MANUAL THERAPY

WHAT IS MANUAL MEDICINE OR MANUAL THERAPY?

Manual medicine, or "manual therapy" as it is commonly known among the public, is one of the non-surgical treatment approaches for musculoskeletal system diseases. Manual therapy includes treatment methods applied with hands. Manual therapy is thought to have a 4000-year history dating back to ancient Thailand. Hippocrates, the father of modern medicine, introduced manual medicine to the field of medicine by treating many musculoskeletal disorders and deformities manually. Again, some manual medicine techniques can be found in the sources related to Avicenna.

BOTH DIAGNOSIS AND TREATMENT WITH MANUAL THERAPY

Disorders of the musculoskeletal system with recovery potential are diagnosed with manual therapy. and treatment is given. Diagnosis in manual medicine requires advanced knowledge and skills. In manual medicine, diagnosis begins with observing the patient's posture and gait, and then continues with a detailed visual examination of the patient's body. Special manual techniques are also used to make the diagnosis. The patient's skin, fascia, muscle, bone and tendon structures connecting the joints, joints and nervous system are evaluated by placing the patient in certain positions. A functional examination is performed on the patients. It is very important to evaluate the patient from head to toe here. For example, a patient presenting with back pain should undergo a functional examination of the whole body, not just the back area. The source of pain in one area may be related to a problem in another body area. Therefore, the diagnoses detected by functional examination in manual therapy are generally diagnoses that cannot be detected by routine radiological tests (such as X-ray, MRI).

However, there are also situations that are undesirable in performing manual therapy. In order to detect these disorders, the patient's history is required. i, both examination findings and radiological examinations should be evaluated together and differential diagnosis should be made by the physician.

WHAT ARE THE TYPES OF MANUAL THERAPY?

During manual therapy, the patient is asked to perform certain movements. makes. If the movement is slow, repetitive and does not involve a sudden maneuver, it is called mobilization. If a manual therapy is performed that involves a fast and low-amplitude maneuver after giving the patient a comfortable position and mobilizing the restricted joint, this is called manipulation. Manipulation can be mistakenly used for all manual therapy methods. However, our patients should know that manipulation is only a part of manual therapy. The basic principle in both mobilization and manipulation is for the patient to relax completely and trust the physician and surrender to the flow of the treatment, which is essential to achieve the desired treatment goal.

GOAL IN MANUAL THERAPY

The primary goal is manual diagnosis (functional examination). is to make a correct diagnosis. Functional examination may be supported by radiological imaging or some blood tests. The treatment goal in manual therapy is to achieve the maximum pain-free range of motion that can be achieved in joints of the body that are painful or have limited movement. The aim is to first diagnose and then treat functional problems in the musculoskeletal system, that is, problems that have the potential to return. In addition to relieving painful conditions, opening restricted joints, returning shortened muscles to their normal length and strengthening weak muscles are among the treatment goals.

REACTIONS THAT MAY EXPERIENCE AFTER MANUAL THERAPY

Movements should not cause pain during the session. However, sometimes the original pain occurs after manipulation. Reactions such as an exaggerated increase in blood pressure or widespread pain may also occur under normal conditions. This situation can pass within 1-2 days and the patient can move on to the full recovery phase. Sometimes the pain may disappear and recur in the following days. In such cases, the patient should not panic and share this situation with his physician.

HOW MANY SESSIONS SHOULD BE DONE?

In manual therapy, which is based on mobilization, every day for pain treatment and 2-3 sessions a week for movement limitation, in total. An average of 8-18 sessions can be given. However, results can be obtained in fewer sessions, or treatments that last up to 40 sessions may be possible. Manipulation should be applied for 3-6 sessions, once a week. However, patients receiving manual therapy should be given home exercise programs and recommendations regarding correct posture in daily life.

WHAT DISEASES OR DISEASES CAN BE PERFORMED IN MANUAL THERAPY?

Manual therapy is used in many diagnoses, including those listed above. However, in some of these diagnoses, manipulation is more prominent, while in others, mobilization is more prominent. The physician should blend different approaches depending on his knowledge and skills and plan the treatment individually (that is, according to the person).

In my clinic, I consider manual therapy suitable for patients who apply with complaints related to these and similar diagnoses, considering many factors, including the age, existing systemic diseases, and expectations of the patients. Taking this into consideration, I plan the treatment individually and continue its application completely individually throughout the session.

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