Manual therapy of the cervical spine - features of the technique

From this article you will learn:

• What is manual therapy
• Who is indicated for manual therapy of the cervical spine?
• What are the contraindications for the procedure?
• How is the manual therapy procedure for the cervical spine performed?
• What effect can be achieved
• What are the possible complications?

Osteochondrosis of the cervical spine is a common disease among people who lead a sedentary lifestyle, for example, those who work in an office. Poor nutrition and decreased physical activity are an inevitable consequence of the development of civilization. In this article we will describe one of the most effective ways to combat the manifestations of this disease, which is manual therapy of the cervical spine.

What is manual therapy and how does it differ from massage?

Manual therapy affects the human body - muscles, joints, bone and ligamentous tissues and internal organs. This technique is minimally invasive, and its effects are based on a variety of manual techniques.

Manual therapy of the cervical spine is suitable for men and women of any age, as well as for children. The history of this technique goes back several centuries. In this field, over the past 150 years, new techniques have been developed that can be used individually and in combination with each other.

Manual therapy helps patients with various symptoms and diagnoses, such as osteochondrosis, arthritis, VSD, headaches, protrusions, poor posture, hernias, gastrointestinal diseases and others.

Not all people understand the difference between this technology and massage. But in reality, there are fundamental differences between them both in the qualifications of the specialist and in the power of influence.

Massage affects only soft tissues (muscles and skin), which eliminates muscle spasms, increases their tone, improves blood circulation and blood supply to tissues.

The difference between a massage therapist and a chiropractor is their qualifications. For the first one, medical education is not mandatory; he undergoes training in special courses.

A chiropractor always has a medical diploma, so he can work on both bones and joints, which a massage therapist absolutely cannot do.

The method under consideration includes non-drug methods for diagnosing and treating radiculitis, osteochondrosis, herniated discs and other spinal diseases. To practice manual therapy, a certified neurologist or orthopedist is trained in this technology through professional retraining courses.

At the doctor's appointment, the patient's medical history is collected. An ultrasound, x-ray or scan is required. The chiropractor also conducts an examination and palpation examination. Based on the results and individual characteristics of the patient, the doctor selects the appropriate treatment technique. Most often, manual therapy methods are aimed at the spine. This is due to its key importance for human health.

Rehabilitation period

During the rehabilitation period, you need to wear a corset.
Correction of the cervical vertebra puts it in place, but after it a period of rehabilitation will be required to consolidate the result and prevent recurrence of the injury. Rehabilitation after editing includes:

• complete abandonment of an active lifestyle, sports, and other physical activities;
• sleep on a hard mattress and orthopedic pillow;
• wearing a corset;
• bed rest for 5 days;
• rest after a session in the clinic;
• a diet with sufficient vitamins and minerals.

During the first time after reduction, it is necessary to carefully monitor how you feel. If unpleasant sensations occur in the spine, neck, or head, you must immediately notify your doctor.

Indications for manual therapy

Manual therapy is prescribed for various diseases. Its most common use is if you are concerned about:

• Pain in the thoracic spine, which radiates to the heart, with a normal cardiogram.
• Osteochondrosis.
• Pain in the cervical spine.
• Scoliosis.
• Acute pain in the lower back.
• Protrusion of intervertebral discs.
• Chronic inflammatory processes in the lumbar region.
• Intervertebral hernia.
• Spondyloarthrosis.
• Lumbar artery syndrome.
• Vegetovascular dystonia.

All treatment procedures must be prescribed by a highly qualified specialist, because incorrectly performed therapy can harm the patient’s health.

Diagnosis of vertebral displacement

Before starting treatment, you must first consult a traumatologist. He will study your clinical picture, medical history, ask about the possible causes of the displacement and then prescribe you to undergo a certain procedure for a more accurate diagnosis.

Displacement of the cervical vertebra can be detected in several ways:

• radiography;
• palpation;
• Magnetic resonance imaging;
• CT scan.

If there are clear signs of displacement of one or more cervical vertebrae, the doctor prescribes an X-ray of the spine (spondylography). If there is a possible displacement of the Atlas (first vertebra), radiography is performed through the mouth.

Palpation is interesting because a well-developed sense of touch is enough to detect a problem.

Each of the two methods provides accurate information about which vertebra is displaced and how much. Once the doctor receives the diagnostic results, he will be able to prescribe the most appropriate treatment for you.

Manual therapy for osteochondrosis of the cervical spine

Treatment of osteochondrosis using manual therapy has been known since ancient times. Many methods and techniques have been developed over 150 years of active development of this area of ​​medicine. When used correctly, this technology improves the condition of muscles, joints and vertebrae in the problem area.

The effectiveness of manual therapy for herniated cervical spine is high. And a guarantee of good treatment results is a qualified doctor with extensive experience.

The patient's appointment begins with functional diagnostic tests, thanks to which the specialist identifies limitations in the mobility of the joints and spine. In manual therapy terminology this is called a block. Problems in this area will be eliminated during treatment.

It is important to remember that it is impossible to build up cartilage tissue and break down osteophytes using this technique. It helps fight pain and increases the mobility of the cervical spine.

If you follow your doctor’s recommendations, a course of manual therapy gives excellent results:

1. Joint mobility returns.
2. The affected tissues begin to recover.
3. Frequent headaches disappear.
4. The dizziness goes away.
5. Tinnitus disappears.
6. Mobility in the neck and shoulders is restored.
7. The pain goes away or becomes significantly less.
8. The muscles of the neck and back relax.
9. There is no more numbness in the arms and legs.

Manual therapy for instability of the cervical spine improves the patient’s well-being and promotes a speedy recovery.

Techniques and techniques of manual therapy of the cervical spine

• Soft tissue techniques.

Suitable for the treatment of patients with osteochondrosis of the spinal joints. With this pathology, the spinal muscles are often in a state of spasm, which leads to a noticeable limitation of movement in the joints. By influencing them, the doctor reduces their tone and thus relieves spasm. The specialist uses his hands to work with compacted areas using pressing and kneading movements, which promotes transverse stretching of the muscles, due to which they relax, and blood circulation in the spine improves.

According to the description, this technique is similar to massage, but unlike acupuncture, during manual therapy the muscles are literally stretched, which leads to a pronounced therapeutic effect.

These techniques precede other treatment methods, more stringent, which ensure further progress.

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• Mobilization technology.

Helps restore normal range of motion in the facet joints of the cervical spine. This is a complex of various manipulations, including stretching and traction. The doctor’s actions are aimed at restoring movement in the joints in all directions and, by adding amplitudes, to develop them as much as possible without damaging the muscles and other tissues.

The specialist uses rotations and tilts to stretch the spine with his hands, gradually increasing the distance between the articular surfaces. The procedure is carried out slowly, at a slow pace, and the movement of the joint reaches the greatest amplitude possible for it.

This manipulation is of great benefit, and this is due to the fact that the cartilage receives nutrition from the bone and from the articular cavity, and in order for it to be sufficient, the cartilage needs to receive a workload.

If a joint atrophies, which often happens if it has limited range of motion, pain will occur. Development during a course of manual therapy helps maintain its normal function.

• Manipulation technique.

Allows you to restore joint mobility and get rid of accompanying muscle spasms. It consists of a sharp, jerking or rotational effect on specific joints, which the doctor carries out with his hands, monitoring the amplitude of their movement. These are the most famous techniques in manual therapy: the patient’s head is sharply turned or tilted, and clicks and even a crunch in the neck are often heard. This technique makes a strong impression, which is perhaps why doctors who practiced such methods were called chiropractors in the old days.

Using these techniques allows you to quickly get results, but when using them there is a high risk of side effects. The technique is recommended for impaired joint mobility caused by a long-term pathological process called blockade.

The professional course of manual therapy of the cervical spine receives positive feedback from patients. They managed to get rid of chronic neck pain, reduce the manifestations of symptoms associated with blood vessels - chronic arterial hypertension, dizziness, and sleep problems.

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What operating techniques does the Gelenk Clinic offer?

Depending on the cause of the pain, surgeons at the Gelenk Clinic in Gundelfingen offer the patient various surgical techniques.

Nucleoplasty

Nucleoplasty is an endoscopic operation designed to treat incomplete intervertebral hernia. If the fibrocartilaginous tissue around the core of the intervertebral disc protrudes and compresses the spinal nerves, nucleoplasty can help cure this disease without the need for open surgery. To do this, the operating surgeon inserts a high-frequency electrode into the damaged intervertebral disc through a special puncture needle. Using an electric probe and the presence of X-ray equipment that allows you to carefully observe the movements of the instruments, the doctor reduces the size of the core of the intervertebral disc until it no longer compresses the spinal nerves. The chances of success with this minimally invasive surgery are very high. Thanks to this operation, almost 80% of patients were able to relieve pain and return to their previous lifestyle.

Intervertebral disc endoprosthetics

A cervical endoprosthesis can replace the original shape of the intervertebral disc.
© Spinal Kinetics For ten years, artificial intervertebral discs have been an effective and widespread treatment method. In addition, this operation is also a promising alternative to the proven spinal fusion, an operation that blocks individual vertebral bodies. Intervertebral disc replacement is also aimed at restoring the natural functions of the intervertebral disc. The goal of this surgery is to relieve or normalize symptoms associated with disc degeneration and herniation, such as chronic back pain and neurological disorders. The endoprosthesis replaces the real intervertebral disc, stabilizes the spine and protects it from subsequent injuries. At the Gelenk Klinik medical center, M6-C type prostheses are used during this operation. Such disc prostheses last a lifetime and do not need to be replaced.

Spinal fusion

A progressive form of wear and tear on the spine often reduces the distance between the vertebrae. Thus, the space between them narrows, which leads to destabilization of the spine and displacement of the vertebral bodies forward, backward or to the side. If conservative treatment methods do not bring the desired result and minimally invasive operations do not help the patient, the technique of immobilizing the painful area is the only solution. The combination of special screws and connecting components ensures immobility of the operated area. Thanks to modern medicine, this operation is performed minimally invasively, through small incisions. It is worth noting that spinal fusion does not provide the patient with complete relief from pain, but only reduces pain in the spine.

How does a manual therapy session work?

The process of conducting a session may differ slightly depending on various factors, but in general the sequence of manipulations is performed according to the general scheme.

First, the doctor must warn the patient about the features of the procedure and possible pain, after which the latter lies down on the couch and the chiropractor examines the problem areas with his hands. The patient should relax, breathe evenly and calmly.

It is advisable to bring x-rays or the results of other examinations to an appointment with a specialist, but an experienced doctor can use his hands to determine the condition of the spine, ligaments and muscles and identify places where there are tension or inflammation. This is the diagnostic stage of therapy.

The actual treatment procedures begin with a light massage, which is necessary for relaxation. Gradually, the intensity of the effect increases, becomes stronger, the doctor realigns the vertebrae, pressing on them, and turns the patient’s neck. At this stage, unpleasant sensations are likely; a characteristic crunching sound is often heard, which is considered normal. After this, in most cases, relief occurs, the pain subsides or decreases.

The duration of treatment and the number of sessions are determined individually, as well as their frequency. In most cases, twice a week is enough. Sometimes procedures can be performed daily, but only if the patient can easily tolerate the impact on the spine.

Manual therapy is often accompanied by pain, which gradually decreases over the course of the course. Usually the pain is short-lived, but if it is so severe that it is difficult to bear, the patient should inform the doctor.

Physiotherapy is often prescribed along with a course of manual therapy, since the combined use of these methods increases the effectiveness of treatment and gives excellent results.

After completing the session, the body needs rest. The patient should follow the doctor's recommendations, possibly reduce physical activity, avoid tilting the head, sudden movements and turns in the cervical spine. In some cases, the spine is fixed with a special corset.

One to two hours after the procedure, discomfort often occurs. This is due to the fact that the body is recovering, and the muscles and ligaments are in the correct position. In order to relieve pain, it is permissible to take a painkiller.

The price of manual therapy of the cervical spine depends on the qualifications of the specialist. A course of procedures will help with neck and back problems.

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Treatment of vertebral displacement

There are two treatment methods: conservative and surgical. More often, doctors prescribe the first option, since there is a high chance of being cured of the disease either with medications or alternative techniques.

The displacement can and should be cured!

If the conservative route does not produce positive results, then doctors have to resort to the surgical route, which is surgery. Surgery is a last resort measure and is rarely prescribed, but with its help you can get rid of the displacement forever.

Conservative way of treatment

The conservative treatment route is a technique based on drug and non-drug treatment options. In the first case, medications are used, in the second case, non-traditional techniques, massages, etc. The conservative path is aimed at curing the disease by strengthening the immune system, resuming the regenerative process and improving the general condition of the body.

In the medical treatment of vertebral displacement in the cervical spine, the following types of medications are used:

• painkillers (such as Ketonal, Kotolex or Ketanov);
• muscle relaxants (“Mydocalm”, “Sirdalud”);
• non-steroidal anti-inflammatory drugs (Voltaren, Ibuprofen).

Non-drug treatment options include the following procedures

• massages;
• acupuncture;
• physiotherapy;
• kinesitherapy;
• physiotherapy.

Prices for massagers

The conservative treatment route, in addition to eliminating the symptoms of the disease, also stops its development. Kinesitherapy contributes especially strongly to this. The principle of its operation is to perform special exercises (strength, functional and dynamic) aimed at stretching the spine. This technique has shown its effectiveness in treating the musculoskeletal system, restoring the functionality of the body, and correcting various pathologies.

Kinesitherapy – simple movements heal!

In addition to taking medications and undergoing various types of therapies, you can also wear special bandages and corsets designed to support the cervical vertebrae.

Let's talk about physical therapy

Physical therapy is one of the most effective treatment methods. All you need is the systematic and correct implementation of special exercises.

Physical therapy is beneficial

Doctors recommend doing physical therapy for twenty to thirty minutes per course visit. The duration of the course is at least one year.

Advice. Even when you feel much better, continue to exercise. This will prevent the occurrence of other diseases and strengthen the body.

Exercises for vertebral displacement

Surgical treatment route

The surgical technique involves curing the disease through various surgical operations. This intervention is prescribed for congenital problems with the spine, after severe injuries such as a fall from a height, complex forms of dislocations or fractures, etc.

During the operation, the damaged vertebrae will be fixed and strengthened using special pins and plates (usually made of titanium). The postoperative period lasts at least six months.

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Contraindications to the use of this treatment method

Manual therapy of the cervical spine is very effective, but, like any other technique, it has its contraindications:

• Age over 75 years.
• Diagnosed tumor of the brain or spinal cord.
• Tuberculous spondylitis, rheumatism and other inflammatory processes of a nonspecific nature in the spine.
• Meningitis, encephalitis.
• Recovery period after spinal surgery.
• If there are fragments of hernias.
• Presence of acute infection.
• High blood pressure.
• Exacerbation of chronic hepatitis, pancreatitis or cholecystitis.
• Recent heart attack or stroke.
• Vascular diseases.

In addition, contraindications for the use of manual therapy of the cervical spine are relative. The decision is made individually if the patient has:

• Exacerbation of cervical osteochondrosis.
• Instability of some parts of the spine.
• Forstier's syndrome.
• Spinal cleft, sacralization or other anomalies of the spinal column.
• Second or third trimester of pregnancy.
• Fusion fractures of the spine.

A truly professional doctor is attentive to the patient’s medical history and conducts a session only in the absence of absolute contraindications.

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Complications after manual therapy

It is important to conduct a thorough examination before the first session so that the doctor knows about all the patient’s diseases that can cause:

1. Hypermobility of the spine as a result of abnormally mobile ligaments.
2. Bleeding.
3. Spinal fracture.
4. Ligament rupture.

Sometimes complications can occur in patients who have no contraindications. If during a session a person experiences very severe pain, unbearable discomfort, and after the procedure the discomfort does not subside and it is impossible to get up, then this should definitely be discussed with a doctor or refuse his services. These symptoms indicate a risk of complications.

The likelihood of side effects among patients is assessed through surveys. According to the results of the study after the session, 15% felt dizzy, 5% experienced spinal hypermobility, 22% experienced increased pain, and 7% experienced progressive disease.

The decision to choose manual therapy for treatment is made by the patient himself, having weighed all the pros and cons, having become familiar with the possible risks and side effects.

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