Review of methods of manual impact on the spine - what is the difference?
Taran G.I.
Candidate of Medical Sciences, pediatric surgeon, director of the Murzilka Medical Center.
Dnepropetrovsk
Today in Ukraine there are several directions for the development of manual therapy. If we reduce these directions into larger ones, fundamentally different in types of impact, approximately 3 main currents can be formed:
1. Manual impact on the spine through massage.
2. Manual correction of the spine using "soft" techniques.
3. Manual correction of the spine using "hard" techniques.
Manual correction of the spine through massage means, in most cases, the so-called. a “deep” massage that, according to its practitioners, “breaks up” tight muscle spasms, thus providing relief to suffering patients. In real life, it is difficult to fully call such an effect manual therapy, because. the very meaning of manual therapy is the restoration of the full function of the spine, by restoring its anatomical integrity. “Breaking” the “muscle blocks” created by the body itself to protect the nervous system from pain when the vertebrae move in the area of nerve infringement, such manipulations give temporary imaginary well-being, because. the unresolved cause of the pain immediately makes itself felt, and in the next 2-3 weeks the pain resumes and the "block" is restored. It can be considered acceptable to use such a technique for the rehabilitation of athletes and hard-working people whose back pain is caused by the accumulation of lactic acid due to constant physical overload. For patients who have a violation of the anatomical position of the vertebrae due to injuries or diseases of the supporting apparatus, such techniques may pose a certain danger.
Manual correction of the spine using "soft" techniques (Still's methods, cranio-sacral and myofascial techniques) is in the full sense of manual therapy, restores the functions of the spine by restoring its anatomical integrity, has a long history, an unlimited number of followers and fans around the world. The essence of the techniques is to restore the innervation and blood supply of suffering organs by eliminating deviations in the anatomical structure of the spine using painless manipulations. Such techniques are especially effective in the event of functional disorders of the spine against the background of a relatively healthy body, when changes in the structure of the spine are acute or subacute, and are not accompanied by the consequences of significant damage to the vertebrae. In other words, "soft" techniques are invaluable when the structural integrity of all elements of the spine is preserved, and there are no "special conditions", when, for example, 10-20 years have passed after a fracture of the spine. This is one of the disadvantages of "soft" techniques.
Manual correction of the spine using "hard" techniques (methods of Kasyan, Stetsenko, etc.) is also in the full sense of manual therapy, restoring the functions of the spine, by restoring its anatomical integrity, has a long history in our country, an unlimited number of followers and is so say "national Ukrainian" system of care for patients with back problems. The essence of the techniques is to restore the innervation and blood supply of suffering organs by eliminating deviations in the anatomical structure of the spine, using any manipulations that allow you to restore the anatomical structure of the spine, regardless of pain or discomfort, and often consciously using pain as an "awakening self-regulatory principle", as part of treatment. Such techniques, as a rule, are quite effective even with the consequences of significant damage to the structure and shape of the vertebrae, because. to achieve a therapeutic effect, they do not limit themselves in the means to achieve the goal.
Based on the above, we must state that a chiropractor who limits his manipulation arsenal to adherence to one of the listed areas, in some cases, risks not achieving the necessary therapeutic effect. Only the mastery of all types of techniques and the choice of a technique suitable for a particular patient, taking into account his individual characteristics, the duration and severity of the disease, can guarantee a high-quality cure and a lasting therapeutic effect.