Manual therapy: what is it?

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  • 1Manual therapy - what is it? Reviews, prices, indications, contraindications
    • 1.1The concept of manual therapy
    • 1.2The meaning of the methodology
    • 1.3History of the origin of the methodology
    • 1.4Importance in modern medicine
    • 1.5Methods of treatment
    • 1.6Main indications
    • 1.7Diagnosis and contraindications
    • 1.8Treatment of osteochondrosis
    • 1.9Causes of pain after a session
    • 1.10Advantages of manual therapy
    • 1.11Cost of treatment
    • 1.12Frequently asked Questions
    • 1.13Accessibility and ease of treatment
  • 2Manual therapy - treatment of osteochondrosis and intervertebral hernia massage and contraindications
    • 2.1What is manual therapy
    • 2.2What the chiropractor is treating
    • 2.3How the manual therapist treats
    • 2.4Methods of manual therapy
    • 2.5Methods of manual therapy
    • 2.6Indications for manual therapy
    • 2.7Manual therapy - contraindications
    • 2.8The price of manual therapy
    • 2.9: a session of manual therapy
    • 2.10Reviews
  • 3Manual therapy: indications and contraindications, receptions, responses:
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    • 3.1The history of the advent of manual therapy
    • 3.2Term meaning
    • 3.3The essence of the methodology
    • 3.4Contraindications
    • 3.5Postisometric relaxation
    • 3.6Causes and stages of osteochondrosis
    • 3.7Treatment of osteochondrosis with manual therapy
    • 3.8Features of the event
    • 3.9Treatment of a hernia of a backbone
    • 3.10Cervical treatment
  • 4What is manual therapy: indications and contraindications
    • 4.1Pathogenetic basis of alternative treatment
    • 4.2What is a function block (FB)
    • 4.3Manual action: classification of receptions
    • 4.4Advantages and disadvantages
    • 4.5What are the features and differences of osteopathy from manual therapy
    • 4.6Indications for therapy
    • 4.7Methodological contraindications
    • 4.8Summary

Manual therapy - what is it? Reviews, prices, indications, contraindications

Often, between such concepts as manual therapy and massage, we put an equal sign. However, this opinion is erroneous. After all, only muscle tissue is treated with the massage.

During the session of manual therapy the specialist has the same effect on muscles and joints.

Such an integrated approach not only solves a number of problems associated with diseases of the spine, but also improves blood flow, nourishes tissues and leads to muscle tone.

Manual therapy has another name - vertebrology. This technique can rightfully become the medicine of the future. An experienced manual specialist often solves problems that could not be eliminated by traditional medical methods.

The concept of manual therapy

Manual therapy - what is it? This concept has quite a wide meaning: it's all that is treated with the help of hands. Hence comes the conviction of its great possibilities.

However, one should know that all existing manual therapy techniques have rather strict rules, developed by professional therapists who practice spinal treatment.

In terms of effectiveness, this therapy significantly exceeds the hardware and medication treatment of spine diseases. And this is due to the fact that during the session the doctor deals with the individual problem of the individual patient.


After all, people of different sex and age come to the centers of manual therapy. As a rule, their state of health and level of physical development are different. This also applies to back problems that they experience.


If one patient complains of permanent migraines, then the other handles an old hernia.

During the session, the therapist uses 2 basic techniques: soft and hard. At the heart of the first is the technique of muscular-energy techniques. In a rigid technique, shock techniques are used.

The specialist applies various combinations of manual techniques to ensure successful treatment. The use of only one technique is often ineffective, and in some cases even provokes complications.

The meaning of the methodology

Manual therapy - what is it and what is its meaning? The main task of the manual therapist is to create the most favorable spatial relationship for radicular vessels and structures of the nervous system.

During the session, the doctor removes such orthopedic defects, as a violation of posture and deformation of the spine.

The main criterion for successful treatment is a reduction in pain and discomfort, as well as a partial correction of the spinal deformity to the 8-10th session. The specialist determines the duration of the full course individually in each specific case.

History of the origin of the methodology

Manual therapy - what is it and when did it appear? The development of manual therapy dates back to ancient times.

It is noteworthy that it is mentioned not in one, but in many cultures of the world, for example in Egyptian, Indian and Chinese. Who were the first manual physicians, nobody knows.

There is an opinion that they were hunters who used special manual techniques for correcting dislocations and treating injuries.

Gradually, these people accumulated knowledge about the anatomy and physiology of the human body and studied the function of the joints. As a result, the first method of treating injuries appeared-bone-chipping. Even Hippocrates mentioned in his writings about a similar method for treating spine diseases.

In the distant past, doctors widely used the technique of stretching the body, walking on the back of the patient, tapping on the back with special preparations of wood and even punching. However, the main development of manual therapy began only in the 19th century. At that time, two directions appeared at once:

They differed in their views and the methods of treatment used. Chiropractors most often used a rigid approach, widely applying various shock techniques.

It is worth noting that these people did not even have medical education.

Osteopathic school, as is known, also did not require compulsory education, however, the osteopaths treated their patients according to the achievements of medicine.

Importance in modern medicine

In the 20th century, manual therapy, the reviews about which spread rapidly throughout Europe, gradually began to acquire popularity and signs of modern medicine. Osteopathic and chiropractic specialized centers began to appear in the cities. They still exist and are engaged in treatment of people.

In Russia, the first symposium on manual therapy was held in 1989, and a year later the first Association of Manual Medicine was established. 1997 was the most significant for the development of manual therapy, as it was officially recognized as a science and approved as a medical specialty.

Methods of treatment

Manual therapy of the spine is a special set of manual techniques aimed at correcting pathology. The goal of manual therapy is to cure back diseases and restore the optimal position of the vertebrae and intervertebral discs.

This is achieved with the help of techniques performed by hands. Thanks to the techniques of manual therapy, the joints are separated from each other.

Specialists working in well-known clinics of this specialization usually practice their own methods cures, all of which are based on the principles on which a manual therapy.


For example, consider the technique of subcutaneous myofascial therapy. The essence of this method is to work with tissues.


It allows to normalize the reflex mechanisms (muscles, structures of connective tissues).

Since this method implies a fairly intense effect on the body, treatment with manual therapy can be carried out only after a thorough examination.

Currently, this technique is used to treat various neurological diseases - headaches and muscle pains, sciatica. It is also used for diseases of the joints and spine (artite, arthrosis, spondylosis, hernia and others).

Main indications

Indications for manual therapy are many. As a rule, it is prescribed for:

  • a herniated intervertebral disk;
  • osteochondrosis and arthrosis;
  • intercostal neuralgia;
  • regular dizziness;
  • permanent headaches;
  • violation of posture;
  • pain and tension in the muscles;
  • impaired mobility of internal organs;
  • chronic fatigue and stress.

Along with this, manual therapy is used as a rehabilitation after trauma.

Diagnosis and contraindications

In order to make the correct diagnosis, use CT, X-ray, MRI, electroneuromyography and hardware reflexodiagnostics.

This method of treatment of the spine is not suitable for everyone. The main contraindication to manual therapy is an infectious disease of the joints or spine.

The courses of manual therapy are contraindicated in the presence of fresh injuries of the spine, hands or feet.

Among other diseases that do not allow manual therapy, one should distinguish arterial hypertension, tumors, mental disorders. Also, it can not be appointed in the postoperative period.

Do not resort to such treatment for infectious diseases with fever and intoxication, acute heart diseases, disorders in the spinal and cerebral circulation.

The manual doctor should always take into account all contraindications, including relative ones, which include old injuries.

Treatment of osteochondrosis

Osteochondrosis is a disease of the spine, associated with dystrophic changes of closely located intervertebral discs and vertebrae.

Manual therapy with osteochondrosis is effective only at the 1st, 2nd and 3rd stage of the disease, in which there are no bony growths.

Cervical osteochondrosis involves special exercises. This disease occurs today quite often.


Therefore, almost all the techniques of manual therapy are aimed at eliminating this symptom.


Autoimmobilization is considered to be an effective technique. During the session, the patient slightly tilts his head forward, grasps it with one hand, and the second rests on the chin, then turns his head and makes a slight wiggle.

Causes of pain after a session

Sometimes it happens that the patient experiences pain in the areas that the manual therapist was working on.

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This is due to the fact that one group of muscles begins to work actively, and the other gets rid of too much strain.

The effect after the session of manual therapy can be compared with when you "sit out your leg" and then straighten it. As a result, not very pleasant feelings appear.

They tend to pass by themselves, but to speed up the process, you can make yourself a self-massage or develop muscles with this or that simple physical exercise.

Advantages of manual therapy

Manual therapy - what is it? It allows you to get rid of unbearable pain that does not go away after taking medication.

Today, manual therapy of the spine is widely used in the treatment of back problems. Often it produces a greater effect than treatment with medications.

The session of manual therapy includes a set of special receptions performed by hands.


They are aimed at relaxing the muscles and normalizing the mobility of bones and joints.


Such sessions can improve blood circulation and reduce pain. Specific methods and techniques the doctor chooses after the examination of the patient.

Cost of treatment

There are many centers of manual therapy, in which professional doctors work, ready to help patients.

How much does manual therapy cost? Prices for specialist services are often lower than the cost of medicines, which sometimes do not bring the desired result. In addition, the methods of manual therapy are rapidly developing and improving.

On average, the cost of taking a chiropractor is about 1800-2800 rubles and depends on the complexity and duration of the procedure.

Find a good center for manual therapy and an experienced therapist will not be a problem. To do this, simply contact a specialized clinic.

The patient can always inquire about the experience and qualifications of those specialists who work in the center, and choose the most suitable manual therapist.

Frequently asked Questions

Many people doubt the effectiveness of procedures or they have questions related to treatment.

They can easily be answered by any specialist in manual therapy.

Below are the answers to frequently asked questions, which should interest people who want to learn more about this technique.

How long does the course of manual therapy continue? Duration always depends on the nature and development of the disease. Applying to the center of manual therapy, the patient is offered to undergo about 8-10 procedures. In fairly complex cases, the number of sessions can be as high as 15.

When does the result appear? Usually the pain starts to decrease after 2-3 procedures of manual therapy. It should be understood that at least 8 procedures are required to fix the effect and completely eliminate the symptoms of the disease.

Is manual therapy of the spine painful? As a rule, pain should not occur during the procedure. The patient may only feel discomfort with some manipulation of the specialist.

If the patient experiences severe pain during the procedure, he should immediately notify the therapist.

Probably, in this case the treatment will have to be adjusted, replacing the manual therapy with more gentle methods, for example, physiotherapy.

Accessibility and ease of treatment

It should be noted that manual therapy, reviews of which are mostly positive, is a fairly accessible and easy method of treating back problems.

Today, there are many specialized centers in all regions of the country that offer the most favorable prices and conditions.

Only the best specialists work in these centers.

Medical centers of manual therapy use unique methods of treatment of all types of diseases of the spine and joints. After a course of treatment, the patient will be able to forget about the pain and return to a full life.

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Manual therapy - treatment of osteochondrosis and intervertebral hernia massage and contraindications

In ancient times, practiced bones, which could cure a number of diseases of the spine and "raise on their feet" even an invalid.

In modern medicine, this specialty is officially called a masseur-manual, and the scope of activity is intensive therapy of extensive pathologies of the musculoskeletal system.

What is manual therapy

Alternative methods of treatment in modern society are very popular, they found their ardent supporters.

Almost every educated person knows what manual therapy is, and how effective this technique is in practice.

Unconventional treatment is practiced in all countries, successfully eliminates spine diseases of different origin, is an effective prevention of pathology of the musculoskeletal system.

The essence of the technique is as follows: first a functional blockade is removed from the spinal column, then symptomatic treatment with relaxation methods is applied.

Simply put, here's what a manual therapist does: first, he overcomes acute pain syndrome, then conducts a series of therapeutic measures to prevent a second relapse.

Currently, there are several author's techniques that can return the patient the joy of movement, life without pain. The benefits of manual therapy are obvious, since after the first session the patient experiences the long-awaited relief.


It is necessary to complete a complete course in order to get rid of the disease, and then maintain your condition with preventive measures.


Received from the therapy manual effect will be delayed for a long time, doctors distinguish three main effects:

  1. Peripheral. Improve blood circulation, restore soft tissues, transport oxygen to cells, update the characteristics of affected cells, normalize body fluids.
  2. Neurophysiological. Restoration of the passage of nerve impulses, the normalization of the functions of nerve endings.
  3. Psychophysiological. Systemic action in the whole body, and not only in its individual parts, has a general strengthening effect.

The doctor manual therapist by profession is a certified neurologist and orthopedist. However, in practice, it works more with hands - it acts directly on the foci of pathology, removes acute pain syndrome.

Such a generalist is more likely to be approached by adults, but his specialization extends to the treatment of the younger generation. Manual massage is the basis of intensive therapy, however, one procedure is not enough.

It takes a complete course, to fix the result.

What the chiropractor is treating

Such a specialist deals with problems of the back and spine, beginning from the neck and ending with the waist, extremities.

He is referred for diploma care for acute pain of unknown etiology.

The manual therapist treats unpleasant sensations, but the main thing is that he looks for and efficiently eliminates the problem of a congenital or acquired character.

Positive dynamics is observed provided that a person adheres to all medical recommendations.

The manual worker works with the spine and joints, but this does not prevent him from productively restoring the functions of the digestive tract, endocrine, nervous, respiratory system.

In addition, it improves the emotional sphere of the patient, the work of internal organs and the brain, strengthens the immune system and stimulates the functions of the circulatory system.

How the manual therapist treats

Manual therapy successfully combines author's techniques with the passage of a course of massage, physiotherapy and reflexology.

Such an integrated approach to the problem ensures the successful treatment of vegetovascular dystonia, scoliosis, migraines, intervertebral hernia, arthrosis, muscular-tonic syndromes and not only.

The principle of the manual - to determine the cause of the pathology, to eliminate it and the symptoms present in the life of the patient. Soft manual therapy is a gentle method that also effectively treats diseases of the musculoskeletal system, it acts systematically.

Methods of manual therapy

Manualschik, depending on the clinical picture, chooses the manual methods of influence directly on the focus of the pathology of the spinal column.

What helps with some diseases is ineffective in others. Therefore, author's methods are so in demand in practice.

The main methods of manual therapy are described in detail below, complement the existing directions of official medicine. It:

  1. Arthrovertebral therapy. He heals the sick joints, contributes to their separation from each other. A more intensive massage is used, which is called a traction push. Manual therapy restores the functions of the disk apparatus of the spine, suppresses the pathological process of compression of nerve endings.
  2. Myofascial therapy. Restores reflexes of muscles and fascia. This appointment is appropriate for extensive pathologies of the vascular system, joint and connective tissue diseases, neurological pathologies.
  3. Visceral method. Treats internal organs such as the lungs, intestines, liver, spleen, myocardium, reproductive system, kidneys. In clinical pictures, soft manual techniques are more often used. Manual therapy can be the main method of treatment, without taking pills.
  4. The cranial method. He treats diseases associated with the brain, affects the joints of the skull, neck muscles. It is also called cranio-sacral method, and resorts to help with frequent dizziness, decreased concentration and memory, migraine attacks, and intracranial pressure disturbed.

Methods of manual therapy

There are many methods known to successfully treat the spine and its departments. The choice is individual, manipulations are carried out point-by-point with an interval of sessions of 1-3 days.

The patient's feedback is positive, but in many respects the result depends on the professionalism and experience of the osteopath.

The basic techniques of manual therapy with a brief description are presented below:

  1. Jogging mobilization. Manipulation with manual therapy is carried out directly on the affected joints. In this way the doctor directs the displaced disks, breaks the integrity of the exostoses, removes subluxations of the joint structures.
  2. Rhythmic mobilization. There are three types of procedure with a clear definition of the method of exposure. The stretching technique is suitable for joint surfaces, rotating - inserting connecting structures, squeezing is used when it is impossible to use the above methods.
  3. Positional mobilization. Smooth stretching of the muscles in the joints, restoration of the functional reserve, elimination of complications of treatment of the musculoskeletal system.
  4. Postisometric relaxation. Intensive muscle tension is effectively combined with their subsequent smooth stretching. The pain quickly passes in the lumbar, thoracic, cervical and other parts of the spinal column.
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Indications for manual therapy

If the acute pain syndrome lasts a long period of time, and the action of pain medication is short-term, it is recommended to visit the manual man urgently. However, there are certain indications for manual therapy that make such treatment possible, appropriate. These are the following diseases of the spine:

  • intervertebral hernia;
  • osteochondrosis;
  • humeroscapular periarthritis;
  • protrusion of intervertebral discs;
  • scoliosis;
  • torticollis;
  • styloidite;
  • flat feet;
  • sciatica;
  • pseudostenocardia;
  • Thoracalgia;
  • epicondylitis of the shoulder;
  • cervicalgia.

Learn about the symptoms, signs and treatment of vegetative dystonia.

Manual therapy - contraindications

Feedback on the methodology is positive, but not all can be implemented in practice, involved in the process of recovery. There are medical contraindications to manual therapy, which cover such clinical pictures:

  • oncology;
  • inflammatory process of the joints, spinal cord;
  • tendency to bleeding;
  • thrombosis of vertebral arteries;
  • previously suffered heart attack or stroke;
  • pregnancy;
  • open wounds of soft tissues;
  • anatomical features of the spine.

The price of manual therapy

Chiropractors are not a free service. The prices depend on the city of reception of the specialist, his professionalism and reputation in the given direction, the level of the private clinic.

You can apply to the state clinic, where a cheap course of manual therapy, for example, 300 rubles per session, or at all for free.

In commercial medical centers and institutes, the price is much higher - the cost of a manual therapy session in the provinces starts from , 00 rubles.

: a session of manual therapy


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Manual therapy: indications and contraindications, receptions, responses:

Manual therapy appeared even in ancient times.

In ancient times people noticed that, performing certain actions, it is easier to transfer pain from injuries or bruises received on the hunt. Also it allowed to recover as soon as possible.

For example, the pain at the site of the injury decreased from the cold flowing river water. And the broken leg fused faster, if it was primed to an even stick.

The history of the advent of manual therapy

Elements of methods of traditional medicine, which have survived to this day, are the following:

- Dressings;

- herbal decoctions;

- use of cold and heat.

Over time, knowledge on the anatomy of the human body, accumulated by many generations, have become one of the branches of medicine - surgery.

Separate its direction in the early stages of the emergence of the chicken business. Another Hippocrates developed a very interesting method that allows you to heal the spine.

The patient was fixed stretched legs and arms, and then walked on his back.

In the 18-19 centuries. Particularly the functions of the bones were performed by the bath attendants. As a rule, they were people with remarkable strength, which enabled them to make joint hoods visitors and perform a procedure of massage, which is a point punch by certain parts of the body.


The witch doctor was also engaged in a chore. In their technique there was massage, shock movements and stretch marks. Various spells from diseases were popular.


Somewhat later, all the experience accumulated by folk medicine men, systematized, studied, somewhat complemented and transformed into such sections of medicine:

- phyto balneo- and psychotherapy;

- massage.

The very same manual therapy by the end of the 19th century. consisted of two main areas. These included chiropractic and osteopathy.

The methods of work of specialists representing these currents were different.

If the first performed manipulations using a rough percussive technique, the latter were, as a rule, theoreticians.

Term meaning

Manual therapy in the modern world performs a number of functions. This direction studies the movement of parts of the body; investigates the sources of pathologies that arise in the locomotor system.

Manual therapy is quite an effective tool used to treat ailments of the musculoskeletal system.

The effect of the method under consideration will be repeatedly strengthened in the case of the parallel use of reflexotherapy of phytotherapy, as well as physiotherapy procedures.

The main thing with which experts work in this area is the spine.

The essence of the methodology

Manual therapy is a whole system, which includes manual techniques. The main purpose of its impact on the patient is to eliminate those pathological changes that have arisen in the ligament, bone, and muscular apparatus.

Manual therapy restores the anatomically correct position of the vertebrae and intervertebral discs. This is not an easy task.

The unsuccessful restoration of the position of the displaced vertebrae can cause infringement of the vessels. This leads to venous stasis and negatively affects the work of many organs.

To correct this situation, too, use the techniques of manual therapy.

Manual impact on the painful areas allows you to distance each other's joint surfaces and restore blood circulation. Manual therapists affect specific areas of the spine in a dosed manner.

This allows to restore normal mobility to the musculoskeletal apparatus. It is very effective to combine manual therapy with homeopathy. However, on this issue it is worth consulting with a specialist in advance.


Conducting sessions of manual therapy is prohibited with such problems:

- infectious diseases that affect the joints and spine;

- tumors;

- hypertension;

- recent injuries of limbs and spine.

What other cases do not perform manual therapy? Contraindications concern patients who have a prolapse of herniated intervertebral discs. This technique is prohibited for developmental defects of the skull. This restriction applies to the same pathology of the spine.

When is manual therapy prohibited? Contraindications concern those patients whose condition is assessed as extremely difficult. And its cause can be not only the above infectious diseases, but also neurotic or psychiatric disorders.

The sessions of manual therapy for somatic diseases, as well as in complex treatment with anticoagulants are forbidden. Therapy of the musculoskeletal device, performed by hand, is not recommended for patients of advanced age.

Do not undergo manual therapy sessions for any pathology of the joints and spinal cord.

Postisometric relaxation

Manual therapy of the spine can be performed using various manual techniques.

One of them is post-isometric relaxation. It is noteworthy that this method has no contraindications.

Its essence lies in the alternating tension and relaxation of muscles.

Manual therapy of the spine, performed by the method of post-isometric relaxation, stretches the muscles, eliminates puffiness, relieves pain syndromes.


This technique is simple and safe to use. The patient, after completing a small training course, is able to replicate at home its basic elements.


Causes and stages of osteochondrosis

This disease causes degenerative changes in intervertebral discs and adjacent vertebral bodies. In pathology, four stages are distinguished. The first of them is difficult to diagnose.

The patient receives complaints only from the general plan. The main symptoms of this condition are malaise and uncomfortable discomfort.

In the second stage, when intervertebral ligaments are broken, pain occurs. There is a squeezing of the blood and lymph vessels.

The third stage is characterized by rupture of fibrous rings and the appearance of a hernia. There are visual curvatures of the spine.

The last stage of osteochondrosis is the displacement and compaction of the vertebrae. The result of this process is the formation of pathological bone growths.

This is fraught with a decrease in motor functions and impaired mobility of the entire vertebral column. The painful process, developing, leads a person to disability.

Described above is typical for all types of osteochondrosis (cervical and thoracic, lumbar and sacral).

Treatment of osteochondrosis with manual therapy

The spine is the main organ to which ligaments, muscles, blood vessels, nourishing them, and nerves are attached. His health is extremely important for the normal well-being of a person.

Manual therapy of the spine provides for specially designed techniques, which include the following components:

- massage:

- mobilization;

- Immobilization;

- manipulation;

- correction of functional relationships, etc.

All these manual influences are directed to the solution of the problem of elimination of pathobiomechanical phenomena of osteochondrosis.


What is manual therapy for these patients? This is an opportunity to restore mobility and activity of the musculoskeletal system.


However, it should be borne in mind that this technique does not eliminate the factors contributing to the emergence and development of osteochondrosis.

How does manipulation affect a patient's condition? The experts' feedback is confirmed by the fact that the use of this technique does not allow to solve the initial problems with the spine. Yes, the pain after the session will pass quickly enough, but the progression of the disease will remain.

The greatest effectiveness of manual therapy can be felt in the early stages of osteochondrosis. But with the further development of pathology, when the displacement of the vertebrae has already occurred, this method is strictly counter-indicative.

Features of the event

Before you start any relaxation technique, you need to cure the underlying disease. To do this, use medicines and physiotherapy.

Manual therapy with osteochondrosis will be most effective if the stressed muscles before the beginning of the session are warmed and stretched using slow movements.

Treatment of a hernia of a backbone

To conduct a session of manual therapy, the patient must undergo a CT or MRI scan. As a result of these studies, the place of hernia formation will be determined, in the area of ​​which the manual therapist will work.

In the event that the disease is in an acute stage, hand techniques should be carried out smoothly, gently, without any physical effort and sudden movements.

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With such an intervertebral hernia, traction (spinal column extension) is often used. The patient is sitting or lying down.

When a hernia is able to help the corset for the spine or the collar of Shantz, put on the neck.

After the acute period is left behind, traction mobilization, post-isometric muscle relaxation, and stretching (manual or hardware) are used. Such manipulations can eliminate the symptoms of hernia of the spine, pain, and, in addition, prevent relapses of pathology.

Cervical treatment

This area of ​​the spine is subject to serious stress. That is why in the cervical region often there is an osteochondrosis.

What is manual therapy for patients with this diagnosis? It is an opportunity to reduce or completely remove pain, and also restore the volume of motor function of the spine or shoulder joints. In addition, manual manipulation is performed to eliminate symptoms of nerve compression, which is expressed by noise in the ears and headaches.

The maximum effect when performing manual therapy comes after two sessions. For maximum results the doctor should be visited seven to ten times.

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What is manual therapy: indications and contraindications

Manual therapy is a unifying medical term for mechanical action, where the hands are the main instrument of treatment. The most advanced form of contact interaction is manual massage.

At the heart of the therapeutic-diagnostic method of alternative (non-traditional) way of treatment, lies osteopathy, which manual therapist, considers as the primary cause of the painful relationship between structural and anatomical systems life activity. In this article we will define what is manual therapy from the point of view of contact interaction with the musculoskeletal system, in what advantages, what are the indications and the main contraindications to manual therapy exist, we will consider the main methods and techniques of manual therapy.

Pathogenetic basis of alternative treatment

The current fundamentals of manual technology combine in themselves:

  • The idea of ​​treating the spinal column as the main osteoarticular formation of the supporting system, its lumbosacral and vertebral elements: intervertebral discs, articular segments, vascular and nerve plexuses.
  • The idea of ​​post-isometric relaxation of muscles of different parts of vertebral motor segments in osteochondrosis, hernial protrusion pulpous contents in the body of the spine, deforming spondylarthrosis, displacement and / or compression pinched meniscoids and similar.
  • The concept of the work of anatomical organs of life.
  • Development of diagnostic methods and special techniques for manual therapy with natural passes on the displacement of the mobile regional department.

Thus, it becomes obvious that manual therapy methods contribute to pathobiomechanical exclusion of locomotor disorders and their pain symptoms.

In other words, manual massage does not significantly affect the degenerative activity and dystrophy of the vertebral-motor parts of the support apparatus.

However, craniosacral and osteopathic gymnastics, performed by a manual or massage therapist, have a very positive effect on the healthy the functionality of the main organ of the nervous system and locomotor vertebral sites, and also significantly helps in relaxing all its muscular-ligament plexuses.

What is a function block (FB)

Under the functional block of the vertebral-motor department is meant the reversible restriction of intraarticular mobility connective-tissue elements relative to each other, which means their violation of the periarticular reflex myofixation.

Reversibility to the functional block is ensured by the action of passive mobilization movements, the traction impulse, and also various kinds of relaxation actions (manual massage, postisometric muscle relaxation, autorealaxation).

The most frequent causal factors in the emergence of a functional block are:

  • Trophic muscular insufficiency due to prolonged immobilization.
  • Overload dynamic impact (sharp jerks and the like).
  • Static overload.
  • Nociceptive reflex action in the disease of the vertebral system.
  • Inertial overstrain of the musculoskeletal segment.

With the evaluation of the limited block, the manualist determines its direction. The opposite of FB is the joint hypermobility of the vertebral segments.

The difference lies in the increased anterolateral, ventrodorsal and dorsoventral displacement of the vertebral-motor segments.


Such differences in excess mobility increase the ability to reversibility of a certain volume of movements during manual methods of mobilization of articular segments of the spine.


The manual-manualist chooses manual exercises proceeding from a pathogenesis and a kind of a biomechanical functional disturbance. The general requirements for the use of therapy are:

  • The indicator of clinical and radiological examination, excluding the main contraindications to manual therapy.
  • Definition of a variety of pathobiomechanical functional impairment.

A correct assessment of the situation and a precise definition of the differential approach to the alternative method of exposure helps the doctor to establish a positive compatibility with the patient, which makes the psychologist contact.

Manual action: classification of receptions

To eliminate pain and other manifestations of clinical symptoms, the manualist selects the appropriate mechanical effect:

  1. Segmental relaxing manual massage. In 3-5 minutes the manualist makes soft stroking and stretching of spasms to provide them with a warming effect. As a result of this action, the muscle tension significantly decreases, the osteoarticular segment becomes more sensitive and flexible to stretch. The patient's response is a reduction or complete disappearance of pain, dizziness disappears, the body becomes more obedient, while the head becomes heavier and tends to sleep. Such a reaction of the body testifies to the high professionalism of the therapist.
  2. Segmental mobilization, that is, providing a painless recovery of the FB or spasmodic shortening of the muscular segment by passively repeated unhurried movements within the joint physiological volume.

At the same time, mobilization requires certain conditions:

  • Stable fixation of the above- or lower-lying parts of the body, especially these conditions are rigorously fulfilled, when manual therapy of the neck is performed.
  • Provide complete muscle relaxation.
  • Any performance of a manual procedure should be performed during the exhalation phase.
  • The manualist provides the direction of smooth and soft movements along the longitudinal axis of intermixing and mutual removal of articular surfaces.
  • Mobilization is carried out until a weak sensation of pain and the appearance of slight resistance in the joint, after the joint segment returns to its original position.
  • Patient and consistent mobilization sometimes completely replaces manipulative action.

So, after establishing the pathogenetic and clinical state, as well as the detailed neurological examination of the patient, a therapeutic tactic of mechanical influence is developed and the question of expediency of treatment.

Advantages and disadvantages

At present, the imposition of various methods of alternative medicine is becoming fashionable.

Street poles are full of announcements about reliable healing by osteopathy, craniopathy and / or visceral manual medicine methods.

It is very difficult to understand this terminology, how they differ from each other, whether these methods of treatment are good, or they have a bad effect on human health, and whether it is worth paying attention to it at all.

Often, home-grown medical specialists say that manual therapy during pregnancy is the only way elimination of pain in the locomotor system of the spine, and also recommend such alternative treatments for small children.

What are the features and differences of osteopathy from manual therapy

Osteopathy finds out the causes of the diseases, and provides a gentle therapeutic effect on the muscular structure, which is permissible even for infants.

Classical manual therapy is the definition of pain symptoms, which reveal the consequence of their appearance and methods of mechanical action.

Craniosacral chiropractic therapy is the metered manipulation by the manual doctor of the cranial bones.

Indications for therapy

The therapeutic effect of mechanical intervention in the vertebral-motor segment should be conditioned by certain conditions, or indication of manual therapy. There are two types of such treatment and recovery prophylaxis - absolute and relative indications and contraindications.

  • Diseases of the osteo-articular organization of the spine, associated with a degenerative disorder leading to the development of functional units of PDS - osteochondrosis, deforming spondylarthrosis and so on.
  • Disgenic reflex disorders at the level of the cervical (cervicalgia), thoracic (thoracalgia) and lumbar (vertebrae), expressed by a certain degree of local pain.
  • Diseases of spondylogic pathology with an irrational-reflex muscular-dystonic disorder.
  • Irritative-vegetative-trophic bone-joint disorders - coxarthrosis, arthrosis of the peri-sacral segment, humeropathy periarthrosis and so on.
  • Acroparesthesia, pseudo-arteritis, thermal paresthesia, restless legs syndrome, that is, all those clinical manifestations that relate to the irritative-reflex-vascular syndromes of the spondylogenic pathology.
  • Diseases of the osteoarticular segments providing myofascial pain in trigger zones.


  • Severity of pain syndrome exceeding the third degree.
  • Spondylogenic symptoms of radicular syndrome in paresis, hyporeflexia, etc.
  • Spondylogenic syndromes with pronounced neurodystrophic disorder.
  • Sympathetic syndromes with pronounced posterior cervical spondylogic characteristics.
  • Symptomatology of the functional block of the vertebral-motor segment with visceral-reflex muscular and / or pain syndrome.

Methodological contraindications

Mechanical impact can have a limitation on absolute and relative signs, which provide some harm from manual therapy.
Absolute signs:

  • Presence of malignant neoplasms in the segmental part of the proposed procedure.
  • The presence of acute infectious lesions.
  • Pronounced instability of the vertebral column.
  • Inflammatory disorders in the spinal organization.
  • Violation of the main blood supply.
  • Injury of the spine or arterial thrombus.

Relative attributes include:

  • Unstable psychoemotional state of the patient.
  • Stage of decompensation of clinical pathologies of internal organs.


A rough or unprofessional hand movement can provoke a complication: fracture of the vertebrae of the cervical or other parts, rupture of the ligament apparatus, violation of the main circulation.

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