A more than 100-year history of the development of scientific manual medicine in the last two decades has clearly defined trend. This is evident in the transition from the rough force action with strikes, jerks and jolts, providing a purely biomechanical effect to the working methods of the soft tissue.
They are based on the elastic properties of tissue and neuromuscular reflex connection with the spine, brain blood vessels and internal organs.
Modern and highly effective methods of manual therapy are myofascial release, muscle-energy techniques, postisometric relaxation of muscles, the technique of tension and counter-tension, etc. These methods (soft manual therapy) are becoming increasingly popular among practitioners.
They are used for the treatment and rehabilitation of:
- neurological manifestations of osteochondrosis
- the consequences of various neck injuries including cervicocranial syndrome and whiplash neck injury
- posture impairments
- some somatic diseases, including diseases of internal organs, when there is their omission (ptosis) or dyskinesia (intestinal)
- different kinds of pain syndromes
Such techniques soft manual therapy is topical at the moment, due to the great social and medical significance of these diseases. They have little or no adverse side effects and do not give complications. The opportunities and framework for the use of manual therapy may be limited only to certain indications and contraindications.
Therapeutic massage, as a preparatory procedure before the manual therapy, contributes to heating of the muscles, relieve tension, improve microcirculation in the affected areas of soft tissues.
Indications for manual therapy, chiropractic and osteopathy
A list of some typical diseases that require treatment including using manipulation:
- pain in the arm and neck with osteochondrosis
- back pain and sciatica with disc protrusion and herniation
- musculo-tonic syndrome (fibromyalgia)
- neuritis and neuropathy
- intercostal neuralgia
- carpal tunnel syndrome
- joint osteoarthrosis
- adhesive capsulitis ("frozen shoulder" syndrome, shoulder joint periarthrosis)
- dysfunction and osteoarthrosis of the temporomandibular joint (TMJ)
Contraindications for manual therapy, chiropractic and osteopathy
There are international criteria for the inspection of patients with dysfunction of the arteries of the neck before the appointment of manipulation. Risk factors are listed below, associated with a high likelihood of disease of the carotid and vertebral arteries in the patient. These factors should be carefully considered during the inspection of the patient and considered prior to manipulation on the cervical spine:
- past history of trauma to cervical spine / cervical vessels
- history of migraine-type headache
- arterial hypertension
- hypercholesterolemia / hyperlipidemia
- cardiac disease, vascular disease, previous cerebrovascular accident or transient ischaemic attack
- diabetes mellitus
- blood clotting disorders / alterations in blood properties (e.g. hyperhomocysteinemia)
- anticoagulant therapy
- long-term use of steroids
- history of smoking
- recent infection
- immediately post partum
- trivial head or neck trauma
- absence of a plausible mechanical explanation for the patient’s symptoms
Signs of arterial disease (head, neck) and cervical spine, in which the manual therapy is contraindicated:
Internal carotid artery disease
Vertebrobasilar artery disease
Upper cervical instability
Selection of patients for chiropractic in our clinic based on an assessment of available clinical symptoms and the presence of comorbidities, and patient. It promotes the safe and effective treatment of the patient.