Manual therapy is a method based on the use of manual techniques aimed at correcting and eliminating pathological phenomena in the spine, joints, muscular and ligamentous apparatus.
It is indicated for displacement of the vertebrae, reflex muscle spasm and some other disorders. The most common complaints when contacting a manual therapy center are pain in the lumbar or cervical spine, numbness of the arms or legs, frequent migraines, dizziness, and neuralgic pain in the chest area.
When is manual therapy indicated?
Osteochondrosis and vertebral hernia, scoliosis and other posture disorders - problems that will help to solve chiropractor massage.
Manual therapy has no age restrictions. Almost always birth injury- the reason why a chiropractor for a child is recommended from the first days of life.
So that the consequences of a problematic birth do not overshadow the life of a child for many years, it is necessary to contact an experienced manual specialist as soon as possible.
In the hands of a professional, manual therapy is optimal remedy for treatment and prevention for young children. In combination with reflexology, it can be successfully used from birth.
Usually, the first signals about problems with the spine begin with the school bench. Increase physical activity causes a violation of posture in almost every child. Hypodynamia and malnutrition exacerbate the weakness of the muscular frame of the spine. A chiropractor can cure scoliosis in a primary school student in a few sessions, because at this age the body has high compensatory capabilities and adaptation mechanisms.
Mechanism of influence of manual therapy
In the human body, everything is in close relationship. Feelings of pain in any part of the back can be a symptom of a disease of the internal organs, connected by reflex links with the spine in one chain of pain impulses.
By acting on the spine, it is possible to significantly alleviate the manifestation of many diseases, such as VVD and frequent headaches. Bronchial asthma is also a "manually dependent" disease caused by bronchospasm. Violation of the breathing process produces the formation of functional blocks in the spine. The removal of these blocks facilitates the patient's condition and prevents new attacks.
A chiropractor is someone who literally does the treatment with their own hands. With the help of special techniques of manual therapy, massage, procedures, etc., the chiropractor successfully helps to eliminate unpleasant symptoms, and sometimes completely get rid of diseases of the musculoskeletal system.
Manual therapy is a specially developed system of techniques that are carried out with the help of hands. Manual impact on sore spots allows you to effectively solve problems associated with any pathologies of the spine, it is also possible to relieve pain in the joints, muscles, and diseases internal organs, disorders of cerebral circulation, etc. The advantage of such treatment is that its use helps to get rid of diseases that are often beyond the power of drug treatment. A chiropractor conducts in his work, to begin with, an examination, and then treatment of the spine, joints, muscles, as well as nervous diseases.
Manual therapy combines the latest techniques and techniques with massage, reflexology, which allows you to achieve the maximum effective result in the treatment of intervertebral hernias, vegetovascular dystonia, arthrosis large joints, scoliosis, chronic headaches, muscular tonic syndromes and many others.
Manual methods show nice results v complex treatment many diseases of the internal organs. The health of our body directly depends on the condition of the spine. With problems with the cervical vertebrae, a person may suffer from dizziness, headaches, etc. This happens due to the fact that the diseased organ sends a nerve impulse to a certain section of the spinal cord, this causes impaired blood circulation and muscle changes. As a result, the chronic form of the disease develops. During the impact on the muscles, ligaments, the chiropractor removes the pain syndrome, and often eliminates the immediate cause of osteochondrosis. Treatment with manual techniques is able to get rid of the cause of osteochondrosis only in one case, when the development of the disease is caused by a violation of the normal functioning of the organs adjacent to the damaged disc, without the formation of a hernia.
After a session of manual therapy, blood circulation in the muscles noticeably improves, as a result, the muscles become toned, tissue nutrition and metabolism become much better. On average, a full course of manual therapy takes 15-20 sessions. Before starting a course of manual therapy, it is necessary to consult a doctor, because sometimes, with some concomitant diseases, such treatment is not recommended.
A chiropractor in his work uses special procedures, massage techniques, physiotherapy. In each case, depending on the problem and the patient's condition, the specialist selects an individual set of therapeutic actions: thermal procedures, vibration massage, physical education, etc.
When Should You See a Chiropractor?
As a rule, a chiropractor is treated for osteochondrosis (disease of the spine). Before starting a course of manual therapy, it is necessary to undergo an examination and exclude contraindications.
The reason to go to a chiropractor is pain in the muscles, joints, discomfort or stiffness when moving the joints. Manual therapy methods will help in the complex treatment of cardiovascular, genitourinary, respiratory diseases, as well as problems with the gastrointestinal tract.
A chiropractor can help even with reduced vision, cerebrovascular accident, chronic prostatitis, impotence, disorders menstrual cycle, gynecological problems (ovarian cyst, uterine fibroids, etc.).
The help of a chiropractor may also be needed by women in postpartum period. Pregnancy and childbirth have female body strong impact, especially on the spine, on which the maximum load is placed during this period. After childbirth, a woman often has pain in the back, pelvis, joints, headaches or dizziness. In such a situation, a chiropractor is one of the specialists who can provide invaluable assistance. Often, women turn to a chiropractor when the pain becomes pronounced, sometimes unbearable, in the case when the process is very advanced and requires long-term treatment.
What tests should be taken when contacting a chiropractor?
When referring to a chiropractor, the doctor in each case may prescribe one or more additional tests. What exactly it depends on the underlying and concomitant diseases, general condition etc.
Additionally, you may need:
- clinical blood test. Also called extended analysis. Based on the results of the analysis, it is possible to assess the level of hemoglobin, leukocytes, erythrocytes, and platelets in the blood. Via clinical analysis anemia (low hemoglobin) is determined, as well as existing inflammatory processes in the body.
- biochemical analysis blood. With the help of this analysis, the functions of internal organs (liver, kidneys), imbalance of microelements, violation of water-salt metabolism, inflammatory process are determined.
If the tests showed that there is an inflammatory process in the body, it is necessary to find out the cause of the inflammation and exclude contraindications to manual therapy.
Women before starting a course of manual therapy should visit a gynecologist and pass necessary tests, because for some diseases of the female reproductive system, manual therapy is contraindicated. These diseases include various tumors and vascular diseases in the pelvis. Regarding various inflammations in women, an individual approach is required here.
You may also need to consult a neurologist or orthopedist.
What diagnostic methods does a chiropractor use?
First of all, a chiropractor should diagnose the spine using additional methods, and only on the basis of the information received, proceed directly to treatment.
First of all, it is necessary to undergo an X-ray examination of the spine. Using x-rays, you can determine osteochondrosis, curvature (scoliosis, kyphosis, etc.), various changes in the intervertebral joints, and the consequences of injuries. Unfortunately, X-ray does not allow to evaluate some pathological phenomena in the spine. For example, it will not be possible to assess the state of the intervertebral discs, because X-rays are not retained by cartilage, but nevertheless, an indirect judgment about their condition by the height of the spaces between the vertebrae can be made. For the same reason, it will not be possible to identify an intervertebral hernia.
- Duplex scanning of blood vessels. This is a modern method that allows you to diagnose cerebrovascular accident, it can be used to assess functional indicators blood flow, anatomical changes in blood vessels (bends, patency, malformation, condition of the walls, etc.). duplex scanning is also carried out for the purpose of research peripheral circulation, limb vessels.
- Electromyography (EMG). Using this diagnostic method, the bioelectric potential in the muscles is assessed. State muscle fibers nerves that conduct impulses are associated with proper work muscles. As a result of a violation of the electrical activity of the muscles, a disease of muscle tissues develops. EMG is completely harmless, in some cases there is pain in the place where the needle electrode is inserted.
- Computed tomography of the spine. A modern method of examination, which is highly effective in determining the disease of the spine. As a result of the study, you can get a three-dimensional picture of the spine, spinal cord, spinal canal. You can also get a 3D image.
With computed tomography, ionized radiation is conducted through the body in a certain dose. Changes in the parameters of the beams when passing through a section are recorded by special sensors, and then recorded on a computer. After processing the received data by the computer, a picture is displayed on the monitor. This digital information allows, if necessary, to re-analyze the state of the spine from the image, without having to re-examine the patient. The diagnostic method is absolutely painless and takes about five minutes, moreover special training(diet, medication, etc.) is not required for a CT scan.
- Magnetic resonance imaging of the cervical spine (MRI). This type of diagnostics is developing quite rapidly and has a high efficiency in the study of the spine. With the help of MRI, you can maximally assess the condition of the soft tissues in the spine. As a rule, a hernia in the cervical spine develops in parallel with osteophytes (bone growth along the edge of the vertebral bodies). Usually hernias and osteophytes are asymptomatic, and are detected only during the examination.
What does a manual therapist do?
A chiropractor must know the functions and structure of the body perfectly. He must be able to find an approach to each patient, taking into account not only his illnesses, but also his physical and mental condition. Only in this case it is possible to avoid complications and achieve the maximum therapeutic effect. The goal of a chiropractor should be to relieve the patient of pain in the spine, restore joint mobility.
In the office of a chiropractor, an examination of the musculoskeletal system is carried out, congenital anomalies of the skeleton are revealed. Chiropractor after examination, prescribes treatment course for pain relief and recovery motor function. A full course of manual therapy will help restore the functioning of the gastrointestinal tract, endocrine, respiratory and other systems, improve blood circulation in the brain, increase defensive forces body, as well as improve the psycho-emotional state of a person.
First of all, a chiropractor must have a diploma of a neuropathologist or orthopedist, and then already own the secrets of "manual" treatment.
Before treatment, the doctor must necessarily find out the complaints, examine the diseased organ, and, if necessary, prescribe additional research methods, primarily X-rays. Only after receiving the picture and the conclusions of the radiologist, the doctor should begin treatment.
For an effective result, it is necessary to conduct several sessions of manual therapy, solving the problem at one time is simply not possible. In manual therapy, exposures that are hazardous to human health should not be used, and many specialists now prefer more soft methods treatment. During work, the doctor must monitor the patient's well-being.
The help of manual therapy may be needed throughout a person's life, starting from birth. For example, in a baby during childbirth, the cervical vertebrae may move, which in the future may threaten problems with the head vessels, but during the assistance provided will help to avoid this. Throughout life, a person faces many problems of the musculoskeletal system, most of which are associated with the spine (pain, stiffness, etc.). Among the patients of a chiropractor, you can see both young and old people. Children and the elderly require special care in treatment, with such patients one should try to use the most gentle techniques.
The main goal of any manual therapist is to restore the biomechanical processes that are observed in the spine, muscles or ligaments and arise from different reasons(injuries, bruises). As a result of this, disturbances develop different kind diseases of the internal organs, the brain. It turns out that manual therapy techniques have a beneficial effect on the entire human body.
The need for manual therapy arises when there is a curvature of the spine, pinched nerves, hernia between the vertebrae, etc. Of course, manual therapy does not always completely cure the disease (for example, vertebral hernia), but severe symptoms and alleviate the patient's condition is quite possible. Also, a chiropractor helps to get rid of diseases that at first glance are completely unrelated to orthopedics or the spine, for example, diseases thyroid gland and lungs. This is due to the passage of lymph flow, as well as the peculiarity of the blood supply to organs.
The human body is a very complex and perfect single mechanism in which a failure in the work of one organ leads to a disruption in the work of other organs. For example, as a result of a toe injury, gait is disturbed, which threatens with arthrosis. hip joint, problems with internal organs can begin due to displaced vertebrae as a result of poor posture, etc. A chiropractor will help you find out the cause and advise on the prevention of the disease.
What diseases does a chiropractor treat?
Manual therapy will help to get rid of many diseases. First of all, from pain in the back, in the cervical region, in the limbs, from the consequences of injuries or surgeries. Normal operation of all organs depends on proper blood circulation. Even with the slightest violations in the spine, blood circulation can be disturbed, as a result of which various diseases can develop - migraine, visual impairment, diseases of the reproductive system, etc. The chiropractor will find the source of the disease and eliminate them.
There are a lot of diseases that can be treated with manual therapy. Among them, osteochondrosis of all departments, postural disorders, intervertebral hernia, joint pain, numbness or pain in the extremities, lung diseases due to impaired blood circulation during displacement of the vertebrae, vegetovascular dystonia, headaches, hypertension, cerebrovascular accident, insomnia, fatigue due to problems with the spine or joints. The organs with which the chiropractor works are the spine, muscles, ligaments.
Like all methods of treatment, manual therapy has its own contraindications: systemic diseases, oncology, osteoporosis (bone fragility), diseases that require immediate medical treatment.
It is necessary to start the prevention of diseases of the spine before the onset of the disease itself in order to prevent its development.
To avoid back problems, you need to lead an active lifestyle, engage in therapeutic gymnastics, if possible, sports, do not lift weights, do not slouch and keep your posture correct. Various applicators and massagers have a good relaxing effect.
If you have sedentary work in the office, you need to get up more often to walk a little, it would be ideal to do some exercises (for example, when telephone conversation or sitting at a table). You need to use the elevator as little as possible, try to walk more. The workplace needs to be made as comfortable as possible, you can purchase special pads on the chair to unload the back. Very important is the location of the monitor, as well as the direction of the light. Such, at first glance, trifles, can lead to significant back problems.
You should be extremely careful when doing sports such as skydiving, running, aerobics, tennis, volleyball, fast dancing, etc. Sudden movements and turns can provoke an exacerbation of back diseases.
Often, intervertebral hernias give complications in the form of pinching. In this case, physiotherapy exercises can help, if you are planning self-study, you should definitely consult a doctor. In addition to physiotherapy exercises, you can do therapeutic exercises in the water or swimming, only under the supervision of an instructor.
At acute pain in the back, you need to observe the most gentle mode, both motor and physical. It is necessary to unload the spine as much as possible (for example, using a corset). Complete rest of the sick department is also recommended, to relax the muscles, improve blood circulation, lymph flow.
A chiropractor, using special techniques on the body, helps to get rid of osteochondrosis, scoliosis, arthrosis, headaches of various origins. The knowledge gained during the training process, the skills acquired during the work, help the chiropractor to provide invaluable assistance to people, often even in cases where traditional medicine is powerless.
Chiropractor is a medical specialist who uses manual techniques for the treatment of diseases - techniques produced by the hand. Chiropractor literally means "healing hand" ( "manus" is Latin for "hand"). The branch of medicine that this specialist studies and practices is called "manual medicine".
Manual medicine is the science of manual methods of influencing the musculoskeletal system, joints or ligaments, including the ligamentous apparatus of human internal organs. The chiropractor has a higher medical education, a diploma of a medical specialist and a certificate in manual therapy. A doctor has been studying manual therapy for 2 years, however, in order to be able to undergo professional retraining, a doctor, after graduating from a medical university, must receive one of the narrow specialties related to manual therapy.
A chiropractor can be the following specialists:
- sports doctor- Specialist in physical therapy and sports medicine;
- neurologist- specialist in diseases of the nervous system ( brain and spinal cord);
- therapist- doctor general profile;
- pediatrician - pediatrician general profile ( he becomes a pediatric chiropractor);
- traumatologist- a doctor who treats bone fractures;
- orthopedist- physician treating various pathologies musculoskeletal system;
- maxillofacial surgeon- a doctor who treats diseases of soft tissues and bones in the face and jaw;
- rheumatologist- specialist in autoimmune diseases connective tissue (rheumatic diseases), which affect bones, joints, muscles and internal organs;
- reflexologist- a doctor who treats biologically active points on the human body.
The presence of these narrow specialties distinguishes a chiropractor from an osteopath ( oriental manual therapist) and a reflexologist, since doctors of almost all specialties can learn osteopathy and reflexology. The fact is that manual therapy, unlike other similar specialties ( hand work), requires a deeper knowledge of the nervous, musculoskeletal system and diseases of the internal organs.
Until 1997, in the CIS countries, there was no medical specialty "manipulation therapist", but still patients turned to specialists in manual therapy, who then did not have a medical education. They "treated" only the symptoms, without delving into the cause, so their help could bring not only benefit, but also harm. In 1997 in Russia, manual therapy was included in the list of medical specialties, in connection with the need for this specialist. The need was to increase the number of patients with pathology of the musculoskeletal system, for whom manual therapy effectively helped to get rid of painful symptoms.
A chiropractor can work in the following medical institutions:
- hospitals ( in the department of neurology, traumatology, therapy or in a specialized manual therapy department);
- polyclinics ( in the department or office of manual therapy);
- health resorts.
What does a manual therapist do?
A manual therapist has theoretical and practical skills in the field of manual therapy, is engaged in the study, diagnosis and treatment of special conditions of muscles, joints, bones and ligaments that can be eliminated using manual methods. As a reason pain and dysfunction of movement, the chiropractor sees a block and a non-optimal movement stereotype. A block is a violation of the natural movement in the joints or a limitation of mobility. As a result of the block, the body begins to adapt to the painful state, reorganizes itself in such a way as to reduce the load on the overloaded ( blocked) plot. Such a habitual and almost imperceptible condition for the patient is called pathological ( suboptimal) motor stereotype. Based on this, the chiropractor works on the principle of "no block - no pain."
The manual therapist deals with the pathology of the following structures:
- spinal column;
- bones;
- joints;
- ligaments;
- fascia ( membranes of muscles and organs);
- muscles.
All of the above structures make up the musculoskeletal system, while the passive part of the apparatus consists of bones and joints ( joints), and the active part is from the muscles. While other specialists restore these structures through something else ( physiotherapy, medicines), then the chiropractor acts on them directly. The musculoskeletal system is the subject of study by an orthopedist and traumatologist, and the nervous system is a subject of study by a neurologist. So it turns out that a chiropractor must know neurology and orthopedics, as well as be able to distinguish "their" pathologies from those that cannot be eliminated with the help of manual therapy.
Musculoskeletal and peripheral nervous system (nerve fibers) are of interest to the chiropractor in terms of movement function. The functional unit of movement in the spine is the spinal motion segment.
Spinal motion segment(PDS)consists of the following components:
- two adjacent vertebrae, which form the intervertebral joint at three points - two joints with the help of the processes of the vertebrae and one through the intervertebral disc;
- one intervertebral disc cartilage) , which connects the vertebrae, acting as a shock absorber ( thanks to the disc, the vertebral bodies are not injured during movement);
- ligaments and muscles- provide connection of two intervertebral discs and create one spinal column.
There are 24 such segments in total ( 7 cervical, 12 thoracic and 5 lumbar). Each motor segment forms openings that are designed to exit ( or entry) spinal roots ( nerves), vessels and veins. Each front spine nerve exiting the spine) has its own muscle group, which it can regulate - myotome ( "myo" - muscle and "tome" segment). At the same time, the same segment of the spine has sensitive posterior roots ( nerves that enter the spine), which receive information from a specific area of the skin - the dermatome ( dermis - skin). Ligaments, fascia, tendons and periosteum receive their "portion" of nerves from the roots ( sclerotome).
Thus, in the pathology of the spinal motion segment, muscle tone, skin sensitivity, degree of ligament tension and organ functions are disturbed.
A chiropractor sets himself 2 goals that are achieved by the same methods - the elimination of pain and the restoration of impaired movement function. They have the same cause - a block in the spinal motion segment.
traffic violation(block)in the motor segment can be:
- functional- reversible violation, not associated with pronounced changes in the structure of the organ;
- organic- irreversible restriction of mobility and changes in the structure of the body.
The function block can have the following reasons:
- abnormal voltage- passive restriction of joint mobility within its natural function;
- local hypermobility- reversible increased mobility joint due to excessive stretching of the ligaments.
The outcome of a functional block is an organic block, and hypermobility can turn into organic instability.
Organic movement disorders can be:
- fixed ( bound, stable) - when the patient's posture changes, the relative position between the two segments does not change;
- unfixed ( overly relaxed, unstable) - offset segments ( vertebrae) varies with posture.
The job of the chiropractor is to restore movement function before pathological process will become irreversible, while such a moment as a reserve of movements is important. The reserve of movements is the ability to loosen the joint with the help of joint play. This reserve is associated not so much with the bones as with a spasm of the musculo-ligamentous apparatus, which disrupts movement in the joints. In order to perform manual therapy, the reserve must be maintained ( this is the function block). Thus, manual therapy does not affect the processes occurring in the bone tissue. No osteoporosis or osteochondrosis ( bone tissue pathologies) a chiropractor does not treat, he only corrects impaired functions. This is important to consider, since manual therapy is not a panacea and does not replace other methods of treatment, but complements them.
The work of a manual therapist, depending on the stage of therapy, can be:
- diagnostic- manual diagnostics;
- medical- manual correction or therapy;
- preventive- manual therapy after correction.
How is a chiropractor appointment?
The office of a chiropractor is equipped in the same way as a doctor's office of any other specialty, there are no decor elements typical for massage parlors. Posters with pictures of the anatomy of the musculoskeletal system can be hung on the walls. The main thing that is present in the office of a chiropractor is a couch for manual therapy, on which the patient lies or sits down during manipulations.
In order for the manual therapist to "have a hand", it is necessary to undergo a detailed examination and find out the causes of the ailment, that is, consultation and diagnostics are required from the side of therapists, neurologists, traumatologists, orthopedists, rheumatologists. The chiropractor accepts the patient already with materials about his illness. This is very important, because there are a number of contraindications for manual therapy, and they must be excluded before contacting a manual therapist.
Reception of a manual therapist includes the following steps:
- questioning the patient- clarification of complaints, circumstances that led to the disease, living and working conditions, other illnesses that have been transferred or are present at the moment;
- inspection- the doctor examines the condition skin, changes in the area of the joints, their mobility, soreness, tension and soreness of the muscles, curvature of the spine;
- anthropometry- the doctor measures the height and weight of the patient using a centimeter tape and floor scales;
- general therapeutic examination- measurement of blood pressure, pulse, auscultation of the lungs, examination of x-ray films of the place of interest;
- neurological examination- assessment of reflexes using a neurological hammer;
- orthopedic examination- assessment of the patient's posture ( free, forced, protective), his constitution, posture, bone elements and natural curves;
- spine examination- comparative evaluation symmetrical zones, conducting diagnostic techniques of manual therapy;
- manual muscle testing- assessment of the strength and functionality of individual muscles, which is carried out with the help of test movements performed by the doctor and the patient together;
- determining the change in the center of gravity- carried out using a plumb line ( thin thread with a small load), which is lowered from the middle of the distance between occiput or from the angle of the shoulder blade to the heel.
At the appointment, the chiropractor can ask next questions:
- Where does it hurt and where does the pain radiate?
- When did the complaints first arise?
- Are there sharp, shooting, stabbing pains?
- Does pain worsen with exertion? movement, weight lifting)?
- Is the onset of pain characteristic at the moment of starting the movement?
- What movement causes pain?
- Does the pain increase during exercise?
- Does the pain decrease with movement?
- Do you have pain at rest?
- Does pain improve at rest?
- Does the pain increase at rest or during sleep?
- Is there a feeling of numbness, tingling ( "goosebump")?
- Is there muscle weakness?
- Has the person been involved in sports? athletes feel pain is weaker than it really is)?
Before performing diagnostic techniques, a chiropractor evaluates the movements that a person in most cases performs “on the machine”. These habitual movements may be incorrect, which in manual therapy is called a pathological motor stereotype ( is a consequence of the block). To identify a motor stereotype, the doctor asks the patient to sit on a chair, get up from a chair, lift weights from the floor.
After the hands-free examination, the chiropractor asks the patient to take off their clothes ( during manual therapy sessions, men prefer to wear shorts, and women prefer bikini swimsuits). This is necessary so that the hands of the chiropractor do not slip on the clothes during the execution of the techniques ( reception requires fixing hands at certain points). The patient sits or lies down on the couch, and the chiropractor begins to search for the blocked area. In the absence of contraindications to manual therapy, this block is removed. "Search block" chiropractor performs with the help of hands.
Diagnostic techniques of manual therapy
| Diagnostic reception | Description |
| Palpation | Palpation is the feeling of joints muscle tissue, skin. With the help of this technique, the manual therapist assesses pain, increased tone muscles, their compaction, barrier and functional reserve. |
| stretching | The degree of extensibility of the “diseased” muscle is determined in comparison with the symmetrical muscle on the other side. |
| Joint study | The study of the joints includes an assessment of active ( produced by the sick) and passive ( produced by a doctor) movements in the joint. In addition, the chiropractor identifies specific joint phenomena, such as joint play ( "springing"), which determines the degree of change in the biomechanics of the joint ( degree of blockade). |
| Jog palpation of the joints | This method examines the spinal motion segments of the spine ( joints). The doctor conducts rhythmic shocks in the direction from the spine to assess the functional reserve and mobility of these spinal motion segments. |
After the reception, the chiropractor makes a functional diagnosis - a conclusion about the degree of dysfunction. This diagnosis is designed to develop a treatment plan. The plan depends on where it hurts and where the pain comes from ( where block), as well as on the severity of the reserve of movements. Thus, the doctor of manual therapy looks at the patient's condition from a slightly different angle. His diagnosis is a syndrome, which in turn is the result of a disease.
With what pathologies do people turn to a chiropractor?
Symptoms that lead a person to this specialist is pain and movement disorder dysfunction of an organ or part of the body). A chiropractor treats or alleviates the patient's condition with a lot of diseases, but not all pathologies are "subject to" the hands of a chiropractor. There are clear indications and contraindications for manual therapy, which are known to doctors of other specialties. If the pathology is at the stage of dysfunction without deep ( irreversible) violations of the structure of the body, then specialist doctors advise you to contact a chiropractor.
According to one of the teachings of manual therapy, all diseases come from the spine. It is believed that if the nerves go to each organ through the spine, then by acting on the spine, it is possible to restore the normal innervation of the organ ( nerve supply and regulation). That is why all the pathologies that a chiropractor deals with are considered from the point of view of their connection with the spine.
Pathologies that a chiropractor deals with are:
- vertebrogenic ( vertebralis - vertebrate, genesis - origin) - pathologies associated with spinal disease;
- nonvertebrogenic- not associated with a disease of the spine or musculoskeletal system or, translating into the language of manual therapy, not due to changes in the spinal motion segment.
Vertebrogenic pathologies can be manifested by the following syndromes:
- vertebral syndromes- local pain, the location of the source of pain and the area of pain coincide;
- extravertebral ( neural, muscular, vascular) - the zone of pain and movement disorders do not coincide with the location of the source of their cause.
Simply put, the pathology of the spine can have many masks that are not directly related to the spine. Such "masks" can occur when nerves and blood vessels are compressed ( compression syndromes) or during their reflex contraction ( reflex syndromes).
The most common pathology of the spine, which has many "masks", is osteochondrosis - dystrophic changes in the spinal motion segment.
Osteochondrosis includes:
- disc degeneration- damage causing compaction and protrusion of the disc;
- intervertebral arthrosis- violation of movement in the joints of the motor segment of the spine;
- spondylosis- proliferation of bone tissue on the surface of the vertebrae.
At the same time, if pain and movement disorders are associated with the spine, this does not mean that a chiropractor can eliminate them. It is important to know that manual therapy is not effective, and sometimes even dangerous, in acute inflammatory, infectious and malignant diseases, as well as fresh injuries and diseases that require surgical treatment.
Contraindications for manual therapy include:
- tumors of the spinal cord and spine;
- osteochondrosis of the spine above stage 3;
- complications of intervertebral hernia ( gap);
- any malignant tumors with metastases;
- ankylosing spondylitis ( inflammation of the intervertebral joints);
- acute disorders of cerebral circulation;
- acute cardiovascular failure;
- scoliosis ( in adolescence and above 2 degrees);
- congenital anomalies of the vertebrae;
- severe diseases of the internal organs ( bleeding, injury, rupture of internal organs, inflammation);
- sharp infectious diseases;
- tuberculous lesion of the spine;
- osteomyelitis ( purulent inflammation ) spine;
- imperfect osteogenesis;
- vertebral dysplasia ( structural change);
- osteoporosis ( decrease in bone density) spine;
- spinal surgery;
- fixative ligamentosis ( dystrophic changes in ligaments);
- blockage of the lumen of the vertebral arteries by a thrombus;
- paresis ( partial paralysis) lower extremities;
- atrophy ( reduction in tissue volume) limb muscles;
- common areas on the body with weakened or lost sensitivity.
The list of indications for manual therapy is longer and includes many syndromes that get their name depending on where it hurts or where the block is located. It is also important to know that different stages of the same disease can be both an indication and a contraindication to manual therapy.
The most common pathologies dealt with by a chiropractor
| Pathology | Origin mechanism | manifestations of pathology symptoms) | The effect of manual therapy in this pathology |
| Syndromes with local pain ( vertebral) |
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| cervicalgia | cervicalgia ( cervix - neck, algia - pain) occurs due to damage to the connective tissue ( ligaments) of the cervical spine and reflex tension of the muscles of the neck, which is often the result of osteochondrosis of the cervical spine. |
| Therapeutic effect due to the elimination of the reflex spasm of the cervical muscles and the block in the spinal motion segment of the spine, as a result of which the tension of the tissues and the formation of pain impulses cease. |
| Dorsalgia | Dorsalgia ( dorsum - back) occurs in the presence of a block of the costovertebral joints or in the pathology of the intervertebral disc ( osteochondrosis) in the thoracic spine. This causes tension in the paravertebral ( paravertebral) muscles. |
| The pain disappears if the chiropractor achieves muscle relaxation, corrects the location of the components of the motor segments ( reduces subluxation). Thus, on the one hand, the root cause of nerve compression is eliminated ( block), and on the other hand, relaxing the muscle relieves pain. |
| Lumbalgia |
| The therapeutic effect is achieved by eliminating chronic pain in the tense muscle of the joint. The absence of pain inhibits further changes in the structure of the periarticular tissues and makes it possible to work out the joint, restoring its function. |
|
| Tunnel syndrome in the arm | Tunnel syndromes occur when the nerve plexuses are compressed inside their bed - this is the name of the place between the muscles and fascia of the limb, which is intended for the passage of nerves ( that's why they are called tunnels). The cause of compression may be an overload of the muscles that form this tunnel, a tendency to edema, or the congenital narrowness of the tunnel. For the lower extremities, the footwear factor is also important. |
| The therapeutic effect of manual therapy is due to a change in the motor stereotype, which caused pinching of the nerves inside the muscular-fascial canals. This is achieved through exercise and muscle relaxation. |
| Tunnel syndrome in the leg area |
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| vertebral artery syndrome(vertebrobasilar disease) | The mechanism of the syndrome is associated with irritation of the nerve plexus of the vertebral artery ( passes through the foramen of the vertebrae), which most often occurs due to instability ( bias) discs of the middle cervical segments. As a result of this instability, the artery is compressed, its lumen decreases, and into the main vessel of the skull ( basilar artery) receives less blood. |
| The therapeutic effect in this pathology is due to the reduction of the displaced cervical vertebra, as a result of which the compression of the artery stops. |
| Heel spurs (plantar fasciitis) | Heel spurs are called bony growths of the calcaneus. The reason for their formation is excessive tension of the plantar ( plantar) fascia and its microtraumas ( fascia is active during walking). As a result, a blockade occurs in the ankle joint, causing painful tension of the fascia. |
| The analgesic effect of manual therapy is due to the relaxation of the muscles and fascia of the foot and ankle joint. |
| functional dysphonia | In the presence of a block in the cervical spinal motion segments, the coordinated activity of the muscles of the larynx is disrupted, they shorten ( spasm) or lose tone ( become lethargic). |
| The therapeutic effect of manual therapy is due to the reduction of displaced segments ( block removal). This normalizes the nerve transmission to the muscles of the larynx. |
| Sliding costal cartilage syndrome | The cause of "slip" is increased mobility ( hypermobility) ends of the costal cartilages where they attach to the sternum. This can occur when the muscles that attach to the sternum and ribs are overstretched. This is where the block is located. |
| With the help of manual therapy, instability in the area of attachment of the ribs to the sternum is eliminated by reducing the displacement and relaxing the muscles associated with these bones. |
| Temporomandibular joint dysfunction | Movement disorder in the temporomandibular joint occurs due to increased tension ( spasm) chewing muscles. High tone can be observed with trigeminal neuralgia or any pathology in this area that causes a reflex spasm of the muscle. |
| Restoration of movement in the joint is achieved by improving blood supply and relieving tension in masseter muscle, interrupting the pain signals that cause it to spasm. |
| Respiratory disorders | In some cases, respiratory distress can be caused by a violation of the synchronism of the movements of the respiratory muscles, if the motor segment of the ribs is blocked ( joint) connects to the act of breathing later than the others, and ends its movement before anyone else. Another cause may be soreness in the muscles of the chest and abdomen. |
| Restoration of breathing with the help of manual therapy occurs due to the removal of the block that interfered with the synchronous movement of the chest and the elimination of pain points in the muscles that cause pain during breathing. |
| Functional disorders of the internal organs | The presence of a block in the spinal motion segment changes the normal transmission of the impulse to the organ along the nerve fibers ( although the anatomical neural pathways are preserved). This leads to violation motor activity organ muscles ( spasm or loss of tone) and contraction of its ligaments. It can also be considered an incorrect motor stereotype, which is manifested by the disease. |
| Manual therapy improves blood circulation in these organs, increases sensitivity to nerve impulses, which stimulates recovery processes. In addition, therapy restores the normal position of the internal organs, that is, it corrects the motor stereotype. |
| Pathologies in children |
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| Birth trauma of the cervical spine (craniocervical injury) | The cervical spine in the fetus experiences the greatest load during childbirth ( although other parts of the spine may also be affected). With any pathology of labor or abnormal position of the fetus in the uterus ( breech presentation) this load increases. As a result, there is a displacement of the vertebrae and their instability in newborns ( "Children's" osteochondrosis). |
| Instability of the vertebrae in children is eliminated in the same way as in adults. The therapeutic effect is achieved by reducing the vertebrae and relieving muscle spasm. |
| Torticollis | The cause of "congenital" torticollis is an uncomfortable position of the child in the uterus during pregnancy or osteochondrosis in childhood. As a result, a block occurs in the cervical spinal motion segments, which causes compression of the nerves and reflex spasm of the neck muscles. |
| The therapeutic effect is due to the removal of muscle spasm, reduction of subluxation of the vertebrae and correction of the motor stereotype ( "learning" muscles). |
| Scoliosis | Scoliosis develops if the child's spine is in the wrong position for a long time ( violin playing, awkward sitting posture) or carries weights on the back ( backpack). As a result, part of the muscles of the spine is in constant overstrain and "pulls" the spine. There is also scoliosis, which occurs due to uneven tissue growth. |
| A chiropractor directs his skill to change the muscle stereotype - the removal of the usual muscle tension. On the other hand, manual therapy stimulates the growth of lagging muscles. |
| Myopia | The cause of this pathology in many children is a functional blockade of the craniovertebral junction - the base of the skull, which is formed occipital bone and the first two vertebrae ( atlas and axis). | The therapeutic effect of manual therapy is based on the removal of blocks in the base of the skull, which eliminates myopia in children in 97% of cases. In adults, this percentage is much less, since over the years of life, other causes of myopia may also join the functional block. |
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What are the types of manual therapy?
Manual therapy is called a complex manual technicians, which have been used since ancient times, but scientific confirmation was found relatively recently. Many experts still do not recognize the "manual" as a science, considering it a pseudo-teaching. Manual therapy gained such a reputation due to the fact that in the United States, due to high profits, they began to “produce” too many chiropractors, who were called chiropractors ( hiro - hand). The activity of chiropractors was effective, but was not recognized by doctors, since chiropractors did not have a medical education. Due to the lack of contact between physicians and chiropractors, manual therapy in this form developed independently of traditional medicine.
Along with chiropractors there were osteopaths. Osteopathy is the same manual therapy that belongs to alternative ( unconventional) oriental methods of treatment.
We can say that manual therapy is a Western version of Eastern alternative medicine, which has evidence base, that is, it can prove exactly how this therapy works in medical language. This is one of the main differences from osteopathy, which uses "language" ( terminology) oriental alternative medicine.
Manual therapy techniques
Reception is the action of a manual therapist in order to restore the initial physiological state of the motor segment or its controlled structures ( muscles). Performing an appointment requires a doctor to have a deep knowledge of anatomy and physiology, neurology and orthopedics. Each department of the musculoskeletal system or part of the body has its own techniques, but they are all grouped, depending on the method of exposure.
To the methods of influence(techniques)manual therapy include:
- mobilization- smooth, rhythmic, as if playing or loosening movements in the joint ( multiple movements), which eventually stretch the shifted component, releasing it from the load, and help to return to "its place";
- manipulation- fast movement against the background of relaxation, which has a small force and a small "span", leading to the reduction of the displaced part in one moment ( reposition);
- relaxation- Techniques that relax the muscles.
All three techniques are often used together as steps in the same technique. Mobilization and relaxation are "soft" techniques, while manipulation is "hard". With proper execution, "hard" manipulation is performed gently ( in contrast to the reduction of dislocations produced by traumatologists).
Some chiropractors add a fourth to these three techniques - pressure. Pressure is an effect on painful points, which occupies an intermediate place between massage and manual techniques.
Manipulative techniques include:
- push;
- traction push ( force traction);
- hit.
Mobilization methods include:
- rotation ( rotation);
- bending;
- extension;
- deflection;
- traction ( traction);
- distraction ( stretching);
- tension ( pressure, tension);
- nutation ( rocking);
- twisting ( twisting);
- reduction ( retraining of a relaxed muscle).
Relaxation techniques include:
- - the doctor causes muscle tension, which is not accompanied by movement ( shortening or shortening), after which for some time the muscle relaxes as much as possible;
- post-reciprocal relaxation- stretching and relaxation of the “sick” muscle occurs in an active way, for which the patient himself “moves” the muscle, which causes movement in the other direction ( for example, if the flexor is diseased, the extensor is activated).
The term "mobilization" is used more often by chiropractors, and it may seem that they only do these techniques, but this is not at all the case. Everything depends on the goal. By mobilization, therapists understand the loosening that sets the tissue in motion. Loosening can relax a muscle or set a vertebra, so mobilization techniques can be used on both joints and muscles, ligaments and fascia. The main difference between mobilization and manipulation is the number of movements. If the movement is made once - this is manipulation, multiple movements in the same place - mobilization.
A chiropractor may use the massage technique in their practice as an additional method, but massage is not a purely manual type of therapy. Classical massage, although carried out with the help of hands, refers to reflexology. The “massage” that a chiropractor conducts is more like kneading tissues.
Depending on the point of application(block location)There are the following types of manual therapy:
- skin-subcutaneous-myofascial manual therapy;
- arthro-vertebral manual therapy;
- craniosacral manual therapy;
- visceral manual therapy.
Skin-subcutaneous-myofascial manual therapy
Muscle movement and skin sensitivity, according to the principle of manual medicine, are disturbed in the presence of a block in the spinal motion segment. This means that the chiropractor does not directly treat muscle pain and skin-subcutaneous thickening and tightness. But pain and dysfunction of muscles and skin are eliminated if the block in the spine is removed. On the other hand, muscle pain maintains a vicious cycle pain syndrome due to the formation of an incorrect muscular-motor stereotype ( pain - muscle spasm - dysfunction - pain). With the help of skin-subcutaneous-myofascial therapy, a chiropractor removes one of the links from this chain - pain, which breaks the vicious circle. Nevertheless, despite this analgesic effect, skin-subcutaneous-myofascial therapy is not so much a therapeutic method as a diagnostic and preparatory method.
The diagnostic component of this therapy is that by determining increased or decreased muscle tone, painful points ( trigger points), compacted foci and a zone of numbness of the skin, the chiropractor finds out exactly where the block originated.
As a preparatory stage, skin-subcutaneous-myofascial therapy is mandatory component treatment. In order to manipulate or mobilize a blocked motor segment, the muscles that receive nerves from that segment must be relaxed. At the preparatory stage, the therapy techniques also help to relieve pain, but the cause of the pain, that is, a block in the spinal motion segment, remains. This means that if the next stage of treatment is not carried out, then the pain will return after some time.
Arthro-vertebral manual therapy
Arthro-vertebral manual therapy, as the name implies ( artus - joint, vertebralis - vertebral), is aimed specifically at the motor segments of the spine in order to remove the block. This type of manual therapy involves the use of mobilization and manipulation. Manipulations are carried out with the help of pushes or blows, which are considered to be correct execution cause a "crunch". In fact, the appearance of a crunch during manipulation is not at all necessary. The cause of the "crunch" is the impact of two articular surfaces in the blocked segment, which occurs reflexively at the moment when the doctor stretches the muscles around the joint.
This type of therapy involves the use of both soft and hard techniques ( the last doctor conducts only with the consent of the patient).
Articular blockades are eliminated with the help of the following tricks:
- manipulation- push, push with extension, blow;
- mobilization- rhythmic rocking in the joints;
- traction- rhythmic or non-rhythmic stretching to the limit;
- post-isometric relaxation- relaxation of the muscle after its tension.
Craniosacral Therapy
Craniosacral therapy is a gentle manipulation of the bones of the skull in the area of the sutures ( junctions of cranial bones). The term "craniosacral" itself consists of two words. 'Cranium' means 'skull' and 'sacrum' means sacrum or 'holy bone'. This combination of words indicates the effect of craniosacral therapy - normalization of current cerebrospinal fluid along the skull-sacrum axis. Professionals working on this method not so much. The fact is that craniosacral therapy is slightly different from other classical methods of manual therapy, it is more related to osteopathic methods of treatment. However, since a chiropractor and an osteopath are like two people who look at the same mountain from its different slopes and therefore see different landscapes, craniosacral therapy, in a slightly modified interpretation, also applies to manual therapy methods.
A chiropractor using craniosacral therapy proceeds from the fact that the bones of the skull, despite the absence of joints between them, still tend to move due to the elasticity of the bone sutures. If this "movement" is disturbed, then various symptoms and diseases of the organs develop. The main difference between craniosacral therapists is that all manipulations are carried out exclusively within the skull.
Craniosacral therapy has advantages and disadvantages. Among the shortcomings, it should be noted the duration of the procedure ( at least 1 hour), and of the advantages - the absence of unpleasant sensations and the need to be naked in front of a doctor.
Visceral manual therapy
Visceral ( viscera - insides) manual therapy literally translates as "treatment of the insides with the hand", while referring to non-surgical intervention. Internal organs are known to be covered with membranes and have muscles, therefore, they can move and block in the same way as muscles and joint capsules. This blockage is especially pronounced when the spine changes ( curvature). To breathe normally, pump blood through the vessels, move food through gastrointestinal tract, empty the bowels and bladder, have intercourse and give birth, it is necessary that the movement of these organs is not blocked.
Visceral manual therapy involves the use of the following techniques:
- direct mobilization- the doctor directly touches the organ with his hands from the side or from the edge, producing rapid rhythmic loosening;
- indirect mobilization- the doctor acts on organs that cannot be touched directly ( internal organs such as the heart) through muscles and ligaments that have functional connections with an organ or bone structures through which the nerves pass to this organ.
- parallel mobilization displacements- are carried out to eliminate the contraction of organs in the presence of adhesions.
Visceral therapy is carried out on the following organs:
- lungs;
- pleura;
- heart;
- diaphragm;
- gallbladder;
- liver;
- duodenum;
- small intestine ;
- colon;
- kidneys;
- bladder;
- uterus and ovaries;
- prostate.
What methods does a manual therapist treat?
In each specific case, the manual therapist selects the necessary and most appropriate methods and techniques ( adequate means "directed to the cause"). There are a lot of techniques, some of them are copyrighted. They differ from each other in a different combination of techniques. Nevertheless, there is a conditional division of all methods, depending on the point of impact and purpose. It is conditional, because the chiropractor will not say “you have been assigned such and such a technique”, he will describe the techniques that he will carry out. Outwardly, these methods for an ordinary observer do not differ from each other ( the doctor presses on something, pulls on something, bends, unbends). In addition, often the patient has a block not in one place, but in several at once. That is why the same patient may require the use of different methods for different stages manual therapy, even if original cause one.
It is important to note that the chiropractor is supposed to use only their hands. In this he differs from a vertebrologist, who can use not only manual therapy, but also other ways to eliminate blocks in the spinal motion segment ( physiotherapy, drug anesthesia ). This is a fundamentally important difference, since chiropractors believe that non-manual methods remove not a block in the spinal motion segment, but only its symptoms ( and that is temporary).
Techniques used by the manual therapist
| Manual therapy technique | Mechanism of therapeutic action | For what pathologies is it used? | What is the duration of treatment? |
| Skin-subcutaneous-myofascial manual therapy | The point of influence with this technique is soft tissues. This method allows you to improve blood circulation and lymph flow by affecting the sensitive nerve endings of muscles, tendons and skin, which causes their reflex relaxation. pressure on pain ( trigger) points cause a reaction from the body - it activates the anti-pain system. |
| The average number of manual therapy sessions is about 10 sessions. maximum amount sessions - 15. Several courses of manual therapy may be required during the year. |
| Arthro-vertebral manual therapy | Application point - joints ( spine and limbs). This therapy is carried out in order to restore the biomechanics of the motor segment ( relative positions of elements) and remove the block. After removing the block, abnormal tension in the muscles, ligaments and capsules of the joints is eliminated, blood flow and lymph flow improves, posture is corrected and the function of internal organs is normalized. |
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| Visceral manual therapy | This therapy restores the relative position of the internal organs ( pathology of the musculoskeletal apparatus of internal organs), which changed when a functional block appeared in the spine. The visceral technique allows you to eliminate secondary blocks, that is, return the internal organs to initial position, which was before the formation of blocks in the spine. |
| Most often, 7 to 10 sessions are prescribed. |
| Craniosacral manual therapy | With this technique, soft techniques of rhythmic mobilization of bone elements and ligaments in the area of bone sutures are used, which leads to an improvement in blood flow in the vessels of the brain, normalizes the movement of cerebrospinal fluid and contributes to the "return" of the vertebrae to their places. |
| 1 session lasts within one hour ( at least 30 minutes). The total number of sessions is set individually, depending on the pathology. |
Chiropractor- a doctor engaged in the diagnosis and treatment of diseases mainly of the musculoskeletal system, as well as internal organs. The main working tool of the manual operator is his own hands.
On the one hand, the work of this specialist can be described as a deep massage, although at the same time it is believed that the technique of exposure and therapeutic techniques is more than massage. The methods used are carried out directly on bone skeleton, while the masseur has the right to work only with soft tissues. As a rule, neurologists and surgeons who have specialized in manual therapy receive such a profession.
Do not confuse a chiropractor with a chiropractor. The latter sets the dislocated bones, while the chiropractor uses about 3 thousand methods aimed at restoring the correct position of certain organs relative to each other. Basically, these are spinal disorders, which, according to statistics, affect approximately 85% of the world's population.
When to go for an appointment?
Often the symptoms that come to the doctor are associated with infringement of the vertebrae or curvature of the spine and they manifest themselves as follows:
- pain in the cervical region, back of an acute or chronic nature;
- persistent headaches;
- various diseases of the spine;
- pain and partial immobility in the shoulder or hip joints;
- dizziness on the background of osteochondrosis;
- poor posture (scoliosis, for example);
- fatigue, restless sleep.
What Diseases Does a Chiropractor Treat?
Speaking about what a chiropractor treats, it should be understood that the list of diseases is very extensive. Let's highlight some of them:
- osteochondrosis;
- posture disorders: kyphosis, scoliosis, lordosis;
- hernia between the vertebrae;
- flat feet;
- arthritis, ;
- diseases of the genitourinary system;
- diseases of male and female reproductive organs, infertility treatment in certain situations;
- excess weight;
- diseases of ENT organs, nervous system;
- disorders of cerebral circulation;
- lung diseases, the cause of which was the displacement of the spine;
- diseases associated with craniocerebral, birth injuries;
- rehabilitation after injuries.
How is the reception going?
The doctor carefully listens to the patient, his complaints about the state of health, looks through the medical documentation. After that, the actual diagnosis begins. The specialist checks the joints for mobility, determines the areas where the muscles are tense, evaluates pain activity.
Having made some conclusions, the doctor determines the tactics of treatment and the duration of the sessions, finds out if there are any contraindications for treatment. In some cases, an additional examination is prescribed. As a rule, the course of treatment is 10 sessions performed 1-2 times a week. After six months, the course is advised to repeat.
Manual therapy methods
Subcutaneous myofascial
It implies work with tissues, which is based on an intensive effect on muscles and fascia. A technique is used to improve lymph drainage, with venous insufficiency, spondylosis, sciatica, intervertebral hernias, headache. All manipulations are carried out only after thorough examination patient.
Cranio-sacral technique
It was created to work with cranial joints and neck muscles. With its help, they get rid of dizziness, intracranial pressure returns to normal, memory improvements are noticeable. All this happens by improving the blood supply to the neck muscles.
Arthro-verbal method
The purpose of this technique is to restore in the shortest possible time the functions of all damaged joints. The treatment is painful and requires prior consent from the patient.
Visceral method
With its help reach 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 set discs, eliminate joint subluxations, break off exostoses.
Positional mobilization
The essence of the method is the slow and smooth stretching of the periarticular muscles. This is how recovery happens.
Rhythmic mobilization
It is often used in manual practice, since along with efficiency, the technique is safe and easy to perform. The patient does not feel pain.
Types of rhythmic mobilization:
- rotating: used to reduce 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;
- squeezing: it is used only when the first two receptions cannot be carried out.
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 any manipulation is contraindicated for the patient. The main reasons for the doctor's 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 of blood.
- Electromyography (EMG).
- Examination of the spine using x-rays.
- MRI and computed tomography of the spine.
- Duplex scanning of blood vessels.
- Additional advice and
Can pregnant women come to the appointment?
Yes, but not all therapies are eligible. So, during pregnancy, shaking, twisting, twisting, rotation are contraindicated. The doctor treats this category of patients only with sparing methods.
What does a chiropractor treat in pregnant women
- severe back pain;
- threat of abortion (not in all cases);
- chronic fetal hypoxia;
- prepares the pelvis for the upcoming birth;
- uterine tone;
- severe and frequent swelling of the legs.
Manual therapy is a set of methods for treating and identifying diseases using the hands of a therapist. The musculoskeletal system and internal organs of a person are most often treated. Manual therapy is inextricably linked with neurology, orthopedics, vertebroneurology, sports medicine and other branches of official medicine.
Who is a manual therapist?
Chiropractor is a doctor who treats patients using his own hands. His competence includes the treatment of curvature of the spinal column and its other pathologies, as well as ridding a person of joint diseases.
Before proceeding with the implementation of therapeutic methods, the specialist will perform a full-fledged diagnosis and only after that will select an individual recovery course.
The advantage of undergoing treatment with a chiropractor is that there is no need to use medicines. In addition, manual therapy can sometimes help people when even conservative treatment turns out to be completely ineffective.
A chiropractor is a doctor who uses the latest methods of diagnosis and treatment in his work, combines them with apparatus methods of therapy, with massage, with physiotherapy, with physiotherapy exercises. As a result, it is possible to achieve a stable result even with such complex diseases, such as: intervertebral hernia, arthrosis of the joints, scoliosis, vegetovascular dystonia, osteochondrosis, etc.
A session of manual therapy is sometimes enough for the patient to feel better. Already after the first impact on the body, blood circulation improves, muscles tone up, tissue trophism increases and metabolism accelerates. Of course, one session to get rid of the pathology will not be enough, it may take 15 or 20 visits to the specialist's office. However, it will be necessary to complete the course completely if the treatment is on early stages gives noticeable results.
What does a manual therapist do?
A chiropractor knows the functional capabilities of the body and human physiology. He builds his reception taking into account not only the main disease of a person, but also taking into account his psychological state. The main goal of the therapeutic effect of a specialist is the elimination of painful sensations, compensation for lost functions (vertebral column, joints, internal organs).
The chiropractor's office is the place where problems with the musculoskeletal system, both congenital and acquired, are detected. Passing a full course of manual therapy can restore health not only to the spine and joints, but also restore the functioning of the gastrointestinal tract, respiratory, endocrine and systems, increase blood supply to all organs, the brain, increase the body's resistance to infections, improve psychological and emotional mood.
As for the specialty, a chiropractor can have a degree in neuropathology or an orthopedist, after which he can receive an additional specialty in manual therapy.
The doctor makes a diagnosis not only on the basis of the patient's complaints, on examination and palpation, but also on additional examination results, for example, based on X-ray pictures. During the treatment process, the doctor is obliged to monitor the patient's condition, monitor his well-being and the dynamics of the disease.
People of different ages seek help from a specialist, sometimes even babies are brought to the appointment. Often there is a displacement of the cervical vertebrae during childbirth, congenital dislocation of the hip is another common problem newborns. In order for these pathologies not to disrupt the quality of human life in the future, treatment should be started from the first months and even weeks of a child's life. A chiropractor has in his arsenal sparing techniques that are used in the treatment of children or the elderly.
Of course, to save the patient from vertebral hernia impossible without surgical intervention. However, a chiropractor is able to help the patient get rid of pain - one of the leading symptoms. this disease. Therefore, another goal of manual therapy is the restoration of biomechanical processes at the site of injury.
Each chiropractor works according to the principle - "one disease entails disruption of the functioning of other systems", since the human body is a single whole. For example, a dislocation of a finger of a lower limb will lead to disturbances in a person’s gait, which will later develop into arthrosis of the hip joint (read also:). Arthrosis will ultimately lead to dysfunction of the internal organs, to displacement of the vertebrae or to the formation of postural disorders, etc. Therefore, even a disease that is insignificant at first glance should be treated in a timely manner.
What diseases does a chiropractor treat?
The patient receives a referral to a chiropractor consultation from another doctor when he believes that the patient has indications for this.
Among the most common ailments faced by a chiropractor are the following:
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Osteochondrosis, which can be expressed in the infringement of the sciatic nerve, in sciatica, etc.;
Periarthrosis humeroscapular;
Violation of posture;
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Intervertebral hernia;
Hypertension;
Syndrome of the vertebral artery.
In addition, a person can independently decide that he needs the advice of this specialist. The reason for treatment may be headaches that occur during the rotation of the head, dizziness, pain in chest and in the joints, stiffness of the joints or spine.
However, there are contraindications for manual therapy. These include:
Osteoporosis;
Systemic diseases.
When Should You See a Chiropractor?
The occurrence of a feeling of stiffness during breathing;
Pain in the lower back, chest or neck;
Numbness of the upper and lower extremities, fingers on them;
Headaches accompanied by dizziness;
Memory problems, visual and hearing impairments;
Pain in the region of any joints;
Pain on turning the head.
How is an appointment with a chiropractor?
At the first consultation, the doctor will interview the patient about his complaints. The doctor must find out if the person has concomitant diseases, diseases of the internal organs.
In addition, the results of past studies, if any, should be brought to the appointment:
The conclusion of a neurologist;
Completed X-ray pictures;
CT scan of the spine.
When the doctor examines them, he will proceed to the examination. It is worth knowing that manual therapy has not only therapeutic, but also diagnostic methods. It is the latter that the doctor will use at the first appointment. Doctor in without fail with his hands he will feel the spinal column, determine its bends and deformations, determine muscle tone, places of increased and decreased muscle tension. The doctor may ask the patient to take various postures (stand up, sit down, lie on his stomach, walk around, etc.), while he himself will continue the examination at this time.
Types of palpation used by a chiropractor:
Surface;
tick;
deep;
sliding;
Plucked.
Some techniques may resemble massage, however, the patient should not express their surprise, as these are standard diagnostic techniques for manual therapists.
When the examination is completed, the doctor will announce the conclusions regarding the patient's diagnosis and determine the need for him to undergo course treatment. Sometimes, in order to determine specific methods and make a final decision on the need for therapy, the doctor sends the patient for additional diagnostics.
Additional diagnostic methods used by a chiropractor
Radiography of the spinal column;
CT scan;
MRI of the spine;
Electromyography.
In addition, the chiropractor himself can send the patient for a consultation with a neurologist or orthopedist.
After all the necessary data are obtained, the doctor will evaluate the available indications and contraindications and decide on the possibility of undergoing treatment. When a course is necessary, a schedule of procedures is drawn up on an individual basis, their duration, frequency and number of sessions are determined.
Expert editor: | MD general practitioner
Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 " Occupational diseases", in 1996 "Therapy".
