Manual therapy for osteochondrosis of the cervical spine indications and contraindications

Often, manual therapy for osteochondrosis of the cervical spine avoids surgery. The doctor acts on the vertebral structures with his hands, which leads to the relaxation of spasmodic muscles and their strengthening, improve blood circulation. After a session of manual therapy, the pain in the back of the head, neck and shoulders disappears, swelling dissolves, and the range of movements in the cervical region is restored.

What is manual therapy

This is a therapeutic technique, consisting in the physical effect on the affected vertebral structures and nearby soft tissues, muscles, ligaments, tendons. Its goal is to eliminate symptoms, improve overall health, prevent painful relapses and prevent the spread of pathology.

Manual therapy is a collective concept that includes several therapeutic methods.

The direction of manual therapyCharacteristics
ReflexologyA complex of medical and diagnostic methods based on physical effects on biologically active points
Applied KinesiologyThe method of therapy, which consists in the restoration of damaged organs and vertebral structures due to exposure to certain muscle groups
OsteopathyTherapeutic technique aimed at restoring the body’s natural abilities to self-correct
ViscerotherapyOne of the types of massage that helps to improve the condition of organs, reduce muscle tension and fascia, eliminate the symptoms of the disease

Effectiveness of treatment

Cervical osteochondrosis is a degenerative-dystrophic pathology that has not yet been completely cured. An integrated approach is applied to his therapy. Drugs are used more often for symptomatic treatment, but massage, exercise therapy and manual therapy help to increase the functional activity of the cervical spine. The use of these therapeutic methods allows for several months to achieve a stable remission – the stage of osteochondrosis, in which there are no symptoms, and the disease does not spread to healthy vertebrae and intervertebral discs. What to expect after several therapy sessions:

  • a decrease in the severity of pain, including at rest;
  • relief of sluggish inflammatory processes in the soft tissues that developed due to the displacement of bone growths (osteophytes);
  • restoration of range of motion;
  • elimination of crunch and clicks when turning and tilting the head;
  • partial regeneration (restoration) of cartilage tissue in patients with 1 degree of osteochondrosis due to improved blood circulation.

The therapist gently acts on the vertebral bodies during the session, which leads to an increase in the distance between them. As a result, the spinal roots and blood vessels cease to be infringed. Specific symptoms of cervical osteochondrosis disappear – jumps in blood pressure, headaches and dizziness, decreased visual acuity and hearing.

Indications for conduction

Before the sessions, the chiropractor examines the results of instrumental diagnostics. X-ray photographs taken in two projections are especially informative. The doctor first gets acquainted with the anamnesis, listens to the patient’s complaints, and makes his external examination. The following pathological conditions become indications for healing procedures:

  • pain in the back of the neck at rest, tilting and turning the head in combination with a decrease in range of motion;
  • protrusion – swelling of the discs outside the spinal canal, not accompanied by rupture of the fibrous ring;
  • various disorders of posture, provoking increased pain, limiting mobility;
  • osteochondrosis of 2 and 3 severity, the course of which is complicated by the deterioration of cerebral circulation.

A chiropractor is often consulted for intervertebral hernias – displacement of the disc with rupture of the fibrous ring, leakage of the pulpous nucleus. They make an appointment with him for pains that are poorly eliminated with medication. Such conditions are indications for surgical intervention, but often it can be avoided due to physical effects on the cervical vertebral structures.

Criteria for choosing a competent specialist

A manual therapist is not in the state of every hospital institution. Therefore, often patients with osteochondrosis have to look for it themselves. What to look for, so as not to make a mistake when choosing a specialist, not to aggravate the course of pathology:

  • the presence of diplomas, certificates. A chiropractor is a doctor with a higher medical education, whose training lasts for many years. He constantly practices, improves his skills. Graduates of medical schools, masseurs, by definition, cannot be manual therapists;
  • medical specialization. Manual therapy involved only orthopedists, neurologists, traumatologists. Doctors of these narrow specializations are well acquainted with the anatomy, structure and functioning of the nervous system;
  • experience gained. It is not always right to turn to a long-term practitioner. Doctors who treat for a long time, usually graduates of the classical school. They use harsh methods, which leads to pain. Young specialists use a sparing effect on the spine, so during the sessions there are only weak discomfort.

Before treatment, a good doctor will always examine the results of radiography, MRI, or CT. At the same time, he will not refer the patient to additional studies. A competent specialist will help to cope not only with osteochondrosis, but also with concomitant pathologies.

The main techniques of manual therapy

The healing effect of manual therapy is based on techniques used in other areas of medicine – both traditional and alternative. With their combination, the therapeutic effectiveness of the procedures is increased many times.

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What techniques are most often used during sessions:

  • superficial palpation – palpation of the back and side surfaces of the neck to determine points of physical impact;
  • deep palpation – strong pressing, affecting deeply located vertebral structures;
  • shift – the displacement of adjacent structures relative to each other;
  • low-frequency, high-frequency vibration – monotonous, often repeated movements of various intensities;
  • stretching the skin and (or) deeper tissues to create a pain impulse, the production of useful biologically active substances in the body;
  • restoration of the anatomical position of the vertebral bodies, intervertebral discs due to their displacement (one of the main methods of osteopaths).

If necessary, during the session, the doctor can use the medicines or prescribe them to the patient for a course dose.

Session Methodology

The chiropractor determines the treatment tactics taking into account the severity and form of the course of cervical osteochondrosis, the general health of the patient. The patient’s trust in the doctor also matters. Only with complete psychological comfort can he fully relax the muscles, which is necessary for maximum impact on the cervical spine. The therapist warns that during the first sessions there are painful sensations. This is a response of the body to physical effects, indicating the start of recovery processes.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Spinal mobilization

This is called a soft effect, the coverage of all tissues surrounding the segment of the spine. Mobilization is used at the preparatory stage, as well as as an independent therapeutic procedure. It is performed in several ways:

  • jerky – biomechanical irritation of vertebral structures, which is used to reposition them, giving them a physiological position. Such mobilization can reduce the size of the formed osteophytes (bone growths);
  • rhythmic – one of the methods of mechanical action on the discs, vertebrae to quickly return them to the anatomical position due to squeezing, rotation, stretching. This mobilization is often used to deeply relax the muscles of the neck and shoulder girdle.

Positional mobilization is often used in the treatment of protrusions and intervertebral hernias. A chiropractor performs basic massage movements to reduce skeletal muscle tone, and then adjusts disks that have moved beyond the spinal column.

Postisometric relaxation

This is a method of manual therapy aimed at eliminating muscle cramps in the cervical region characteristic of osteochondrosis. The therapeutic effect is achieved by alternating tension and relaxing skeletal muscles. The doctor performs movements leading to contraction of muscle fibers. And then stroking, rubbing it achieves their relaxation. There is a strengthening of the muscular skeleton of the neck, an improvement in the blood supply to the discs, vertebrae with nutrients.

Duration and number of sessions

A good chiropractor will not insist on many sessions. Often, 2-3 procedures are enough to restore the anatomical position of the discs and vertebrae. Their duration depends on the degree of osteochondrosis, the number of developed complications, and the severity of symptoms.

Procedures are not performed more often 3-4 times a week, as the muscles must adapt to the loads. At the initial stage of cervical osteochondrosis, treatment rarely lasts more than 3 weeks. And with pathology of 3 severity, manual therapy lasts from a month or more.

Possible risks and consequences

High qualification of the doctor is the main guarantee of the correct treatment. Such a manual therapist immediately determines the source of problems with the spine, purposefully affects him. A visit to a doctor with a dubious reputation causes serious complications:

  • hypermobility of the cervical spine;
  • infringement of the intervertebral hernia of the spinal roots, vertebral artery;
  • increased intensity of pain.

In some cases, there is a blockage of the vertebrae, rupture of muscles, ligaments, tendons due to rough mechanical action.

Contraindications to the procedure

Sessions are not carried out with a complex course of arterial hypertension, respiratory, intestinal, urogenital infections. They are contraindicated during rehabilitation after injuries or surgery, as well as in the presence of osteoporosis, malignant neoplasms.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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