Chiropractic, osteopathy

Chiropractic, osteopathy

A more than 100-year history of the development of scientific manual medicine in the last two decades has clearly defined trend. Chiropractic adjustment is a procedure in which trained specialists (chiropractors) use their hands or a small instrument to apply a controlled, sudden force to a spinal joint. The goal of this procedure, also known as spinal manipulation, is to improve spinal motion and improve your body's physical function.

They are based on the elastic properties of tissue and neuromuscular reflex connection with the spine, nerves, spinal cord, brain, blood vessels and internal organs.

Modern and highly effective methods of manual therapy are myofascial release, muscle-energy techniques, postisometric relaxation of muscles, the technique of tension and counter-tension, etc. These methods (soft manual therapy) are becoming increasingly popular among practitioners.

They are used for the treatment and rehabilitation of:

• neurological manifestations of osteochondrosis
• the consequences of various neck injuries including cervicocranial syndrome and whiplash neck injury
• posture impairments
• some somatic diseases, including diseases of internal organs, when there is their omission (ptosis) or dyskinesia (intestinal)
• different kinds of pain syndromes

Such techniques of the soft manual therapy is effective in patients wiht low back pain, neck pain and headaches - the most common problems for which people seek chiropractic adjustment. They have little or no adverse side effects and do not give complications. The opportunities and framework for the use of manual therapy may be limited only to certain indications and contraindications.

Therapeutic massage, as a preparatory procedure before the manual therapy, contributes to heating of the muscles, relieve tension, improve microcirculation in the affected areas of soft tissues.

 

Indications for manual therapy, chiropractic and osteopathy

A list of some typical diseases that require treatment including using manipulation:

• headache
• pain in the arm and neck with osteochondrosis
• back pain and sciatica with disc protrusion and herniation
• musculo-tonic syndrome (fibromyalgia)
• neuritis and neuropathy
• intercostal neuralgia
• carpal tunnel syndrome
• joint osteoarthrosis
• adhesive capsulitis ("frozen shoulder" syndrome, shoulder joint periarthrosis)
• dysfunction and osteoarthrosis of the temporomandibular joint (TMJ)

 

Contraindications for manual therapy, chiropractic and osteopathy

There are international criteria for the inspection of patients with dysfunction of the arteries of the neck before the appointment of manipulation. Risk factors are listed below, associated with a high likelihood of disease of the carotid and vertebral arteries in the patient. These factors should be carefully considered during the inspection of the patient and considered prior to manipulation on the cervical spine:

• past history of trauma to cervical spine / cervical vessels
• history of migraine-type headache
• arterial hypertension
• hypercholesterolemia / hyperlipidemia
• cardiac disease, vascular disease, previous cerebrovascular accident or transient ischaemic attack
• diabetes mellitus
• blood clotting disorders / alterations in blood properties (e.g. hyperhomocysteinemia)
• anticoagulant therapy
• long-term use of steroids
• history of smoking
• recent infection
• immediately post partum
• trivial head or neck trauma
• absence of a plausible mechanical explanation for the patient’s symptoms

Signs of arterial disease (head, neck) and cervical spine, in which the manual therapy is contraindicated:

	Internal carotid artery disease	Vertebrobasilar artery disease	Upper cervical instability
Early presentation	mid-upper cervical pain, pain around ear and jaw (carotidynia), head pain (fronto-temporo-parietal) ptosis lower cranial nerve dysfunction (VIII-XII) acute onset of pain described as "unlike any other"	mid-upper cervical pain occipital headache acute onset of pain described as "unlike any other"	neck and head pain feeling of instability cervical muscle hyperactivity constant support needed for head worsening symptoms
Late presentation	transient retinal dysfunction (scintillating scotoma, amaurosis fugax) transient ischemic attack cerebrovascular accident	hindbrain transient ischemic attack (dizziness, diplopia, dysarthria, dysphagia, drop attacks, nausea, nystagmus, facial numbness, ataxia, vomiting, hoarseness, loss of short term memory, vagueness, hypotonia/limb weakness (arm or leg), anhidrosis [lack of facial sweating], hearing disturbances, malaise, perioral dysthaesia, photophobia, papillary changes, clumsiness and agitation) cranial nerve dysfunction hindbrain stroke (e.g. Wallenberg's syndrome, locked-in syndrome)	bilateral foot and hand dysthaesia feeling of lump in throat metallic taste in mouth (VII) arm and leg weakness lack of coordination bilaterally

Selection of patients for chiropractic in our clinic based on an assessment of available clinical symptoms and the presence of comorbidities, and patient. It promotes the safe and effective treatment of the patient.