The related concepts of osteopathy and chiropractic are sometimes used as synonyms or analogues to chiropractic. In chiropractic theory, pain in the spine and joints is caused by a disturbance in the location of joint parts, but in osteopathy, pain is considered to be caused by a muscle block – a local spasm of the musculature that occurred in the problem area. Chiropractic is a harsher method of treatment, using sudden movements and jerks, while osteopathy is much gentler, with a predominance of special massage and stretching. Modern chiropractors usually combine both of these areas, using both elements of chiropractic and osteopathy methods depending on the indication and condition of the patient.
What is a Vertebral Musculoskeletal Segment (VMS)
A chiropractor often uses the term “spinal-motor segment” when treating spinal disorders. The spine consists of multiple vertebrae connected by joints, each with a special “shock absorber” – the intervertebral disc. Two adjacent vertebrae, the joint and disk between them, as well as the adjacent ligaments and muscles, and just form one vertebral-motor segment. Thanks to the chain of these segments, the spine has the mobility and elasticity that allow it to move and protect it from damage. When treating osteochondrosis and other pathological conditions of the spine, the chiropractor is concerned with restoring the location of parts of the spinal-motor segment, as well as normalizing muscle tone and blood flow.
Indications for chiropractic care
The main problem addressed by chiropractors is pain in any part of the spine. There is so-called visceral chiropractic care, which deals with the treatment of diseases of the internal organs, but it is much less common. So, the main patient of the chiropractor is the osteochondrosis patient. Nevertheless, chiropractic care is very popular among athletes, where the problem of osteochondrosis is little relevant, but the load on the muscles and joints sometimes exceeds the limits of the acceptable level.
The main indications for manual therapy are:
- Functional joint blocks;
- Regional muscle imbalances.
A functional block (blockade) is a transient limitation of joint mobility. It is caused by a disturbance in the interpositioning of the individual elements of the motor segment, which leads to spasm of the surrounding muscles. Such muscle tension has a restrictive and protective role, but it also causes pain by compressing the vertebrae and pinching the spinal nerve roots. Functional block can occur in case of osteochondrosis, herniated disc, trauma, heavy load on the spine, or, on the contrary, low mobility.
Regional muscle imbalance is the shortening of one muscle while lengthening the other. Such a condition may be caused by overloading or prolonged work in a non-physiological position of the spine. Regional imbalance is manifested by stiffness, limitation of passive and active movements, fatigue, pain, and a tingling sensation or numbness in the affected area. Outwardly the muscular imbalance can manifest itself through the change of posture – rounded shoulders, unnaturally arched neck, and protrusion of the shoulder blades.
Contraindications to manual therapy
Chiropractic treatment is a very serious technique. In skillful hands, it becomes an effective treatment that can eliminate pain and impaired mobility in just a few minutes. However, do not be surprised if a chiropractic specialist prescribes you a set of examinations. For this method of treatment, as, however, for most others, there are contraindications – those conditions and diseases in which this method of therapy can worsen health and lead to dangerous complications:
- Tumors – malignant of any localization and some benign cancers
- Inflammatory process in the musculoskeletal system – osteomyelitis, spondylitis and some others
- Acute traumatic injuries to bones and joints of the spine
- Severe displacement of the vertebrae
- Severe diseases of the nervous and cardiovascular system, respiratory organs, hematopoiesis
The entire chiropractic technique is divided into three main groups of actions: relaxation, mobilization, manipulation itself.
All three types of influence are used sequentially: from relaxation proceed to mobilization, which, in turn, is a preparation for manipulation on the pathologically altered motor spinal segment.
Relaxation consists in relaxation of the corresponding muscle groups. At this stage, massage techniques and other ways of relieving muscle tension are used. Isometric tension followed by reflex muscle relaxation is widely used: the patient counteracts the doctor’s effort, trying, for example, to bend or unbend the leg held by him, after which this muscle group is stretched and relaxed.
Mobilization is designed to increase joint mobility. This is usually accomplished by rhythmic repetition of movements in the affected blocked joint, with each successive movement having greater amplitude. Such “rocking”, carried out on the prepared relaxed muscles, allows increasing the range of motion in the joint without significant pain. Often already at this stage, patients feel relief due to the release of muscle tension and automatic restoration of the normal positioning of the parts of the affected joint.
Manipulation achieves a “righting” of the position of the bones, cartilage and intervertebral discs. Manipulation is similar to mobilization, but the range of motion is maximized and the specialist uses an additional force at the very end of flexion, extension or twisting. Usually at this point there is a click, a crunch, which brings a feeling of lightness and the disappearance or reduction of pain.
The chiropractic procedure can last from 15 minutes to an hour – everything will depend on the condition of the patient and the skill of the specialist. Several more appointments with the chiropractor are often required to improve and consolidate the effect obtained.