After a session of manual therapy, you should limit the load. What do patients feel after a manual therapy session? Complications after manual therapy in infants

“I should note that manual spinal correction as such has been known since ancient times. Almost every nation had its own masters of medicine who tried to help people suffering from diseases of the musculoskeletal system. Often, troops on military campaigns were accompanied by chiropractors or directly by healers who, among other medical skills, had experience in adjusting joints and treating bone fractures.

Methods of spinal correction in the past were mainly formed in practice, with the help of trial and error. Therefore, they can rightly be called "a matter of chance." In addition, it should be taken into account that in the process of learning about the actual result of the treatment of the musculoskeletal system, one had to talk only when correcting obvious pathologies, for example, the presence of a dislocation of the shoulder joint, jaw, bones of the arms or legs.

However, as such, manual correction for hidden diseases of the same spine was carried out almost “blindly” and was focused on temporary pain relief without taking into account and understanding the true causes of this disease. This is natural, because even today, scientists who study the development of processes in the cells and tissues of the spine at the molecular level already know a lot, but far from everything. What then can be said about the time when doctors had primitive knowledge even in the field of anatomy? Therefore, the experience of the ancient doctors involved in manual correction of the spine was based mainly on observations: it helped - well, it didn’t help - they tried it in a different way. Often the same methods were applied to patients with the same symptoms and location of pain. However, as stated in the article , The cause of the origin of pain can be completely different. If it is not established, then instead of treatment, it is quite possible to render the patient a truly “disservice”. So in different countries, through trials, taking into account experience and mistakes over time, various methods of manual correction of the spine were identified, which temporarily eliminated pain syndromes, allowing the patient to remain able to work for some time.

Starting from the ΧΙΧ century, various schools began to open one after another in the USA, where they taught essentially the old methods of treating the spine with the help of manual influence, but with an attempt to highlight the significance of these manipulations in the light of the new-fangled scientific interpretation at that time ...

It should be noted that schools were mostly built on a business basis, where, along with the study of anatomy, they taught courses in "business practice", that is, they taught how to "sell" their "skills" profitably. The course of study usually lasted two weeks. Amateurs of alternative medicine were recruited for the courses, who were able to pay for this training. Naturally, there was no talk of any medical professionalism there. The increased number of graduates of these schools and their activities contributed to a decrease in the authority and fees of representatives of official medicine. Therefore, initially both directions [ approx. "long-lever" and "short-lever" schools of manual therapy] were in a very difficult relationship with official medicine. Instead of scientific discussions, there were litigation and civil proceedings.

In the modern world, although the attitude of official medicine to manual methods of treatment has somewhat changed (lat. manus- hand, Greek therapy- treatment), but still the traditional foundations laid back in those days have survived to this day. The main one is relieving the patient of pain, which is what chiropractors of various directions mainly appeal to in their defense today ... "

“Moreover, chiropractic, osteopathy, craniosacral therapy, PIR (post-isometric relaxation) and others, including some folk methods and methods of “treatment” of the spine, are essentially aimed at disrupting adaptive mechanisms. With degenerative-dystrophic processes in the intervertebral discs, the use of such methods inevitably leads to a more rapid progression of this pathology.

“In this regard, I would like to ask relevant questions directly to the patient. Do you really care if the doctor knows what he is doing to your spine? Does the doctor know what will happen to your health after his manipulations in a month, in a year? Or do you really not care what happens to you later and what price you have to pay for temporary pain relief?

A number of patients, due to the lack of timely information, have already answered these questions with their sad experience and poor health. I invite you to familiarize yourself with some of the materials from my documentary medical archive.

MRI No. 69 shows smoothness of the physiological lordosis of the lumbar spine, protrusion in the L5-S1 segment compensated by spondylosis, epiduritis at the same level.

On MRI No. 70 of the same patient, a condition is observed after four sessions of manual therapy, in the segment L5-S1 - sequestered herniated intervertebral disc with caudal migration of the sequester, absolute stenosis of the spinal canal, smoothing of physiological lordosis, epiduritis.

This story began with the fact that due to the development of protrusion and epiduritis, the patient developed pain in the lumbar spine. On the advice of friends, he turned to the center of manual therapy. The doctor of this center (chiropractor), having examined him and listened to his complaints, sent him for an MRI examination (No. 69). Based on the results of the examination, the same doctor prescribed 12 sessions of manual therapy for the patient. Already after the fourth session, the patient developed a sharp pain in the leg and numbness. They did a second MRI (No. 70). The chiropractor got acquainted with his result, referred this patient to neurosurgery (but that's another story).

The first MRI No. 69 clearly showed, in addition to protrusion, the presence of epiduritis. Therefore, this patient needed drug therapy under the supervision of a neurologist, to whom the patient should have been referred after an MRI examination. In this case, it was categorically impossible to treat by methods of traction or manual therapy. After all, when applying these methods, the result could be easily predicted! Again, this is an illustrative case when "specialists" send a person for an MRI, but evaluate the images unprofessionally. Otherwise, they could make an elementary forecast of the consequences of their "treatment". By the way, most of these "specialists" provide only one-time assistance and do not monitor the patient's health for both the immediate and long-term periods of time (months, years) after their treatment.

As for this case, I do not think that these specialists did these manipulations intentionally, for the sake of profiting from the health of this person. Most likely - out of ignorance of the basics of vertebrology and, accordingly, the choice of a method of treatment. This led to the fact that now the patient's life has become much more complicated, and health after such "help" has deteriorated disproportionately. "Ne noceas, si juvare non potes" - "Do no harm if you can't help".

The following case testifies to how some of the original traditions of the American school of "folk chiropractors of the 19th century" are still alive.

This patient, having decided to get rid of back pain, asked for help from a "chiropractor". But, as it turned out later, there was, as they say, only one name from the chiropractor. This "specialist", an American model of the 19th century, having felt the patient, said that the disc had fallen out and that he would now set it. Having put the patient on the floor (on the stomach), he began to alternately raise his legs, simultaneously pressing on the lower back, then, laying him on his side, he carried out a “twisting”. Thus, having performed several manipulations from the “set” of conventional manual therapy, he moved on to “own developments”. He asked the patient to sit on the floor with the legs extended forward and the lower back bent backwards. Then he began to sharp, strong pushes to put pressure on his shoulders. Then, asking the patient to rise, and clasping his hands under the armpits, he lifted him up and shook him vigorously. After these manipulations, this “specialist” announced in a businesslike manner that the patient would come the next day for another such session.

After the second session, the patient's pain intensified. He went to the district hospital. The local traumatologist sent the patient for an MRI. But contrary to common sense, the patient went with the results of the examination (MRI No. 71) not to a traumatologist, but again to the same "bone breaker". He, having carefully looked at the pictures, said that “everything is clear” to him, the herniated disc “fell inward, into the stomach” and that “usually one or two sessions are enough, but this is a serious matter and it just needs to be done one more, or maybe two session." The patient, naively, agreed. Everything repeated as in the first two times, only this “specialist” significantly increased the strength of his influence when he put him on the floor and began to push on his shoulders with jerks, obviously so that the disc would definitely “come out of the stomach and go where it was needed”. This is called: "there is power, mind is not needed." After several such shocks, the patient felt a sharp pain (“like a discharge of current”) that passed from the coccyx to the head, the legs became numb. A few days later, this patient developed pelvic disorders. They did a second MRI No. 72. The result is more than depressing: compression fracture of the L2 vertebral body, sequestered herniated disc in the L5-S1 segment, absolute stenosis of the spinal canal.

MRI No. 71 shows smoothness of physiological lordosis, herniation of the intervertebral disc in the L5-S1 segment, spondylosis at the same level, multiple Schmorl hernias, and stenosis.

On MRI No. 72, in addition to all of the above, there is also a compression fracture of the L2 vertebral body and a sequestered herniated disc in the L5-S1 segment, absolute stenosis of the spinal canal.

On MRI No. 73 - an enlarged fragment of MRI No. 71 at the level of the L1-L2 segment, on which an injury to the endplate of the L2 vertebra is observed, as a result of the first two sessions with this "specialist".

On MRI No. 74 - an enlarged fragment of MRI No. 72 at the level of the L1-L2 segment, which clearly shows the consequences of the third session of "reduction of the disc", and as a result - a compression "break" of the L2 vertebral body and its end (hyaline) plate and internal rupture intervertebral disc.

The reason for this tragedy is elementary illiteracy, and not only of that “native specialist” of the 19th century model, but also of the patient himself. After all, sometimes even elementary knowledge, or at least the presence of common sense on one of the parties, can save a person from making a fatal mistake that entails grave consequences.

So if you see a promising advertisement that says that specialists are engaged in non-surgical treatment of hernias, then you need to understand that they are engaged in treatment, but do they cure? This is a question. And in order to be convinced of the sincerity of the intentions of the specialists of such medical centers, it is necessary first of all to get acquainted not only with the reviews about the subjective feelings of their patients, but also with the objective results of the examination recorded on MRI images, for example, before and after the treatment of their patients with similar diseases, and, if possible, the results of the long-term consequences of such treatment.

Typical injuries as a consequence of manual methods of influencing the spine are hemarthrosis (from the Greek. haima- "blood", arthron- “joint”) of the facet joints, that is, hemorrhage into the cavity of the facet joints.

On MRI No. 86, there is a hemorrhage (dark spot on MRI) in the cavity of the left facet joint - as a result of treatment by a chiropractor who tried to "set the prolapsed disc".

On MRI No. 87, hemorrhages are observed in the cavity of both facet joints. This case is already connected with another patient, another chiropractor, but with the same disappointing result - another hemorrhage!

Unfortunately, such complications after manual therapy are quite common. Their reason is banal - just an attempt by a chiropractor to eliminate the so-called subluxation or "functional block" in the patient. Often the result of such an impact is a hemorrhage into the cavity of the injured facet joints. Let me remind you that the inner layer of the articular capsule of the facet joints has many synovial villi rich in blood vessels. After an injury, when the blood fills the cavity of the joints, the patient experiences pain, restriction and soreness of movements up to the loss of the patient's ability to move independently.

It seems to be already the 21st century, but such unfortunate incidents still occur that are harmful to the health of the patient. What is the reason? It was not in vain that I mentioned that the theory of "subluxation" of the 19th century chiropractic school is alive and is still being used to build a theory of manual therapy. But these attempts are unsuccessful and will be so in the future, since this is tantamount to "building a house on the sand."

So what exactly is the "root of evil"? If you read several different manuals on manual therapy, you will notice that almost all of these books emphasize that during the manipulation to eliminate subluxation there must be a crunch (click), which supposedly indicates the correctness of the manipulation. So chiropractors twist until it crunches. ”

We will consider the nature of the occurrence of such a crunch in more detail. The main conclusion about the true reason for the occurrence of such a crunch during the manipulations of a chiropractor:

“... a water hammer with a characteristic sound, formed after appropriate manipulations by a chiropractor, and generates microtraumatization of the joint capsule with microtears, areas of hyperextension, microcracks (including areas of hemorrhage, which are clearly visible in the laboratory under a microscope on the corresponding samples of this tissue). And with significant hemorrhages, this can already be observed during a diagnostic examination (MRI) ".

“... Why, during the manipulation of a chiropractor after a crunch (in most cases), the patient experiences extraordinary lightness, almost euphoria, after which “pain passes”, “mood improves”, and so on. The answer is simple: the culprits of this sudden surging state of "pain relief" are mainly endorphins and enkephalins- biologically active chemical compounds with a morphine-like effect, which are produced, including during stress, and are natural opioid peptides, in other words, "natural drugs". But we will also consider this issue in more detail in our future publications.

So the manipulations of a chiropractor, in which your spine crunches, is far from a safe procedure for the body. Keep this in mind when you meet a “19th-century chiropractor” on your life path and will tell you that your “discs have thus become in place”, “joints have been restored” and “subluxation has been eliminated”.

Manual therapy is an area of ​​medicine that is becoming more and more popular every year. However, not everyone fully understands what the features of this type of treatment are, how it differs from massage, and what diseases can be treated with manual therapy. To all these and many other questions in an exclusive interview with the portal fashion time answered the clinic's chiropractor GMS doctor Andrei Ivanovich Oros.

What are the main goals of manual therapy? By what means? How do they differ from standard practice?

Manual therapy is a branch of medicine in which a doctor performs manipulations with various tissues of the body, body parts, and exposure to them relieves pain syndromes. That is, thanks to manual therapy, pain is relieved, the mobility of tissues and joints improves, preventive measures are taken - for example, slowing down the aging process of tissues due to a large amount of movement.

If you delve into history, then manual therapy is based on rachitherapy - oriental techniques for influencing the spine. Manual therapy consists of subsections: soft tissue techniques (when a chiropractor works with muscles, skin, subcutaneous fat), articular techniques (when he works with joints) and specific techniques that came to us from the science of osteopathy. In addition, techniques for working with the bones of the skull, cervical spine and sacrum and visceral manual therapy techniques have been added - this is work with internal organs. There are also techniques of body-oriented manual therapy - that is, when, working with his hands, the doctor works on relaxation.

- When did manual therapy begin to develop actively?

In 85-86 years of the last century. The first books of Karel Levit were published, and he immediately had students. But then there was such a mixed manual therapy - rather harsh and manipulative techniques. So, everyone was waiting for a “manipulation click”, there were even ways to create it on purpose, but in fact, many manipulations in the joints occur without any sound phenomenon at all.

For whom is manual therapy most relevant?

First of all, for residents of large cities. In villages, it is less relevant, as people are constantly moving there. Thanks to this, their muscles work, there is no isometric tension, static deformations, static overloads. In big cities, in addition to the hustle and bustle, stress has become a sign of the times. We have biomechanical stress (static), chemical (what we breathe) and psycho-emotional. And the manual therapist solves these problems. The nervous system cannot develop in isolation from the muscles; any stress reaction is prescribed in them. Proper work with these muscles is relieving tension and a reflex response to the brain - calming, relaxing, relieving stress.

- Should a chiropractor have a medical education, a license?

Manual therapy can be professionally dealt with by doctors of two specialties - an orthopedic traumatologist and a neuropathologist. After receiving one of these specialties, the doctor must complete a five-month training in manual therapy and receive a certificate. That is, a chiropractor must show you: the first is a doctor's diploma, the second is one of the specializations: a traumatologist or a neuropathologist, and the third is a certificate that is currently valid, which is issued for five years. Almost all chiropractors receive additional education, because osteopathic medicine does not pass through the official register, and therefore, when cranial therapy techniques, visceral techniques are needed, you study separately. Another very important point: a chiropractor must have a wealth of knowledge in individual therapeutic exercises, in exercise therapy. He should give the patients exercises.

What are the side effects of manual therapy sessions? Can manual therapy not help, but harm the patient?

In any profession, harm can be done. In manual therapy, you can do harm if you do not conduct a thorough diagnosis. It is based on an incorrect diagnosis and the rigid implementation of techniques.

It is desirable that the patient comes to the chiropractor no more than twice a week, a maximum of three times, but the third time should be only soft tissue, that is, work only with muscles, without manipulation. According to the rules, for a course of 10-12 sessions there should be no more than two or three manipulations, and sometimes they are not needed at all. The course should not be 10 days. Let it be better to have 10 sessions twice a week. Against this background, in addition to the fact that you work with your hands, you must teach the patient exercises to stabilize the body, give the safest exercises that do not wear out the spine, but load the most important muscles. Be sure to work according to the weight of the patient. It is very good if the chiropractor knows dietology, because he can tell you how to eat right. You also need to understand what aerobic and anaerobic loads are in order to advise how best to deal with those diseases that the patient has.

Should I visit a chiropractor for preventive purposes or only when necessary? If so, how often?

I have a lot of patients on prophylaxis. I usually train with them once or twice a week. It's a matter of money. We do not have social programs in this area. In our country, manual therapy by orders is legalized, the number of rooms per thousand people of the population is written, but in fact, so far this is a rather chaotic industry.

How long does a manual therapy session usually take?

A normal chiropractor will not do two clicks in 10-15 minutes - and that's it! A session usually lasts 45 minutes - 1 hour. At the same time, it begins gradually, tissues are prepared, gradually brought to a certain state. When a chiropractor works on the flow, the patient, for example, comes with a complaint of pain in the cervical region, and he works only with the cervical region. And it is correct and useful for the patient to work out all the links of the kinematic chain: thoracic, lumbar, pelvis. And only when all these zones are relaxed, you can move on to the neck.

- What are the indications and contraindications for manual therapy?

Indications are all manifestations of osteochondrosis, pain syndromes in the back, in the muscles, in the collar zone, in the lumbar, in the thoracic region, post-traumatic pain syndromes, contractures (impaired range of motion in the joints). Indications also include static deformities, scoliosis, kyphosis, flat feet, varus deformity, muscular tonic syndrome associated with static overload. There is also a term that we have collected in the clinic - “office worker stress” - a complex psycho-emotional and static stress that accumulates due to working at a computer and strong pressure, which leads to the fact that a person tenses up and then the muscles do not relax. Another indication is testing the patient before playing sports.

As for contraindications, firstly, it is an acute injury, a fracture. Secondly, severe vascular problems, heart rhythm decompensation, heart attack, stroke, hemorrhage, blood clotting disorders. Also, contraindications include oncology, tumors, metastases that are in the bones, working with which, you can cause a fracture, osteoporosis of pronounced degrees, when the patient has a very fragile bone. In this case, there are absolute contraindications, but there are relative ones. In principle, it is possible to work both with osteoporosis and oncology, but using certain techniques, with a certain rhythm and a certain sequence.

- Can children visit a chiropractor? What are the age restrictions?

Chiropractors work with children from a very early age, using very soft techniques on the cervical spine, with the bones of the skull, massage techniques, stretching, muscle relaxation. Usually in such cases, the specialist only deals with children. Most often these are women, since they have softer hands, small children are less afraid of them. But in general, there are no age restrictions. Elderly people can also visit a chiropractor. Soft tissue techniques are used here, mainly the removal of muscular-tonic syndromes, soft stretching, work with joints.

- Do people with good sports training, yoga and Pilates lovers find it easier in manual therapy sessions?

My patients who do yoga, Pilates, are much more comfortable with manual therapy for the reason that, firstly, their joints are developed, and secondly, they, doing all this, feel the need to work in a passive barrier. The range of motion in a joint consists of three elements: there is an anatomical zone, there is an active zone and there is a passive zone. Your muscle works in the active zone, you go to train and work in this zone, but you cannot get into the passive zone, it can only be influenced from the outside. This is a medical area. Patients who are actively involved in sports have a need to get into this passive barrier, because they themselves understand that during exercise it is not always possible to get there. And when the doctor begins to work in this range, they experience great pleasure.

But at the same time, the sessions themselves with a chiropractor cannot replace sports or somehow compensate for their absence?

Never. A person must lead an active lifestyle so that nature heals him, and a chiropractor must help if there is any problem, decompensation, injury, disease. The biggest deception is if at least one chiropractor says that he will give you such techniques that you don’t have to go to the gym after that.

Patients who have severe back pain often seek help from specialists whose practice does not accept the use of drugs.

A chiropractor treats people with the help of a mechanical effect on the musculoskeletal system and internal organs.

Often, patients do not quite understand how the disease can be cured without drugs, but some specialists succeed.

A wary attitude towards osteopaths leads to the fact that the slightest deterioration in well-being - and often happens after several sessions - is perceived as unskilled work.

Why does the back hurt after manual therapy, if the experts themselves promise miraculous healing after just a few sessions?

How it works

Manual therapy techniques are based on the use of a complex of shock, soft tissue and other types of effects on the body.

With the help of such a complex, it is possible to restore the motor functions of the spine, improve the patient's condition.

It allows you to restore joint mobility, restore muscle tone, eliminate spasms, and return bones to their places. At the same time, the system of internal organs is restored, various pathologies are cured.

An individual approach is selected for each patient. The complex consists of a kind of back massage. But this is not exactly a massage, but measures aimed at:

• restoration of blood flow;
• improved metabolism;
• getting rid of the manifestations of the disease.

It has been proven that such treatment is much more effective than medication if it is performed by a qualified professional.

The manual uses sparing techniques for influencing tissues, while they are aimed at quick recovery. So why does my back hurt after manual therapy?

Possible causes of pain

After the first visit to the chiropractor, pain begins to appear after 1-2 hours. This is due to the beginning of the displacement of bones, joints and internal organs in the right direction.

Even with the restoration of only the spine, changes occur in the entire skeleton. Such feelings of severe discomfort are a sure sign that the recovery process has been launched, and the body has begun to fight the pathology.

Back pain after manual therapy may be accompanied by fever and fever. In such cases, osteopaths themselves advise taking painkillers that will help improve the condition.

In order to consolidate the effect, you should unquestioningly follow the recommendations of the doctor, perform the prescribed exercises, adhere to the restrictions. If you follow all the recommendations, then soon the condition will improve.

Why did it get worse

Can my back hurt even more after several manual therapy sessions? Yes, since the peak of the pain syndrome falls on the 3-5th day. Ligaments that support organs or bones must work in a new way, in an unfamiliar position.

The muscles will have to work hard to keep the spine and other systems in a new place. This process causes pain until the body gets used to it.

It should take some time to recover. After 5 procedures, the pain gradually begins to fade, and then disappear.

A person quickly rebuilds and gets used to a new, and most importantly, the correct location of the spinal column and other organs.

If pain occurs later than 1-2 hours after treatment of the back with manual therapy, then it is worth looking for the cause due to which the condition worsened.

Most likely, this is a manifestation of some kind of disease, because the kinesiology effect has a number of contraindications.

Another cause of pain can be an incorrectly chosen technique. The specialist could overdo it, not calculate the strength of the impact. If so, then in a couple of days everything will pass.

It is important to distinguish between muscle pain and joint pain. Muscle pain after osteopathy is normal. It is quite easy to define it. For this you need:

• take a hot bath;
• rub your back;
• do a relaxing or warming massage.

After these procedures, the state of health should improve, and discomfort should decrease. Muscle pain occurs due to the fact that manual back massage leads to muscle tone.

This is a kind of gymnastics, as a result of which the muscles are strengthened, and since lactic acid is released in them, it causes discomfort. With a rigid method of exposure, the muscles can hurt like after intensive training in the gym.

How to fix the result

It is simply necessary to consolidate the effect, and here a logical question arises - is it possible to do a back massage after manual therapy? Only a doctor can decide this, since in some cases massage may be prohibited.

If there are no contraindications, then every six months such a procedure should be done to help the muscles maintain the spine in the correct position, that is, as a preventive measure.

Denial of responsibility

The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or for medicinal purposes. This article is not a substitute for medical advice from a doctor (neurologist, internist). Please consult your doctor first to know the exact cause of your health problem.

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The popularity of manual therapy has led to a significant increase in the number of osteopathic specialists. However, it is not easy for them to meet the growing demand. At the same time, many patients complain that they feel worse after manual therapy. To understand the reason for such conflicting reviews, you should understand what manual therapy is and how it works.

What is manual therapy and what is its danger

Manual therapy is a set of techniques by which a doctor works with his hands on the musculoskeletal system, adjacent tissues and internal organs of the patient in order to restore their functioning, normal range of motion and eliminate muscle spasms.

Unlike massage, this is not about manipulations with soft tissues and receptors located on the skin, but about the impact on the spine, ligaments, muscles and joints. However, massage is often used in preparing the patient for a manual therapy session. In part, this allows you to reduce some of the negative effects that sometimes occur after a session. (We are talking about complaints that the lower back hurts after manual therapy).

Manual therapy is a good alternative to prescribing medications in the treatment of a number of diseases. Its main danger lies in the lack of appropriate qualifications of many osteopaths. As a result, due to their unprofessional intervention, patients have to go to medical facilities with tendon ruptures, ligament muscles, and even damage to bone structures.

Basic techniques and techniques of manual therapy

There are several basic methods of manual therapy:

• mobilization (allows you to bring the joints, ligaments of the limb to the required position and overcome mobility restrictions);
• stretching (used for scars, shortened ligaments and muscles);
• relaxation, or relaxation;
• pressure (allows you to eliminate trigger points).

Depending on the condition of the patient and the goals set, chiropractors combine the above techniques, and also use soft or hard techniques, or a combination of them.

Soft technique does not imply push mobilization, impact. Basically, she uses massaging movements. After it, as a rule, there is no pain, since it begins with a massage, after which the joints are gently and painlessly put in place. With this technique, complications are usually minimal. For example, patients do not notice that their back hurts after manual therapy.

Rigid technique has long been a staple in the arsenal of chiropractors. It is based on the wide use of percussion techniques. Often it is she who causes pain after the session, while providing a stimulating effect on the nervous system and the body as a whole.

What are the possible complications after manual therapy?

Complications that may appear after a session of manual therapy, as a rule, are associated with two reasons: insufficient qualifications of the doctor and the patient's individual response to therapy.

The first option has already been mentioned above. The most innocuous consequence of visiting a doctor who does not have the appropriate education will be a complete lack of results.

Other consequences after manual therapy are more serious and often lead to dangerous complications. For example, hypermobility of the spine, which occurs due to too frequent visits to the osteopath and, as a result, stretching of the ligaments.

No more than 15 sessions of manual therapy are allowed per year

The most deplorable results of a rough impact on the musculoskeletal system are ruptures of the vertebral arteries, muscles, ligaments, tendons, displacement of the vertebrae and separation of the vertebral processes, even fractures of the ribs and bones, and deterioration of the general condition. Complaints relate to general well-being, back pain, migraines. Sometimes patients even notice a decrease in vision after manual therapy.

The second reason for the occurrence of complications is not related to the skill level of the specialist. It depends on the individual characteristics of the patient: abnormalities in the development of the vertebrae, tissues and blood vessels, difficulties in diagnosis, serious diseases of the spine (for example, neglected intervertebral hernias). In such cases, one manual therapy may not be enough, complex treatment up to surgical intervention will be required.

Why pain occurs

In general, mild muscle pain after manual therapy is natural. They occur 1-2 hours after the session and are associated with changes in the functioning of the musculoskeletal system that began after visiting a doctor.

The main indication for manual therapy is a functional block (limitation of the volume of normal mobility). Problems with the spine or internal organs cause pain, which, in turn, provokes muscle spasm, which prevents the usual work of individual segments of the spine. Other segments and muscle groups have to work for the problem area.

By restoring the normal position of the joints, bones and muscles, the chiropractor disrupts the established pattern and forces the spine, ligaments and organs to function as they should. This cannot but cause some discomfort in the body.

After a chiropractor, the muscles receive an additional load, comparable to enhanced workouts in the gym, and in both cases, lactic acid is released, which causes pain. Sometimes it is accompanied by fever and fever, which can be managed with pain medication recommended by a doctor.

The peak of pain occurs on the 3rd-5th day, but then everything passes, and the body adapts to the changes.

Why did it get worse after manual therapy

In some cases, the pain does not go away even after five days. It can get worse and be accompanied by additional symptoms. Patients may complain that they have a headache and neck after manual therapy, vomiting and nausea have appeared.

If these symptoms do not decrease, but only increase, you should urgently consult a doctor, because serious problems can arise due to insufficient attention to your health. To the symptoms listed above, many others will be added, which in the future are not the most harmless. Many note that the temperature has risen, and the pressure has suddenly risen after manual therapy.

The cause of such problems can be a number of diseases that are contraindications to manual therapy:

• acute inflammatory diseases of the joints;
• oncology;
• infectious diseases of the spine and joints (osteomyelitis, tuberculous spondylitis);
• spinal injury;
• acute diseases of the gastrointestinal tract;
• stroke, heart attack, bleeding;
• intervertebral hernias.

The cause of pain can also be an incorrectly chosen technique, as a result of which the effect on the body was too harsh.

What to do if it gets worse after manual therapy

It is not uncommon for patients to deal with consequences such as muscle pain and weakness after manual therapy. These manifestations are within the normal range and simple recommendations from doctors will help to cope with them.

Manual therapy and physiotherapy for cervical osteochondrosisArticle rating: 5.00 /5 (votes: 1 )

Manual therapy for cervical osteochondrosis is a very effective non-drug method of treatment. It consists in a biomechanical effect on the affected elements of the musculoskeletal system through the hands of a doctor. Manual therapy is carried out by specialized doctors - an orthopedist-traumatologist, a neurologist or a manual therapist who have a certificate.

Fundamentals of manual therapy

The goal of manual therapy is to restore the function of the motor segment or the mobility of the ligament between adjacent vertebrae.

With cervical osteochondrosis, a combination of an inactive segment (blockade) and hypermobile areas is observed. As a result of impaired mobility in any parts of the spine, neighboring intervertebral joints take on an increased load.

Gradually, the ligaments are stretched, the spine becomes unstable. This leads to subluxations of the vertebrae. Therefore, the task of manual therapy is to remove the block.

Manual treatment is carried out using the following manual techniques:

• mobilization (relaxation of the muscles of the neck and shoulder),
• contact direct manipulations (pressures and impacts of various strengths on the processes of the vertebrae and joints of the spine, traction, turns, flexion and extension),
• contact indirect and semi-indirect manipulations (movements of the upper limbs of the patient).

Some techniques can be quite tough, sometimes the doctor may need the help of assistants. The mechanism of action of manual treatment is due to mechanical and reflex effects. The doctor acts on various reflexogenic zones, receptors of muscles, joint capsules, tendons, yellow ligament of the spine.

Manual therapy for cervical osteochondrosis helps to relax the muscles of the neck, improve arterial, venous blood flow and lymph flow. There is also a release of pinched nerves and spinal roots. Restoring the normal ratio of the vertebrae and improving the stability of the spine normalizes posture. But most importantly, such unpleasant symptoms of cervical osteochondrosis as severe pain in the neck, headache, feeling of tension, dizziness, etc. are reduced.

The best results from manual therapy are observed at an early stage of osteochondrosis. In this case, a significant improvement can be achieved after 1-3 procedures. In the later stages, the course includes 15-20 manipulations or more, depending on the degree of damage to the segments, the severity of symptoms and the body's response.

Indications for manual therapy:
The main indication for cervical osteochondrosis is the appearance of pain. Manipulations are also indicated for cervical migraine and vertebral artery syndrome, which occur as a result of chondrosis.

How does a manual therapy session work?

In the doctor's office, the patient undresses to the waist and lies down on a special couch face down or turning his head to the side.

During the session, you should try to breathe evenly and slowly.

An orthopedic traumatologist first manually examines the condition of the spine, muscles, ligaments, and joints. It is usually not difficult for an experienced specialist to determine the localization of the pathological process, even without an X-ray examination. But despite this, the doctor carefully examines the radiograph and data from other examinations.

To relax the muscles of the neck and shoulder, a light massage is first performed. Then the techniques are performed with a fairly large effort. The doctor can strongly press on the vertebrae, hit them, as if adjusting, make sharp turns of the patient's neck. During manipulations, a characteristic phenomenon almost always occurs - a crunch and clicks in the joints of the cervical region. These sounds are called "acoustic phenomena". Do not be afraid of them, usually after the appearance of a click, the pain decreases significantly. This symptom means that the vertebra is in a normal position. An indirect criterion for a successful procedure is the disappearance of clicks by the end of the session.

Tip: during the manual therapy procedure, try to relax as much as possible. It depends on how relaxed the muscles are, whether the doctor will be able to fully influence the ligaments and vertebral joints.

The frequency of manipulations depends on the stage of osteochondrosis, the radiological and clinical picture, the type of patient's nervous activity, and the features of the constitution. The procedure is carried out every 3-4 days. If there are no acute phenomena and severe pain, then the sessions are carried out every other day or even daily. Various physiotherapy procedures for cervical osteochondrosis can be combined with manual therapy. These methods will complement each other.

How does the patient feel during the session?

During manual therapy, a specialist affects many receptors and reflexogenic zones. Therefore, the patient may feel a feeling of warmth in the neck or even throughout the body. Ears, face may “burn”, sweating appears. Do not be afraid of these sensations, as they do no harm.

Important: manipulations can be noticeably painful, but this is a short-term phenomenon. If the pain is very severe, tell your doctor.

What to do after a manual therapy procedure

After the end of the session, the patient is prescribed rest, bed rest, the spine is immobilized using a special corset or collar. It is necessary to exclude physical activity, forward bending, sudden movements in the cervical region. Sometimes after the procedure there may be a short-term increase in pain, as various techniques cause additional microtrauma to the tissues. In this case, painkillers are prescribed.

Contraindications for manual therapy

Absolute contraindications include:

• tumors of the vertebrae, brain and spinal cord;
• specific and non-specific inflammatory diseases of the spine and joints (osteomyelitis, tuberculous spondylitis, active rheumatism);
• inflammation of the spinal cord, brain and their membranes (meningitis, leptopachimeningitis, meningoencephalitis, etc.);
• fresh spinal injury;
• transferred operations on the spinal column;
• the presence of fragments of a sequestered hernia;
• spinal cord compression in intervertebral hernias;
• any acute infections;
• arterial hypertension over 180 mm Hg. Art.;
• acute diseases of any organs or exacerbations of chronic processes (hepatitis, pancreatitis, cholecystitis, etc.);
• acute or recent disorders of cerebral and coronary circulation (stroke, heart attack).

There are also relative contraindications, in which the issue of prescribing manual therapy is decided individually:

1. phase of exacerbation of cervical osteochondrosis;
2. severe instability of the spinal segments;
3. some congenital anomalies in the development of the spinal column (non-closed vertebral arches, lumbarization, sacralization);
4. fixing ligamentosis (Forestier's disease);
5. fused fractures of the vertebrae;
6. pregnancy for more than 12 weeks.

Complications of manual therapy

Complications of manual treatment are very rare. Usually they happen when referring to an unqualified manual, which is why it is so important to choose a good clinic and doctor. Another reason for complications is insufficient preliminary examination.

There may be complications such as:

• hypermobility of individual segments of the spine, when they become pathologically mobile (with stretching of the ligamentous apparatus);
• fracture of the vertebrae in the transverse processes;
• rupture of ligaments;
• hemorrhages.

You can not contact masseurs and manuals who do not have a medical education and relevant qualifications. Only the attending physician can decide on the need and possibility of manual therapy. Drug therapy, exercise therapy, physiotherapy, acupuncture for cervical osteochondrosis are usually prescribed in combination with manual treatment.

Physiotherapy of cervical osteochondrosis

Physiotherapy of osteochondrosis includes the following hardware procedures:

• electrophoresis with novocaine and lidase,
• ultrasound,
• magnetotherapy,
• vibration therapy,
• shock wave therapy,
• laser treatment.

These physiotherapy procedures cannot be performed during an exacerbation of chondrosis, except for electrophoresis with novocaine and other painkillers. These methods improve blood circulation and relax muscles, speed up the metabolism in tissues, which helps to reduce the symptoms of osteochondrosis.

Treatment of cervical osteochondrosis with acupuncture

Acupuncture is a cross between manual and physiotherapy. With massage and manual therapy, acupuncture is similar in its reflexogenic action. This is not quite a traditional way of treatment, rather it belongs to Chinese medicine.
Acupuncture is the insertion of special thin needles into the active points of the neck. These points are located in the projections of the main nerve endings. Impact on the nerves reflexively enhances local blood flow, relieves spasm and pain, stimulates the production of hormones by the endocrine glands. Acupuncture for cervical osteochondrosis can significantly improve the patient's condition, increase his emotional background and normalize overall metabolism.

Indications and contraindications for acupuncture are similar to those for manual therapy. However, in most diseases of the musculoskeletal system, when manual techniques are contraindicated, acupuncture is allowed. Before starting a course of acupuncture, you should consult with your doctor.

Prevention of osteochondrosis of the neck

Prevention includes the following measures:

• the fight against physical inactivity (adequate physical activity, morning exercises, performing simple exercises during breaks at work);
• strengthening the muscles of the neck with the help of special exercises;
• good nutrition with sufficient content of minerals, proteins and vitamins;
• if possible, quit smoking, since nicotine causes vasospasm and malnutrition of all body tissues, including articular ones;
• self-massage of the neck - especially useful for people with a sedentary profession;
• using a comfortable pillow and not too soft mattress (it is better to buy orthopedic ones);
• conscientious passing of preventive medical examinations.

These are the basic rules for the prevention of cervical osteochondrosis.