Manual therapy for osteochondrosis of the cervical spine

Manual therapy is a set of methods of influencing the patient’s body (mainly the spine) for therapeutic and diagnostic purposes. Chiropractors are popularly called chiropractors, since treatment by specialists in this profile allows one to correct the position of spinal motion segments in accordance with the anatomical characteristics of the body. Manual therapy for osteochondrosis of the cervical spine is aimed primarily at eliminating pain, which limits the patient’s mobility and significantly reduces his quality of life. Manual techniques (“hand treatment”) are successfully used in sports medicine, vertebrology, orthopedics and neurology, as well as in the treatment of chronic diseases of internal organs, the functioning of which is directly or indirectly related to the condition of the spine (for example, the pelvic organs).

Manual therapy for osteochondrosis of the cervical spine

The effectiveness of manual therapy for cervical osteochondrosis

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Manual therapy as a method of treating osteochondrosis and other diseases of the spine has been officially used since 1970. Doctors working in manual therapy clinics must not only have a license allowing them to engage in this type of activity, but also have primary education as a neurologist or orthopedist, since even small mistakes can cause serious complications and disability for a person.

Cervical osteochondrosis: which doctor to go to

Before starting treatment, the patient must undergo a comprehensive examination, which necessarily includes radiography of the spine or MRI.

Radiography as a method for diagnosing osteochondrosis

The use of tomography is necessary, since this diagnostic method allows us to identify not only changes in bone structures, but also signs of inflammatory, destructive and other pathologies in the surrounding tissues (in all planes).

Magnetic resonance imaging is the most popular diagnostic method

If you want to learn in more detail how the MRI procedure of the spine is performed, and also consider when a magnetic resonance examination is indicated, you can read an article about this on our portal.

The main indication for the use of manual techniques for cervical osteochondrosis is chronic pain syndrome associated with deformation of the cervical vertebrae and pinched nerve endings. The positive result of the treatment becomes noticeable after the first visit, but for complete relief from pain, it may take from 3 to 10 visits, which are carried out at intervals of 2 to 5 days.

Manual therapy allows you to get rid of neck pain in just a few sessions

Daily treatment is considered impractical by most chiropractors because the muscles need time to recover and adapt (usually about 48 hours).

With the correct impact on the spine after treatment, the following results can be achieved:

• reduction or complete disappearance of headaches;
• complete or partial restoration of the functions of the affected motor segments (vertebrae and intervertebral discs);
• elimination of symptomatic manifestations of cervical osteochondrosis (tinnitus, decreased visual acuity, dizziness, migraine, etc.);
• normalization of blood pressure (in the absence of other pathologies of the heart and blood vessels).

After manual therapy sessions, patients’ blood pressure normalizes and headaches stop bothering them.

After undergoing manual therapy, the feeling of stiffness and tension in the neck, shoulders and back of the head decreases or completely disappears, the intensity of radicular pain decreases, and the range of motion in the cervical vertebrae is restored. In approximately 60% of patients, neurocirculatory function is restored, numbness in the limbs disappears, and the frequency of spasms and paresis decreases.

Manual therapy allows you to get rid of spasms and paresis

Important! Cervical osteochondrosis is a chronic pathology, so it is impossible to completely cure it with manual therapy. Despite this, manual intervention can be very useful, as it can reduce the risk of exacerbations and achieve stable and long-term remission, as well as restore the usual amount of physical activity.

Treatment process

If, based on the diagnostic results, the doctor prescribed manual therapy for osteochondrosis of the lumbar or other region, a date and time for the session are set. Treatment is carried out as follows. In a specially designated room, the patient undresses to the waist and lies down on the couch. The specialist’s actions are divided into 3 stages:

• Relieving muscle tension, preparing for subsequent manipulations. Unlike a regular massage, no creams or oils are used, and the effect is only on reflex zones.
• The stage of mobilization of the body, during which the affected intervertebral discs return their functions. One of the main tasks is to release nerve endings from pressure on them and change the position of displaced vertebrae.
• Manipulation of joints or vertebrae. At this stage, the main impact on the displaced element occurs - the doctor begins to work with it directly, and not indirectly, as before. There may be slight pain, increased temperature, and a crunch in the spine.

During the entire procedure, the specialist “listens” to the patient’s condition. The latter should report this to the doctor in case of sharp or prolonged pain. If the session is conducted by a qualified therapist, all unpleasant sensations stop immediately after they occur.

As soon as you leave the clinic, refrain from physical or emotional stress. It is better not to drive in the next few hours - you may become drowsy or distracted. The feeling of heat or cold should go away shortly after the session.

Already at the very beginning of the course, people notice improvements in their well-being. However, in order to consolidate the result, it is necessary to bring it to the end. The most difficult are the first procedures, when work is just beginning with vertebrae that have been literally out of place for many years.

Themes

Osteochondrosis, Spine Date of publication: 02.25.2016 Date of update: 29.11.2018

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Manual therapy methods

Manual therapy is a set of “manual” techniques aimed at restoring the basic functions of the spine, returning the anatomically correct position to various segments of the spinal column and correcting muscle tone, which plays an important role in the development of radicular syndrome (the dominant sign of osteochondrosis, regardless of the location of the pathological process). The main methods of therapeutic effects on the spine used by chiropractors are presented in the table below.

Table. Methods of manual treatment for cervical osteochondrosis

Technique

Chiropractors in the treatment of cervical osteochondrosis and other diseases of the spine use different techniques that differ in the intensity of exposure, techniques and therapeutic effect.

Spinal mobilization

In total, there are three techniques for mobilizing the spinal column.

1. Push-like (manipulation). This technique is a type of biomechanical irritation of the spine and allows you to realign intervertebral discs, subluxate joints, and also destroy benign growths on the surface of the bone structures of the spine, which can be in the form of spikes and are formed as a result of ossification of cartilage tissue.
   Push mobilization with symmetrical pressure in the supine position

   Option for manipulation with symmetrical hand pressure and fixation of the chest from the front and sides using the patient’s hands

2. Rhythmic mobilization. Combines several techniques: stretching, rotating and squeezing. It is a painless technique of manual therapy and allows you to achieve significant results in cases of pathological anatomy of the spinal joints and severe overstrain of the neck muscles.

   
   Mobilization of the cervical spine in combination with traction

3. Positional mobilization. It combines the techniques of rhythmic mobilization, manipulation and relaxation techniques, due to which a smooth stretching of the muscles around the damaged motor segment is achieved and the elimination of radicular syndrome.
   Positional mobilization of the OS1 segment

Mobilization of the cervical spine allows for restoration of functionality and normalization of mobility of the cervical vertebrae, which is the basis for maintaining long-term remission in osteochondrosis.

Postisometric relaxation

Massage pillow for neck and shoulders

This is a gentle method of manual therapy, the basis of which is the sequential alternation of periods of muscle relaxation and tension. Patients note positive results after the first session, but to achieve a stable therapeutic effect, at least 3-5 procedures will be required. The therapeutic effect of post-isometric relaxation is manifested by a decrease in the severity of pain, elimination of chronic muscle pain and a decrease in sensitivity when irritating the most painful points.

Muscle-relaxing combined (combining soft tissue and joint effects) manual techniques

Muscle-relaxing combined (combining soft tissue and joint effects) manual techniques (continued)

Mechanism of action of PIR

Methodological recommendations for conducting design and survey work

Rules for conducting a survey

Rules for conducting survey work (continued)

Note! The technique of post-isometric relaxation can be used in isolation from mobilization methods not only for the treatment of osteochondrosis, but also for the correction of muscle contractures, as well as restoration of mobility after injuries and operations.

Option 1

Option 2

Option 3 and 4

Option 5 and 6

Option 7

Option 8

Indications and contraindications

The main indication for manual correction is severe or chronic pain associated with damage to the intervertebral discs of the cervical spine or other segments of the spinal column. This treatment is also effective for combined forms of osteochondrosis, when several segments of the spine are affected at once. The treating neurologist or orthopedist may recommend treatment with a chiropractor for functional blockades of 2-3 degrees and complicated cases of osteochondrosis. Postisometric relaxation, based on alternating periods of tension and relaxation, is indicated for intervertebral hernias and protrusions.

Hernia of the cervical spine

Contraindications

Absolute contraindications for manual therapy are:

• infectious and inflammatory diseases of the spine (including purulent inflammation of the epidural tissue);
• early postoperative period (depending on the diagnosis and condition of the patient, it can range from 3 to 12 months);
• condition after injury (especially with spinal injury);
• malignant tumors (regardless of their location);
• blood diseases (leukemia, severe anemia, leukemia, etc.);
• arthrosis, polyarthritis.

The use of manual therapy is not allowed for sequestered intervertebral hernias, which are the most severe complication of osteochondrosis and are characterized by complete separation of the nucleus pulposus and its prolapse beyond the fibrous membrane.

What is a sequestered hernia of the spine?

Limitations for the treatment of cervical osteochondrosis by a chiropractor are also pregnancy, spinal tumors, and disc myelopathy.

Symptoms of spinal osteochondrosis

Manifestations of the disease may differ depending on which specific part of the spinal column is affected.

Cervical osteochondosis is characterized by:

• dizziness that worsens with movement;
• pain in the arms, chest, neck;
• problems with the speech apparatus - change in voice, impaired diction;
• migraine;
• decreased hearing and vision, the appearance of phantom sounds, colored spots before the eyes.

Signs of lumbar osteochondrosis:

• persistent aching or sharp pain in the lower back;
• discomfort that occurs during physical activity or movement;
• pain radiating to the sacrum, legs, pelvic organs;
• significant decrease in sensitivity of the legs;
• Often a person cannot turn or bend over without experiencing difficulties.

Other symptoms are typical for thoracic osteochondrosis:

• pain in the chest and between the shoulder blades when raising your arms, bending, while inhaling, after hypothermia or physical activity;
• numbness of certain areas of the skin, “goosebumps”;
• itching, burning, feeling of cold in the legs;
• attack of pain between the ribs while walking;
• noticeable pressure on the chest.

Manual therapy has become an effective way to prevent the development of lesions - a painless method with virtually no contraindications.

Possible complications

The risk of complications during manual therapy sessions, according to various sources, ranges from 4.3% to 17.9%. The main factor determining the safety of treatment is the professionalism of the doctor, so before starting the sessions you need to make sure that the selected specialist has a diploma in medical education and the appropriate qualifications. If the effect on the spine is unsuccessful or incorrect, the following complications may develop:

• increased range of motion in the musculoskeletal segments of the spine (spine hypermobility);
• injuries and fractures of various segments of the spine;

  
  Compression fracture of the spine

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• strangulated intervertebral hernia;
• displacement and deformation of the cervical vertebrae;

  
  Displacement of the vertebrae in the cervical spine

• damage to ligaments and muscles.

Important! People with heart disease and malignant arterial hypertension (stable increase in blood pressure up to 180/110 mm Hg and above) have a high risk of ischemic heart attack and ischemic stroke, therefore, this category of patients should receive consultation and recommendations from a cardiologist before performing manual therapy.

Manual therapy is an effective way to treat cervical osteochondrosis, but it must be combined with other methods of conservative therapy (massage therapy, recreational exercise, physical therapy, etc.). Chiropractors themselves say that the use of manual techniques is effective only in the absence of bone growths, that is, with grade 3-4 osteochondrosis, the appropriateness of their use is decided on an individual basis, taking into account the characteristics of a particular patient.

Results of an application to the First Family Clinic of St. Petersburg

Manual therapy of the cervical vertebrae in our clinic is a consistent and step-by-step elimination of the problems with which you came to us.

Professional diagnostics using modern expert equipment, the use of innovative and classical treatment methods, drawing up an individual therapy program for each patient and control over each stage of treatment is the hallmark of our multidisciplinary centers.

If you have any problems with your neck, the chiropractors at the First Family Clinic are ready to provide you with professional help and become your allies on the path to health.

By calling the phone number listed on the website, you can make an appointment with a doctor at any time and date convenient for you. You also have the opportunity to request a call back or fill out an online application.

Chiropractors provide consultations in our centers in the Petrogradsky district at Kamennoostrovsky Ave., 16 (“Petrogradskaya”, “Gorkovskaya”, “Chkalovskaya”) and the Primorsky district of Kolomyazhsky Ave., 36/2 (“Pionerskaya”, “Udelnaya”).