other. These are mainly spinal disorders, which, according to statistics, affect approximately 85% of the world's population.

When should I go for an appointment?

Often the symptoms that come to the doctor are associated with pinched vertebrae or curvature of the spine and they manifest themselves as follows:

• pain in the cervical spine, back, acute or chronic;
• constant headaches;
• various diseases of the spine;
• pain and partial immobility in the shoulder or hip joints;
• dizziness due to osteochondrosis;
• incorrect posture (scoliosis, for example);
• fatigue, restless sleep.

What diseases does a chiropractor treat?

When talking about what a chiropractor treats, you should understand that the list of diseases is very extensive. Let's highlight some of them:

• osteochondrosis;
• postural disorders: kyphosis, scoliosis, lordosis;
• hernias between the vertebrae;
• flat feet;
• arthritis, ;
• diseases of the genitourinary system;
• diseases of men and women reproductive organs, treatment of infertility in certain situations;
• excess weight;
• diseases of the ENT organs, nervous system;
• cerebrovascular accidents;
• lung diseases caused by spinal displacement;
• diseases associated with traumatic brain and birth injuries;
• rehabilitation after injuries.

How is the reception going?

The doctor listens carefully to the patient, his complaints about his health condition, and examines medical documentation. After this, the actual diagnosis begins. The specialist checks joints for mobility, determines areas where muscles are tense, and evaluates pain activity.

Having made some conclusions, the doctor determines treatment tactics and duration of sessions, and finds out whether there are contraindications for treatment. In some cases, additional examination is prescribed. As a rule, the course of treatment is 10 sessions, performed 1-2 times a week. After six months, it is recommended to repeat the course.

Manual therapy methods

Subcutaneous myofascial

It involves working with tissues, which is based on intensive effects on muscles and fascia. A technique is used to improve lymphatic drainage, with venous insufficiency, spondylosis, radiculitis, intervertebral hernias, headache. All manipulations are carried out only after thorough examination patient.

Cranio-sacral technique

It was created to work on cranial joints and neck muscles. With its help, they get rid of dizziness, intracranial pressure returns to normal, and memory improvements are noticeable. All this happens by improving blood supply to the neck muscles.

Arthro-verbal method

The goal of this technique is to restore the functions of all damaged joints in the shortest possible time. The treatment is painful and requires the patient's prior consent.

Visceral method

With its help they achieve positive results in the treatment of internal organs. The use of this technique improves the functioning of the heart, lungs, intestines, liver, and reproductive system.

Basic techniques and techniques

Push mobilization

Helps to straighten discs, eliminate subluxations of joints, and break off exostoses.

Positional mobilization

The essence of the method is a slow and smooth stretching of the periarticular muscles. This is how restoration occurs.

Rhythmic mobilization

It is often used in manual practice because, in addition to being effective, the technique is safe and easy to perform. The patient does not feel pain.

Types of rhythmic mobilization:

• rotating: used to realign the knee, shoulder or elbow joints, while one segment of the limb is fixed, and the second is gently rotated;
• stretching: the essence is to stretch all surfaces of the joints;
• compressive: used only when the first two steps cannot be performed.

Postisometric relaxation

Section of soft manual therapy. The result is achieved through short-term muscle tension(about 10 seconds) followed by muscle stretching (also about 10 seconds). Such relaxation is very effective in the treatment of osteochondrosis.

Contraindications

The chiropractor may conclude that the patient is contraindicated for any manipulation. The main reasons for doctor refusal to treat include:

• oncopathology;
• early period after surgery;
• diseases of the joints (spine) of an infectious nature;
• mental disorders;
• persistent increase in pressure;
• extensive disorders in the spinal or cerebral circulation.

What additional examinations may be needed?

• Clinical and biochemical analysis blood.
• Electromyography (EMG).
• Examination of the spine using x-rays.
• MRI and computed tomography of the spine.
• Duplex scanning of blood vessels.
• Additional consultation and.

Can pregnant women attend an appointment?

Yes, but not all therapy methods are approved for use. So, during pregnancy, shaking, turning, twisting, and rotating are contraindicated. The doctor treats this category of patients only with gentle methods.

What does a chiropractor treat during pregnancy?

• severe back pain;
• threat of termination of pregnancy (not in all cases);
• chronic fetal hypoxia;
• prepares the pelvis for the upcoming birth;
• uterine tone;
• severe and frequent swelling of the legs.

Few people clearly understand who a chiropractor is and what he does. Patients often assume that the specialist's area of ​​work is back massage, which is an unconventional spinal therapy option. In fact, a good and qualified chiropractor is an important specialist, closely related to neuropathology and effectively treating many diseases.

It's called manual therapy medical field, which involves the use of a doctor’s hands to treat pathological processes in the joints, spine, muscles and internal organs. All treatment methods are divided into hard and soft. The latter type of influence is also called osteopathy.

A chiropractor is a doctor who uses his hands not only to soft fabrics, but also on bones and joints. This significantly increases his rating compared to an ordinary massage therapist. This specialist, first of all, has a medical degree in neuropathology or orthopedics, and only then additionally studies manual therapy.

What do chiropractors treat?

Doctors in this specialty work with diseases that can be treated externally. The list of pathologies that fall within the scope of activity of a chiropractor is very large.

Patients with the following problems are treated by a chiropractor:

• osteochondrosis and any of its complications (one of the most common diseases of the spine in which dystrophic processes in the articular discs and their degeneration occurs with subsequent displacement of the vertebrae);
• flat feet (many people prefer to ignore the incorrect position of the foot, but it entails back problems caused by the redistribution of the load on the legs);
• radiculitis (inflammatory process in the roots spinal nerves which is accompanied by severe pain);
• postural disorders (this includes scoliosis, that is, curvature of the spine to the right or left, kyphosis and lordosis, that is, disturbances in the physiology of bends in the thoracic and lumbar regions, respectively);
• inflammatory process in the area sciatic nerve(one of the most common pathologies in women);
• arthrosis and arthritis (various types of joint damage: isolated and as part of systemic connective tissue pathologies);
• spinal hernia (in adults, a chiropractor treats this pathology in 50% of cases, if not more often);
• traumatic injuries and rehabilitation after them;
• manifestations vegetative-vascular dystonia(headaches, tachycardia, pressure surges, sleep disturbances, fatigue, and so on);
• chronic and sharp pains in the back, joints without a clear diagnosis;
• syndrome chronic fatigue(manual therapy often helps better than pills);
• any clinical manifestations related to improper positioning or functioning spinal column, joints.

Not only the patient, but also the doctor in the clinic who issues a referral to a specialist must understand who he is and what a chiropractor does.

Most often, the patient gets to the doctor after visiting a therapist, neurologist, rheumatologist or orthopedist.

How does an appointment with a chiropractor work?

When visiting such a therapist, the patient expects that he will immediately begin to be treated according to the diagnosis. Because this doctor is a certified specialist, he must verify for himself the correctness of the established diagnosis and conduct a series of examinations to clarify the nuances of the disease.

First of all, at an appointment with a chiropractor, a survey is carried out regarding complaints, anamnesis of the disease and the presence of additional pathologies, possible contraindications. Then a chiropractor conducts an examination, during which he finds out the location of the problem, its characteristics and makes a preliminary diagnosis. Already at this stage it is being developed rough plan treatment, which is approved after additional research.

The chiropractor may prescribe the following laboratory and instrumental methods diagnostics:

• clinical blood test (detection of inflammation, anemic syndrome);
• clinical urine test (assessment of kidney function);
• biochemical blood test (presence of acute phase indicators, protein balance, coagulogram, liver tests, blood glucose, and so on);
• specific laboratory tests (for example, rheumatoid factor);
• radiography of the affected area (visual assessment of joint displacement and the stage of their damage);
• computed tomography (a clearer diagnostic method that allows you to determine treatment in the most difficult situations).

Having figured out what a chiropractor treats, the patient can independently turn to him for help. However most often he will first be referred to a general neurologist or a therapist to exclude contraindications to manual treatment.

Treatment with manual therapy

The basis of manual therapy treatment is individual approach to every patient. The therapist must take into account the severity of the disease, associated conditions, physical stress on the body and many other factors.

The therapy is carried out in several sessions, which are not recommended to be skipped.

The chiropractor can choose any treatment method from the following options:

• acupuncture (is a specialized analogue of acupuncture);
• pharmacopuncture (is a complement to the previous method, as it involves the administration of drugs through acupuncture);
• massage (there are many varieties of this method of treatment, often with a chiropractor massage is the basis of a complex of therapy);
• moxa therapy (represents heating of points of influence on the lesion);
• traction (used to give physiological position to bones and joints);
• various variations physical therapy(types of sports and loads are selected taking into account the patient’s condition);
• nutritional recommendations (in some pathologies, for example, gout, this is most important).

Chiropractor doing therapy medicines more successful. In addition, it affects the mechanism of occurrence pathological signs, which is much more effective than symptomatic medications.

Contraindications to hand therapy

Unfortunately, not all patients are allowed to undergo this type of treatment, which the specialist must take into account before issuing the appropriate referral. A chiropractor provides a specific type of treatment that has a number of contraindications. The doctor must remember this and always rule out their presence. The main contraindications:

• malignant neoplasms of any location, duration, severity;
• some congenital pathologies of the spine that cannot be corrected and prevent adequate manual treatment;
• acute phases inflammatory processes in the body;
• pathologies of the gastrointestinal tract in the acute phase;
• diseases of the spinal cord and brain;
• chronic pathologies in the stage of decompensation;
• mental disorders.

In addition to therapeutic activities, the doctor chiropractor is also involved in health education work. The pathologies treated by this doctor are easier to prevent, therefore there is a set of recommendations for patients. It includes the following items:

• the human body should receive a moderate amount of physical activity daily to keep muscles and joints in good shape;
• a person must have a well-developed back muscle that supports the spine (for this it is recommended to perform a set of special exercises);
• healthy eating is the basis of health;
• a profession involving sedentary lifestyle life, must have a properly equipped workplace;
• normalization of the work and rest regime, as well as the organization good sleep allows you to reduce the risk of a huge number of pathologies.

By following these recommendations, you can significantly reduce the likelihood surgical intervention. The patient should know that the doctor who offers to cure many pathologies of the spine and joints without surgery is a chiropractor. However, such a doctor must have an appropriate diploma.

Manual therapy received its official recognition not so long ago:

• In 1958, the MFMM (Manual Federation of Manual Medicine) was created.
• 1987 - a similar society was organized in the USSR.
• 1988 - officially allowed to use manual therapy methods in the USSR.
• 1997 - a new one appeared in Russia medical specialty: “chiropractor.”

Despite the fact that the effectiveness of manual therapy has not yet been proven (it happens), it has become widespread, especially in the treatment of CMS diseases. Today, not a single orthopedics or vertebrology clinic can do without a manual on its staff - this is usually a generalization for all doctors involved in manual therapy and massage. Many patients are interested in who this specialist is and what he does, and how to distinguish him, say, from an osteopath.

Manual therapy evolved from pre-existing chiropractic and osteopathy (alternative health sciences).

Chiropractors

Chiropractic is literally translated from Greek as “manual action.” The method originated in England in 1890 (its founders were the father and son Palmers). Chiropractors dealt with:

• subluxations of joints (especially vertebral ones);
• muscle spasms;
• circulatory disorders;
• biomechanical disorders.

(Isn’t it all so familiar?)

Many of them initially used rather harsh methods of reduction and traction, considering subluxations to be the cause of everything, and neglected diagnosis. Side effects often occurred as a result of these treatments, especially when vertebral hernias Oh. Later, mixed, more tolerant techniques appeared, using traditional diagnostics, massage, physical exercise, cold treatment, acupuncture, homeopathy.

Chiropractic has become more widespread in Europe. In Russia, it is more familiar as chiropractic.

Osteopaths

Osteopathy (literally translated as bone disease) was founded by the American surgeon Steele at the end of the 19th century. It originated from general philosophical concepts (mind, body and spirit are one), and today deals not only with bones, but also with internal organs, looking much more broadly at diseases. There are three branches of osteopathy:

• Structural O. - correction of anatomical motor disorders using the principles of biomechanics, self-regulation and remote influence.
• Visceral O. - restoration of the correct position of organs and their rhythm; treatment of organ disease by affecting the vertebral segments.
• Craniosacral O. - massage of the skull to regulate the movement of cerebrospinal fluid from the brain to peripheral system and improving metabolism (there is no scientific evidence for this).

Osteopathy is more gentle. It is aimed more at eliminating the very cause of the disease, rather than its symptoms or consequences.

The method of osteopathy has become widespread in Russia.

Manual medicine

In Europe, manual medicine was promoted by the Czech professor Karel Levit, who wrote a work of the same name on this topic, in which he simply included many methods of chiropractic and osteopathy and gave them a new name. It would seem that chiropractic and osteopathy are pseudosciences that are even prohibited in the USA. But for some reason they did not ban manual therapy, although it conscientiously ripped off methods from chiropractic and osteopathy. Well, these are the visible oddities of the highest medical associations and communities.

Manual therapy is not something new. This is a symbiosis of many methods of manual influence, drawn from other alternative medical practitioners, as well as ancient Chinese and Japanese medicine.

Manual therapy has learned:

• From chiropractic - techniques for reducing subluxations, sprains, applied kinesiology.
• From osteopathy - anatomical-structural, visceral, craniosacral therapy, lymphatic drainage.
• From Chinese and Japanese medicine - reflexology (acupuncture and acupressure).

A professional chiropractor today must be proficient in many techniques, traction and reduction techniques, be a reflexologist, and understand the anatomy of the musculoskeletal system in adults and children no worse than a surgeon.

At the same time, manual therapy does not completely replace osteopathy, since it does not follow its first principle - the integrity of the body. Its goal is to cure a specific disease, and not the entire body as a whole. In this sense, it has a narrower practical scope of application. A chiropractor does not cure “everything,” but is sometimes able to help where other means do not help.

Capabilities of a chiropractor

The use of manual methods of influence allows you to:

• Perform drug-free pain relief.
  • All painkillers (NSAIDs, corticosteroids, muscle relaxants) are applied great harm and they cannot be used for a long time. And pain during degenerative processes easily moves from radiculopathy to persistent chronic muscle pain.
• Avoid surgery.
  • Arthrosis at a late stage often ends with ankylosis (complete immobility), as occurs with coxarthrosis, or instability, characteristic of gonarthrosis. Periodic repetition of manual therapy sessions at the first and second stages of arthrosis will allow you to avoid expensive endoprosthetics and painful long-term rehabilitation in the future.
  • A spinal hernia of a posterolateral direction can cause a lot of troubles and cause severe pain, motor disorders, organ dysfunctions. An alternative to surgery may be manual spinal traction. Attention! This procedure is performed exclusively experienced professional with knowledge in vertebrology and anatomy.
• Maintain mobility of the spine by correcting displacements, relieving muscle spasms and joint blockages caused by:
  • displacement of the ribs due to loads and movements;
  • increased static stress in the thoracic region caused by an uncomfortable posture;
  • arthrosis of the costovertebral joints, due to which they are blocked in the articular fossa.
• Correct compensatory curvatures of the limbs and spine, acting on the root causes, sometimes remote:
  • reducing hallux valgus deformity feet, solve the problem of X-shaped legs;
  • by correcting displacement of the pelvic bones after childbirth, they prevent the development of lumbosacral scoliosis and hernia l5 - s1;
  • eliminating flat feet, correcting the entire biomechanics of the spine, including the cervical spine, and eliminating headaches, insomnia and other consequences of cervical deformities.
• Eliminate the consequences of certain congenital anomalies.
  • Torticollis in a child when due to incorrect position in the womb, the sternomastoid muscle shortens and subluxation of the atlas occurs. Torticollis leads to headaches in children, poor circulation, and insomnia. The therapist's actions: reduction of the dislocation and manual stretching of the muscle.
  • Congenital hip dislocation - pathology embryonic period and a consequence of birth trauma.
  • Osteochondrosis of newborns: in newborns the spine is compressed, and it is connected by nerves to all organs, and for this reason there are stomach cramps and jumping. After the first two months of life, the symptoms of osteochondrosis in children gradually disappear, but can persist for up to a year. Manual stretching of the spine can relieve a child from back pain and gastrointestinal cramps and colic.
• Help a woman during and after pregnancy:
  • eliminate back pain;
  • prevent spinal curvature and hernia;
  • reduce increased uterine tone;
  • prepare the pelvic bones for childbirth;
  • eliminate displacement of the pelvic bones after childbirth.

What does a chiropractor treat?

Those who have pathologies should contact a chiropractor musculoskeletal system, associated primarily with structural benign reparable disorders of the musculoskeletal system.

This is first of all:

• arthrosis;
• subluxations and dislocations as a result of injury;
• curvature of the spine;
• muscle tension;
• myalgia (muscle pain),
• intercostal neuralgia;
• early hernias;
• tunnel neuropathies (piriformis syndrome, median nerve syndrome),
• post-traumatic and age-related contractures, etc.

Also the M.T reading area:

• Visceral pathologies are diseases of organs caused by incorrect anatomical position (for example, bending of the gallbladder, prolapse of the kidney).
• Pathologies of impaired blood circulation (dizziness and headaches when cervical osteochondrosis, pain in the pelvic area, legs, venous insufficiency).
• Diseases associated with poor lymph circulation cerebrospinal fluid(lymphostasis of the limb, increased intracranial pressure).

All such problems are dealt with by a chiropractor.

Contraindications

Not every subluxation, displacement or pain is a reason to go to a chiropractor. Manual therapy is contraindicated:

• with congenital subluxations caused by abnormalities of bone development, pronounced asymmetry;
• curvature of the spine of the third or fourth degree;
• spondylolisthesis;
• acute radiculitis (radicular syndrome);
• dorsal hernia with symptoms of radiculopathy or myelopathy;
• destructive bone lesions (osteomyelitis, tuberculosis);
• infectious myositis;
• all chronic infectious, purulent, oncological processes;
• osteoporosis;
• spondyloarthritis;
• rheumatoid arthritis;
• traumatic injuries.

What does a chiropractor do during a session?

To restore movement in the joints, return displaced bones to their place, remove blocks and spasms, the chiropractor uses more than a hundred different techniques (more than a thousand are used in osteopathy).

Here are some of them:

• Mobilization - the bones of the immobilized joint are gradually loosened and gently stretched.
• Manipulation - unlocking the joint is carried out with one strong movement. The method may cause pain.
• Stretching - applying multidirectional efforts, the therapist stretches the shortened muscles and ligaments. This technique is used to treat contractures.
• - under the guidance of a chiropractor, the patient first creates tension in the muscle stretched to the pain barrier, then relaxes it, and the doctor stretches it a little further than the barrier. Each time it increases the stretch, thus eliminating muscle spasm.
• (acupuncture) - introduction to special meridians active points needles followed by manipulation. The method allows you to relieve muscle spasms and treat visceral diseases.
• Acupressure - manual pressure to the same points (

“There are many diseases, but one cause – the spine,” said the great Hippocrates. He is considered the first chiropractor: by tapping, stretching, and realigning displaced vertebrae, the ancient healer not only relieved his patients of back pain, but also simultaneously cured diseases of the throat, kidneys, bladder, respiratory organs. At first rejected by medical science, this method of treatment defended its right to exist, putting more than one thousand patients on their feet. Today, spinal manual therapy is popular among doctors and their patients; it is considered the best fast, drug-free method of restoring the health of the musculoskeletal system and reflex organs.

“Healing with your hands” is how the name of the well-loved healing practice is translated from Latin. We have already talked about it in detail in the article “Manual massage: restoring beauty and health in 45 minutes.” Like any other area of ​​medical science, manual therapy is based on basic rules and principles, the implementation of which becomes law for every doctor.

Chiropractors pay special attention to working the spine, even if the patient does not complain of back pain. This is because spinal nerves provide sensitivity, motor activity, trophism and autonomics of any organ in the human body. A major artery, which supplies most of the brain, passes through the processes of the cervical vertebrae.

Therefore, many diseases of the nervous system and internal organs: VSD, hypertension, dyskinesia biliary tract, cardialgia, headache - begin with pathological changes in the spine. When selecting methods of influence, one also follows strict rules: rotational (rotational) techniques are preferred when working with the lumbar and cervical region; for the thoracic area, a pressure technique is chosen.

Thematic material:

Contraindications

Considering the intensity of manual therapy and the global changes that occur under their influence in the body, the prescription should be approached with caution. Absolute contraindications to the procedure are:

Interestingly, manual therapy is not contraindicated for spinal hernia. But inept actions, especially in the cervical region, can lead to serious disruption of blood flow and oxygen starvation, so you need to act with extreme caution.

Basic Techniques

The purpose of this type of manual therapy is to improve the health and correct the functions of the spine. For this purpose, techniques have been developed over the centuries to help relieve pain, return displaced vertebrae to their place, increase the space between them, eliminate functional blocks, release pinched nerves and blood vessels. The result was medical complex, which combines unique techniques based on knowledge of anatomy and physiology.

Postisometric relaxation (PIR)

The goal of this method is to eliminate pain, relax and stretch the muscles surrounding the spine as much as possible, and prepare the patient’s body for subsequent more intense effects. Manipulations are performed very carefully. Otherwise, muscle spasm occurs, which only worsens the condition.

The mechanism of action of this technique is very simple:

The action algorithm is repeated 7–10 times, depending on the patient’s condition. As a result, pain goes away, muscle tissue becomes soft and elastic, allowing the therapist's fingers to penetrate deep bone structures.

Post-isometric relaxation techniques are carried out on all parts of the spine: cervical, thoracic, lumbosacral, using different techniques of influence. Cervical area, due to its openness and mobility, is considered the most convenient for a chiropractor to work with. Downside The medal becomes particularly sensitive, which increases the risk of all kinds of injuries and damage.

Push mobilization

Despite the name, this radical technique is a common type massage effect, because:

• represents a not too intense, but sharp single push, directed towards the greatest restriction of movement;
• performed unexpectedly for the patient, at the moment of exhalation and complete relaxation;
• changes the physiological boundaries of joint mobility.

With this technique, chiropractors realign displaced discs, eliminate subluxations of joints, and remove osteochondral growths - exostoses. Treatment of the spine begins with thoracic, then move to the lumbar, and end with the cervical vertebrae.

A specific click or crunch indicates the correctness of the procedure and increased mobility in the massaged segment. Accompanied by relaxation of the muscles that carry out the functional blockade, relief of tension and relief pain. It is interesting that, despite numerous studies of the nature of the click, the reason for its appearance has not yet been precisely established. One of the versions is called the vacuum phenomenon - the rupture of surfaces “glued” together.

Rhythmic mobilization

This technique is considered safe, easy to perform, painful, but very effective. Just like push manipulation, it removes functional blocks and increases the mobility of joints. Working with the spine, the therapist:

• Performs traction - stretching of the joint, changing the distance between its surfaces. The main task in this case is to maintain pre-stress. The efforts should not be excessive: they increase at the moment of stretching and decrease when releasing.
• Performs rotation, slightly shifting the articulation elements relative to each other and smoothly swinging them towards the limitation with a frequency of 1–2 movements per second. This technique is most often used to correct the cervical, thoracic and lumbar spine.
• Performs compression - rhythmic pressure on those areas where previous techniques are impossible. On the back, this is the sacrum area and areas surrounded by highly spasmodic muscles.

Rhythmic mobilization is carried out as an independent procedure or used as a preparatory stage to more intensive actions.

This technique is considered universal, as it combines elements of manipulation, rhythmic mobilization and post-isometric relaxation. Performed at a slow pace:

1. The doctor finds a position in which maximum tension occurs in the joint in the direction of limitation.
2. Holds with force for 1–2 minutes.
3. At the same time, it affects the muscles: it stretches the flexors and contracts the extensors.

As a result, the position of the joint elements is corrected and spasms are relieved muscle fibers, the physiological boundaries of joint mobility expand, the functional reserve of tissues is restored.

Features of manual therapy of the spine

It's amazing how everything is interconnected in the human body. The lungs, stomach, liver, head or gallbladder If your nerves are out of kilter, take care of your spine health. Simple techniques of manual correction in many cases can improve the condition or permanently get rid of the “unsolvable” problem.

For lumbar hernia

The human spine is often compared to a spring: it not only cushions and supports our body, but also provides the ability to perform complex movements. What makes it so functional is the intervertebral discs, or more precisely, their core - an elastic substance called the nucleus pulposus.

IN healthy body this structure is reliably protected by a dense fibrous ring, which under unfavorable conditions becomes brittle and cracks. In this case, the pulp comes out, squeezing blood vessels and nerve endings, causing severe pain, disrupting motor activity, and sometimes leading to disability.

Manual therapy techniques can help gently move the bulge back into place. To do this, choose one of many methods, focusing on the results of research and initial examination. The massage therapist works in stages:

1. Warms up muscles and vertebrae using classic massage techniques.
2. Eliminates functional blockade, relieves spasm and pain using spinal stretching, working out trigger points, pulse technique or defanotherapy - sharp and quick pushes, tapping, aimed at restoring the location of the vertebrae relative to the vertical axis.
3. Engaged directly intervertebral disc using the tensile load technique. It helps restore nutrition and activate the flow of cerebrospinal fluid, the deficiency of which leads to thinning and desiccation. cartilage tissue.

After such manipulations:

• blood flow to the affected area increases;
• tension is relieved from muscles and ligaments;
• the position of the vertebrae is corrected;
• the distance between them increases;
• the damaged cartilage disc becomes denser;
• muscle tone increases.

Manual practice for lumbar hernia is prohibited in postoperative period, with infection, instability of the vertebrae or abnormalities of their development.

For cervical hernia

The symptoms of this pathology are:

• pain in the back of the neck, aggravated by coughing or sneezing;
• numbness of the hand, tingling, crawling “goosebumps”;
• headaches and dizziness;
• memory impairment.

If you have these signs, hurry to see a doctor. With a hernia cervical region This is not a joke: the disease can lead to dangerous compression of the spinal cord, which causes paralysis of the limbs or respiratory tract.

A chiropractor will be able to set the hernia back into place. To do this:

• before and after the procedure the patient is prescribed bed rest and complete rest to remove excess stress from the cervical spine;
• massage begins only when the patient is completely relaxed;
• used for treatment various techniques mobilization, manual traction, acupressure, shock-pulse and decompression effects.

These techniques create negative pressure in the spine, causing the hernia to literally be pulled into the center of the cartilage disc.

In terms of effectiveness, this treatment ranks second after surgical intervention. However, it is important that the procedure is performed only by a qualified therapist.

For fractures

Our spine consists of vertebrae, which, like any other bone structure, may break. The provoking factor is excessive axial loads, injuries, complicated diseases (osteoporosis, the last stage oncological process). In 50% of cases it suffers lumbar region, chest and cervical - much less common.

Sometimes only the integrity of the vertebrae is compromised, but spinal cord and the nerves remain unaffected. Most often in this case we are talking about a compression fracture, which occurs due to strong compression, bending or twisting of the vertebrae. The situation becomes much more serious with a comminuted or mixed fracture, when the spinal cord, nerve cells or blood vessels are damaged.

Therapy is prescribed depending on the severity of the lesion. It could be:

• Conservative treatment – ​​pain relief, fixation of the damaged area, medication.
• Surgical intervention - as a rule, several days before the operation the patient undergoes decompression - traction of the spine, and then the traumatic debris is removed.

Damaged vertebrae heal on average within 3 months. During this period, the patient needs to be provided with complete rest, and any movements and loads should be limited. All manipulations, especially such intensive ones as manual techniques, in the immediate vicinity of the spine are prohibited.

Gentle influence is permissible only in late period rehabilitation of uncomplicated fractures. Its goal is to relieve pain, relieve muscle spasms, and restore normal work spine. We remind you once again that only a master should perform the procedure in this case.

For scoliosis

This condition is characterized by displacement of the vertebrae, due to which one or several pathological arches are formed in different planes. Eliminate the problem with surgical or conservative treatment.

Manual therapy is prescribed from the age of three if the cause of the disease is:

• different leg lengths;
• displacement or deformation of the vertebrae;
• incorrect posture;
• sedentary lifestyle;
• big physical activity or lack thereof.

After a preliminary relaxing massage, the therapist realigns the vertebrae, removes functional blocks and muscle tension, using post-isometric relaxation techniques, stretching, and twisting. Rough movements and shaking are prohibited.

Manual manipulation is strictly contraindicated if the cause of scoliosis is birth injuries, infectious diseases of the spine, malignant formations, compressing the spinal cord.

For osteochondrosis

With this pathology, the vertebrae and cartilaginous discs develop degenerative changes. On initial stage they do not make themselves felt in any way, but over time pain appears and the mobility of one or another part of the spine is impaired. If the problem is not addressed, hernias form, osteophytes grow, links are displaced and deformed, leading to disruption motor activity patient.

Manual therapy effectively fights the disease. The main thing is not to waste time and carry out the procedure correctly at the very beginning. To do this:

After the procedure, you need to lie down for 10 minutes to give your body a break. Then fix the spine by wearing a special corset or collar (if we are talking about the cervical region).

With cerebral palsy

Sometimes during pregnancy or birth, the parts of the brain responsible for motor and muscle activity are affected. The baby becomes disabled for life: not only is he affected musculoskeletal system, but also the psyche, vision, speech.

Those suffering from cerebral palsy often experience pain in the neck, back, and joints. Their cause is increasing degenerative changes in bone and cartilage tissue. Manual influence can improve the patient’s condition, remove discomfort and stop destructive processes.

The doctor selects the treatment complex based on the needs of each patient. Three types of manual therapy are mainly used:

• Craniosacral– the impact is on the bones of the skull.
• Manipulative– the doctor works with the patient’s spine and joints.
• Visceral osteopathy– gentle effect on the muscle corset and internal organs.

As a result of properly performed massage, it is possible to restore the conductivity of nerve impulses, normalize muscle tone, accelerate regenerative processes in tissues, and significantly improve the patient’s well-being and mood.

The effectiveness of manual intervention

Manual therapy was recognized as a medical science back in the 19th century, but scientists are still debating its effectiveness and monitoring the effects of techniques on the body. Clinical studies showed that after a treatment course:

In the treatment and rehabilitation of some acute and chronic diseases such an effect is often much more effective than many expensive medications.

Session cost

In salons in Moscow and St. Petersburg, the price of one session of manual spinal correction ranges from 1,500 to 3,500 rubles and depends on the qualifications of the therapist, the complexity and characteristics of the course of the disease.

A visit from a specialist to your home will cost an average of 3,000 rubles. The procedure is usually carried out once every four days, the full course consists of 10-15 sessions.

What do inept manipulations lead to?

Despite the undeniable benefits of the procedure, the development of complications after manual therapy sessions is, alas, not uncommon. The most serious of them:

• ischemic stroke;
• pinching of the vertebral hernia or nerve endings;
• impaired blood supply due to compression of blood vessels;
• muscle and ligament ruptures;
• fractures of ribs or vertebrae;
• displacement of ridge links;
• development of hypermobility of the joints or spine.

The reason for such unpleasant consequences First of all, there is a low qualification of the chiropractor, lack of knowledge or experience. Ignoring contraindications, inaccurate diagnosis or incomplete medical history also leads to deterioration of health.

Performing the procedure at home

It is worth repeating that you should trust your health only to a qualified specialist. If for some reason a person is unable to get to a medical institution, a doctor is called to his home.

But some elements of manual therapy are still done independently. These are so-called automobilization techniques (“auto” means “oneself,” “independent”) to stretch the spine and relax nearby muscles.

Manual therapy is a set of minimally invasive techniques that influence muscles, joints, osseous-ligamentous apparatus and internal organs of a person using a variety of manual techniques.

Manual therapy is ideal for children and adults, men, women, and the elderly. It has existed for centuries, and over the past 150 years it has been supplemented with new techniques that can be used either in isolation or in combination with each other.

Manual therapy can be used to treat various diseases and symptoms: osteochondrosis, arthritis, VSD, headaches, hernias, problems associated with the gastrointestinal tract, protrusions, poor posture, etc. can be eliminated.

Manual therapy of the spine or joints is always prescribed in a course that, on average, consists of 5–7 sessions; sometimes treatment may be prescribed in fewer sessions. Sessions are held regularly, but not more than twice a week.

How is manual therapy different from massage?

Manual therapy and massage are absolutely two different ways impact. During massage, only soft tissues are affected. Manual techniques have a more severe effect on the joints, head, cartilage and internal organs. This is a serious interference in the functioning of the body; if performed incorrectly, serious and even irreversible consequences for the patient’s health are possible. Therefore, the literacy and experience of a specialist when performing manual techniques is directly proportional to the effectiveness of the course of treatment.

Specialists with experience in their field (5 years or more) who have higher education(doctors) and a certificate of specialization in the profile of manual therapy. In this specialty, a lot is learned in the process practical activities, therefore, the doctor’s work experience and intuition are especially important. Manual therapy can be prescribed only after consultation with medical specialists.

Objectives of manual therapy

The goal of manual techniques is to restore optimal function of the joints, spine, muscles, normalize the functioning of the nervous system and internal organs.

Chiropractor creates individual algorithm for each patient, which allows you to effectively influence problem areas and eliminate pathological processes and pain syndrome in them (joints, spine - cervical, lumbar and other parts, ligamentous and muscular apparatus, etc.)

Manual therapy methods

There are 4 main methods used in the manual direction:

• myofascial;
• cranial;
• arthro-vertebral;
• visceral.

Myofascial method- This is a manual impact on soft tissue, the main purpose of which is to restore reflexes and muscle tone. Myofascial work is soft, gentle, and has nothing to do with the reduction of intercostal discs.

This method of manual therapy is used to eliminate: headaches and muscle pain, radiculitis, arthritis, vertebral hernias, spondylosis, etc.

Cranial method used to correct problems caused by impaired brain function (pinched spinal nerves, headaches, previous TBI (traumatic brain injury), impaired blood supply to the brain). In this case, the area that the doctor influences is in the neck and base of the skull. The manual influence of a specialist restores the normal mobility of the skull bones, as a result of which the negative symptoms diseases. After the first procedure, the patient experiences noticeable relief, and after the entire course of treatment, the condition is completely normalized (intracranial pressure decreases, blood circulation stabilizes, headaches disappear, etc.).

Arthro-vertebral method restores the function of joints and spine by changing the reaction of nerve endings. The technique is quite painful, but effective. It perfectly relieves pain and prevents the development of degenerative diseases.

Visceral method used to correct pathologies of internal organs. In this case, massage actions (compressive, shifting) are carried out through the anterior abdominal wall. In this way, most diseases of organs located in the abdominal and thoracic cavities can be treated and prevented.

Techniques and Techniques

In the manual direction, many techniques are used: active, passive, direct, hard, soft. The main operating techniques are:

1. push;
2. rhythmic and positional mobilization;
3. post-isometric relaxation.

At push mobilization The chiropractor adjusts the discs, which eliminates pain in the back and other parts of the body.
Rhythmic mobilization can be stretching, rotating or compressive. Get a visual representation different types and manual therapy techniques allow various videos and photo.

Positional mobilization combines several effects (relaxation, manipulation and rhythmic mobilization). Actions are carried out sequentially (gentle stretching, bending). An important component of the technique is complete preliminary relaxation of the muscles. A set of manipulations leads to a gradual restoration of the reserve capabilities of the motor system.

Postisometric relaxation involves alternating tension and stretching of muscles, this allows you to increase the mobility of the spine or joint (for example, knee and hip), eliminate disc displacement, increase the mobility of ligaments and muscles, and relieve swelling. The effect on the body during relaxation is not accompanied by sudden jerking movements.

Indications for prescribing manual techniques

Manual therapy is a widespread area of ​​medicine; indications for its use are:

• intervertebral hernia, the presence of protrusion;
• arthritis, arthrosis;
• pain syndrome (neuralgia, pain caused by lumbar osteochondrosis, systematic headaches);
• VSD, pressure fluctuations;
• disruption of the stomach, intestines, liver, etc.;
• chronic fatigue, stress;
• rehabilitation after injury, etc.

Contraindications

Contraindications to manual techniques are:

1. inflammatory processes in the acute and subacute stages (gastrointestinal tract, spine, shoulder joint, knee, spinal cord);
2. early postoperative period;
3. presence of fresh injuries;
4. disc myelopathy;
5. hemangiomas;
6. sequestration of hernias;
7. rheumatism;
8. congenital pathology of the spine;
9. spinal fractures;
10. Bekhterev's disease;
11. tumors of malignant etiology of any location (especially in the area of ​​manual intervention);
12. tuberculous spondylitis;
13. blood diseases with a violation of the coagulation process.

Possible complications

Manual therapy, like any intervention in the functioning of the human body, can lead to complications, the main of which are:

• impaired blood circulation in the affected area;
• increased pain syndrome;
• sudden shooting ( sharp pain in the back area) - manual therapy in some cases can increase pain;
• hemorrhages (in the cavities of joints, muscles);
• muscle spasms;
• gap ligamentous apparatus, fractures of ribs, vertebrae.

Most often, complications during manual therapy are caused by an unqualified approach to work by a specialist. That is why it is important that the specialist has experience good reviews patients, acted as carefully and competently as possible so as not to harm the body.

A qualified doctor carefully evaluates the symptoms of the disease, diagnoses it before starting treatment, takes into account contraindications and high probability predicts the outcome of treatment and its effectiveness.

What happens during a manual therapy session?

Visually, a manual therapy session imitates a massage procedure. Its main difference is the dosage of force used when treating problem areas. A correctly dosed mechanical load can help the body, but an incorrect one can lead to a critical condition (ruptured ligaments, fractures).

A qualified specialist, using various techniques and techniques, can help the human body permanently get rid of a problem that he has been trying to correct for a long time with expensive medications.

Additional techniques

Additional manual therapy techniques include:

1. acupuncture, acupressure and Shiatsu;
2. craniopathy;
3. massage;
4. myofascial release and kinesitherapy;
5. lymphatic drainage

At acupuncture Bioactive points located on the surface of the skin are affected (special needles are inserted into them). Acupressure It is similar to acupuncture, however, the points are affected by pressing them with fingers or massaging them. Shiatsu has great similarities with acupressure (the impact is carried out on the bioenergy points of the body).

Craniopathy or craniosacral therapy. At this method Manual influence is applied by the doctor to the sacrum and skull bones. Massage is a well-known relaxation method that improves blood microcirculation, increases muscle tone and restores the sensitivity of nerve endings.

Myofascial release- This is a stretching of ligaments and muscles, eliminating compactions in them that cause pain. With the help of myofascial release, children's posture is corrected and recovery from injuries is accelerated.

Kinesitherapy– this is a treatment carried out by correct movements own body(performed with or without the use of simulators, using adaptive gymnastics).