Unblock

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After an exact diagnosis, hand grip techniques are used specifically against blockages that do not resolve spontaneously.

In manual medicine, unblocking is the release of blockages . Since a blockage is a reversible, segmental movement disorder, the aim of treatment is to completely restore the mobility of the affected joint . Successful treatment immediately releases the blockage and thus immediately restores the physiological mobility of the affected joint.

Basics

Blockages can be resolved spontaneously or through therapeutic intervention. The latter are usually special hand grip techniques or movements performed by the patient. A basic distinction is made between mobilization and manipulation.

Mobilization

Special tables for optimal positioning of the patient are helpful when unblocking.

A mobilization can be passive or active. This group includes all muscle energy techniques including post-isometric relaxation and longitudinal and transverse stretching of the muscles affected by a blockage.

  • In passive mobilization, traction is performed perpendicular to the tangential plane of a joint. A distinction is made between loosening (slight traction without increasing the distance between the joint surfaces) , tightening (tensing the capsular ligament apparatus without stretching it) and stretching (moderate stretching of the capsular ligament apparatus) . As part of the treatment of a joint, the “tightening” and “stretching” stages are repeated several times while constantly exercising traction.
  • With active mobilization, the force to unblock a joint is applied by the patient himself and not by the therapist.

manipulation

It acts directly on the blocked joint. A mechanical impulse is exerted on a joint that is in a moderate end position (basic tension). In doing so, the range of motion previously determined with passive motion may be slightly exceeded. A characteristic, brief cracking sound often occurs. A manipulation is always carried out in a free direction of the blocked joint with as little force as possible. There

“... it should be emphasized again, the manipulation of a joint is exclusively a medical act that cannot be commissioned. Only the doctor is able to make the indication and recognize contraindications, taking into account the entire medical aspect of the current disease state. He alone can intervene immediately in - albeit very rare - incidents. "

- Quoted from: HD Neumann

Benefits of therapeutic unblocking

There are studies that assume an improving effect at least for a subgroup of patients with back problems. However, the data situation and the methodology of the studies are criticized as inadequate.

“In some patients, spinal manipulation leads to rapid success, especially in those with uncomplicated acute pain in the lumbar spine. There is not enough data to make statements about the effectiveness of the manipulation in chronic pain of the lumbar spine. "

- Quoted from: Shekelle et al.

“The effectiveness of spinal manipulation in patients with acute or chronic lumbar spine pain has not been demonstrated with reasonable randomized trials. There is certainly evidence that the manipulation might be effective in some subgroups of patients with lumbar spine pain. These impressions justify additional efforts on this topic. Methodological quality remains a critical aspect that should be considered in future studies. "

- Quoted from: Koes, Assendelft et al.

References and comments

  1. R. Kittel et al .: Blockage of the cervical spine in segments C3 to C5 . In: Manuelle Medizin , 2002, pp. 325–329, Verlag Springer, Berlin / Heidelberg, ISSN  0025-2514 (print), ISSN  1433-0466 (online).
  2. ^ HD Neumann: Manual medicine . Springer-Verlag, New York / Berlin / Heidelberg 1989, ISBN 0-387-50511-3 , pp. 73-76.
  3. PG Shekelle, AH Adams, MR Chassin, EL Hurwitz, RH. Brook: Spinal manipulation for low-back pain . PMID 1388006
  4. Spinal manipulation is of short-term benefit in some patients, particularly those with uncomplicated, acute low-back pain. Data are insufficient concerning the efficacy of spinal manipulation for chronic low-back pain.
  5. BW Koes, WJ Assendelft, GJ van der Heijden, LM. Bouter: Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials . PMID 9112710
  6. The efficacy of spinal manipulation for patients with acute or chronic low back pain has not been demonstrated with sound randomized clinical trials. There are certainly indications that manipulation might be effective in some subgroups of patients with low back pain. These impressions justify additional research efforts on this topic. Methodological quality remains a critical aspect that should be dealt with in future studies.