The problem of pain in general and back pain in particular - is more than relevant.
In Ukraine, vertebrogenic pathology with neurological manifestations in the general structure of morbidity with temporary disability takes second place. It brings great economic losses to the state and we need to find appropriate, effective treatment from the medical and socio-economic point of view.
There are many approaches offering help with pain, and often these approaches are competing with each other, namely: allopathic medicine, osteopathy, chiropractic and applied kinesiology.
For the average person, when there are many approaches and alternative therapies, it is important to understand in what situations one or the other method may be adequate. There is no more or less effective approach or method of treatmentis but more appropriate in a particular situation, and most patients can face the problem that a method and approach absolutize all clinical situations. So, if you have arthritis, intense pain with suspected herniated disc, nerve root involving in the process - allopathy is adequate approach. In acute myofascial pain syndrome, joint locks, subacute and chronic pain syndromes,musculoskeletal allopathy often has little effect and in these cases osteopathy or applied kinesiology is better choice.
It is possible and the combination of treatments. When the disk pathology providing treatment methods in conjunction with allopathic therapy, craniosacral therapy, visceral therapy, balance ligamentous tension is effective. In these situations, it is important that a neurologist or orthopedic surgeon in the presence of secondary trigger zones not try to unsuccessfully treat them, but advice a professional osteopath or applied kinesiology specialist. If osteopath or technician applied kinesiology specialist faces the acute severe disc disease with inflammation and dysfunction of the spine it is better way to not waste patient’s time, and send him to a neurologist, neurosurgeon or ororthopedic surgeon.
In some cases, a qualified and experienced osteopath can help without medication in acute disc pathology, if it is absence of significant radicular pathology (it is important to quickly apply a means to relieve edema and secondary compression of the spine).Some doctors are both osteopaths and representatives of allopathic medicine, and can choose one or the other approach adequate in various situations. It is important to understand that osteopathy and traditional medicine are complementary approaches to health problem.
About 0.01 % of people are born with mirrored arrangement of internal organs : heart, liver and gall bladder – the left and the stomach and spleen are located right at it . These people compared with a population more common heart abnormalities , but most often not even aware of their features. Patients transposition organs (situs inversus) without a full examination difficult to diagnose , because the doctor can not complain right to interpret without further examination . In the absence of congenital heart disease , people with a transposition of the internal organs can lead a normal life without any complications related to their medical condition . Under the transposition of internal organs with levokardiey – heart defects observed in 95 % of cases. In view of this, patients require additional examination .
Standardization of approach in medicine on the one hand ensures provable algorithm patient care, based on statistical research, the results of which are combined in the average approach, and it is justified in emergency situations and in severe illness. On the other hand, the standardization does not take into account the nuances under acute and chronic diseases, reflex and functional syndromes, does not consider the adequacy of rehabilitation. Individual-based approach to standardization in medicine allows more nuances in the mechanism of the disease and thus is more effective when it is not required emergency medicine measures. Individual approach also helps to develop a more effective rehabilitation measures, and to prevent exacerbations of the disease.
Often patients are faced with the problem of absolute one treatment approach for all diseases and neglecting other treatment options. In reality, there is no single cure for all diseases. There are diseases which can help only one method (as Western medicine or only alternative medicine – depending on the situation). There are also a disease in which the efficacy of therapeutic effects increases with a combination of different treatment methods. An integrated approach to adequately working on different links of the pathological process can suppress the disease in conjunction with the stimulation of the body’s own healing power. This approach allows to improve the prevention of repeated exacerbations.
To improve the efficiency of health care developed an algorithm medical approaches adequately situation. Important is the choice of methods to evidence-efficiency (in particular drawing on evidence-based medicine), individual approach, rather than follow patterns, if necessary, an integrated approach of combining classical techniques of western medicine and alternative medicine techniques, rational rehabilitation techniques. As the effectiveness of treatment and prevention of disease relapse, – it is important to the active cooperation of the patient in the implementation of the recommendations, subject to protective regime and lifestyle changes conducive to recovery.
Osteochondrosis of the spine (intervertebral osteochondrosis) – neuro-orthopedic degenerative disease of the spinal motion segment, primarily affecting the intervertebral disc and adjacent vertebrae, which further leads to the secondary development of compensatory and dekompensatornyh changes in spinal ligaments.
The term “osteochondrosis” and his theory of justification – the achievement of the Soviet and post-Soviet medicine. The term is not quite correct and unreasonably overpriced post-Soviet neurologists and orthopedists.
Osteochondrosis in the English language used to refer to a degenerative process in the centers of ossification in children (Osteochondrosis – A disease of the growth or ossification centers in children, which begins as a degeneration or necrosis, followed by regeneration or recalcification). In the literature of post-Soviet countries for these diseases used the term “osteochondropathy.”
In English literature instead of osteochondrosis use such terminology:
• «herniated disc» – en: Spinal disc herniation; herniated disk,
• degenerative disease of the intervertebral disc – en: degenerative disk disease, en: Degenerative disc disease (DDD),
• Back Pain – en: Back pain, lower back pain – en: low back pain (LBP), pain in the neck – en: neck pain,
• spondylosis – en: spondylosis
• damage to the drive – en: annular tear, internal en: disc disruption syndrome, discogenic pain en: discogenic pain,
• radiculopathy – en: radiculopathy,
• neck – shoulder syndrome – en: cervicobrachial syndrome, lumbago with sciatica – en: lumbago with, en: sciatica.
The term “osteochondrosis” in English and in the post-Soviet literature – is a completely different disease. Which is reflected also in the International Classification of Diseases ICD-10.
The analysis of the pathogenesis of osteoarthritis and pain on his background:
As a result of chronic microtrauma at sub-optimal dynamic and static physical activity, locking spinal motion segment with the change of microcirculation, trophic and other biochemical processes – the annulus becomes less elastic with the formation of micro-cracks, loosened, then it implemented the nucleus pulposus, which subsequently breaks through the fibrous ring with subsequent traumatization of the posterior longitudinal ligament, compression and irritation of the venous plexus of the dura mater. Thus is formed a herniated disc. At the onset of pain are important mediators of pain and other biologically active agents (interleukins Prostoglandin, substance P, tumor necrosis factor, histamine, etc.). These substances are released at the time of formation of disc herniation or ligament injury. Also during stimulation of the nerve sinuvertebralnogo Lyushka formed reflex muscle pain component with limited mobility in spinal motion segment. When completed biochemical cascade and which edema, despite the presence of a herniated disc pain is still gone.
Most often overstretched Lower cervical and lower-lumbar vertebral-motor segment, at least – thoracic spine.
Syndromes of the intervertebral osteochondrosis: 1 – compression, 2 – reflex syndromes (musculo-tonic, neuro-degenerative, vegetative-vascular reactions).
The view that low back pain is the leading cause of back pain and pain radiating to the extremities – in practice is confirmed as the primary cause in the third case. Pain in osteochondrosis may occur in advanced stages or in the event of a large protrusion or herniation of intervertebral disc formation. Pain disturbed only during the formation of structural changes after the passage of a period of acute herniated disc causes no pain, but the presence of the hernia vertebral-motor segment is not quite a full-fledged structure that at low loads can easily be overloaded and cause a relapse. After the recovery period, the injured structures of the spine, degenerative changes may not cause pain.
Various authors have previously discussed, whether the “spondylarthrosis” in the term “low back pain”, at the present time are the two disease entities. Osteoarthritis of the facet joints can themselves cause both local and referred pain is a herniated disc. Just facet capsule injury or harm to the folds of the capsule may give local acute pain (what an MRI or X-ray can not be seen).
In 1/3 of the cases between the vertebral dorsopathies (osteochondrosis) is not a cause of pain in the neck or back. Not rarely the paradox, when revealed a herniated disc on MRI, or degenerative changes on radiographs, but this area is painless, and radiating or referred pain is not invested in the topography of Neurology localization of hernia, and the causes of pain are rooted not in osteochondrosis. There is plenty of reflex myofascial pain and carpal tunnel syndrome, which in no way associated with osteochondrosis. It may be the result of purely myofascial, viscero-autonomic reflex-muscular syndromes with the formation of secondary tunnel syndrome, or reflected visceral pain. A number of these syndromes may be in the early stages of compensatory and adaptive (but later become not adequate to the situation), and the root cause may be the place blocking tissue (fixation of the joint, organ or fascia), and she did not send pulses of pain (be dumb problem).
Also in the third case there is a mixed clinical situation where the degenerative pathology of intervertebral disc and facet joints act as an aggravating factor, not the underlying cause.
Engaged in the treatment of degenerative disc disease of the intervertebral neurologists and orthopedists, as well osteopaths and therapists, and advanced stages – neurosurgeons.
In view of the different views on these issues (English-language medicine, post-Soviet medicine and alternative medicine) – should be given to the role in the formation of osteoarthritis pain in the neck and back, do not overestimate the additional methods of inspection data (in this case, and not to neglect them) rely primarily the clinical picture of the individual patient, wider and deeper approach to the problem of pain syndromes, low back pain is not treated, and the reasons that actually cause pain and can also cause low back pain himself. To avoid confusion in terminology, medical traditions of different countries – to use the terminology of medicine constructive to English-speaking countries under the international classification. Osteochondrosis and osteopathy
The effectiveness of osteopathic treatment of pain in patients with the inter vertebral discopathy (protrusion or herniated disc) is that with the help of soft techniques there is an influence on the internal organs and spine units craniosacral system, causing the patient’s body, using its own hidden reserves and self-recover .
The osteopath will diagnose and correct the cause of the disease, improve the biomechanics that facilitates the launch of the system of self-regulation body and mechanical load redistribution.
In addition, thanks to osteopathic treatment, balanced, not only the musculoskeletal system, and hormonal, vascular, neural and other functional aspects of life. With the help of osteopathic techniques can reduce the secondary vein swelling in the affected vertebral-motor segment, improve regional drainage of tissue fluid and blood, which will accelerate the elimination of inflammatory mediators; overstrained balance the deep paravertebral muscles, which also facilitate the patient’s condition and reduce the degree of pain.
Thus, osteopathy combines the high efficiency of the causal treatment of degenerative disc disease with safety and softness therapy.
Scoliosis – a curvature of the spine in the coronal plane with the rotation of the vertebrae, which can increase the physiological curves of the thoracic kyphosis, cervical and lumbar lordosis.
diagnosis of scoliosis
Physician during the examination notes different horizontal shoulder level, curvature of the spine, towering on the one hand or shoulder rib reinforced asymmetrical bending waist, different horizontal level of the iliac bones protruding hip. Test scores in the slope at which the normal spine is almost flat, and is noted for scoliosis arc aside. The degree of curvature of the spine is measured using an X-ray of the whole spine standing. Just for an X-ray can see the anomalies of the vertebrae.
Scoliosis should be divided into structural and functional
-In the case of structural scoliosis occurs deformation of the vertebral bodies, and with the progression and ribs, chest and pelvis. In view of the curvature of the spine stable.
-In the case of functional scoliosis should not say more about scoliosis and scoliosis of the adaptive posture without deformation of the vertebral bodies. When troubleshooting a pathological factor scoliotic posture may regress.
Causes of scoliosis (structural)
1 – scoliosis myopathic origin.
2 – scoliosis neurogenic origin.
3 – dysplastic scoliosis.
4 – scar scoliosis.
5 – traumatic scoliosis
6 – idiopathic scoliosis (or poorly understood, or have a genetic predisposition).
Severity scoliosis deformation is divided into four degrees:
• Scoliosis 1 characterized by a small degree of lateral deviation (up to 10 °) and initial mild twisting detectable on radiographs.
• Scoliosis 2 degrees is characterized not only noticeable deviation of the spine in the frontal plane ¬ but pronounced twist on ¬ lichiem compensatory arcs. The X-ray snim ¬ ke clearly manifested deformation of the vertebral bodies at the level of the top of the curve. Angle of the primary arc of curvature in the range of 11 ° -25 °.
• Scoliosis grade 3 – persistent and severe form of spinal deformity, the presence of costal mountains ¬ ba, significant deformity of the chest. Primary angle ¬ Noah arc of curvature within 26 ° -50 °.
• Scoliosis 4 degrees accompanied by severe bending of the trunk. Marked kyphoscoliosis of the thoracic spine, fixed deformity of the chest, back and front rib hump deformity of the pelvis, torso deviation. The angle of curvature of the core reaches 50 °.
Osteopathic view of the origin of scoliosis:
1) Neurological origin (idiopathic): difficult amenable to correction; orthopedic, surgical approach and osteopathic treatment should complement each other.
2) vertebral origin: if not traumatic deformation, it lends itself well to correction in children using osteopathic treatment and optimization of static and dynamic loads.
3) Cranial origin. Tensioned membrane of the brain inside the skull between the bones, providing the brain suspensory ligament system. Dura is stretched between the occipital bone and the sacrum. When cranial dysfunctions in response to twisting membranes and bones of the skull changes the balance of tone throughout the musculo-skeletal system, violated fascial traction in the body. As a result, formed “patterns”-disadaptative load distribution models and the human motor stereotype. In the treatment should focus on the cranio-sacral therapy.
4) visceral origin – it is important to consider the impact on the balance of the internal organs and muscle tone fascial structures may reflex muscle imbalance. In visceral scoliosis can help in childhood and early adolescence.
5) the same type, repetitive asymmetrical static and dynamic loads. 6) from the Pathology lower extremities. Contribute to the curvature of the spine, orthopedic abnormalities, flat, different leg length, pelvic asymmetry, disease of the hip joints.
7) Consequences of surgical treatment gives a prerequisite for “twisting” of the tissues around the scar. 8) Injuries to the spinal column.
9) Birth injuries. In the form of scoliosis can occur in subsequent vertebral compression fractures, subluxations, damaged muscles.
Scoliosis treatment can be conservative (allopathic and osteopathic approaches) and surgically.
1) allopathic approach
Conservative treatment of scoliosis is to use specialized medical gymnastics antiskolioznoy by Schroth and korsetoterapiyu principle Abbott-Chenault.
Scoliosis treated more than 20-25 ° derotiruyuschim corset and intensive medical gymnastics.
In some cases, teens can achieve scoliosis correction using conservative treatment, which depends on the degree of curvature of the spine, the patient’s age, genetic predisposition. In other cases, adolescents not stop the progression of scoliosis.
Disadvantages korsetoterapii abuse – with prolonged use of the corset muscle tone decreases and there is untrained muscles.
At the age of 20-25 years after scoliosis formed when conservative measures are not effective, but it can help the body to be more adapted to the current situation (despite the presence of scoliosis, if help the body to adapt, the scoliosis will not cause complaints). For some patients in their teens, it is important not so much to align emerging scoliosis, how to stop its progression, without orthopedic treatment and compliance regime is not feasible.
2) Osteopathic approach
The purpose of the osteopathic approach – addressing the causes of scoliosis, back-up systems to stimulate adaptation, gradual “self” (self-regulation) correcting body posture.
Elimination of external pathogenic factors, the correction effects of birth trauma – an essential condition for the effective treatment of scoliosis.
Osteopath in fact “does not cure, but allows treatment is finished.” Adequate approach that osteopath, not impose their vision of the patient correct posture. The patient’s body itself chooses the most optimal way to adapt and heal. Osteopath only “fulcrum” for the patient’s body.
Grade 3 and 4 scoliosis any recalcitrant to conservative treatment. Under the influence of these degrees of scoliosis on the internal organs may discuss surgery.
Osteopathy can not really change the posture, 3 and 4 degrees of scoliosis (especially after 20 years), but it can help to harmonize the body and help the body adapt to the situation in which the patient is here and now.
In order to get the best effect of osteopathic treatment for scoliosis, you need to seek medical help as soon as possible, when the first signs of the disease in childhood and adolescence.
Should take into account the relevance and interaction orthodontist osteopath in the treatment and prevention of cranial dysfunctions as important an adequate selection ortoezov footsteps ascending to correct dysfunctions.
The difference between allopathy and osteopathy in treating scoliosis
Classical (allopathic) medicine through their representatives: neurologists, orthopedists and surgeons faced with scoliosis, sees only two problems: curvature of the spine and the concomitant pain. Osteopath finds a lot of subtleties that are deep and meaningful causes of back problems.
Specificity of osteopathy – the ability to see all the causal relationships, considering the body as a whole system. This allows you to remove the original cause of pathology.
Indications for surgical treatment depends on the degree of scoliosis, severe scoliosis influence on the internal organs, the age of the patient and psychological problems (angle of curvature between 45 ° and 70 ° Cobb, ie scoliosis 3-4 tbsp.) if all possibilities have been exhausted, and conservative treatment is not effective.
When too late to start (teenage) idiopathic scoliosis surgery is usually not indicated.
The surgical treatment using metal rod straightens the spine, which leads to the immobilization of the spinal segment (it violates the biomechanics of the spine and is not quite optimal). Internal fixation can prevent further progression and deterioration.
When there are diseases of the spine is necessary to pay attention to prevention of recurrent acute and exclusion provocative factors.
Enemies of health and performance:
If you have any pathology of the musculoskeletal system, we do not always take into account the importance of the prevention of recurrent exacerbations and avoid provocative factors. The enemies of health and performance: 1. Irrational working posture. 2. Long-term static overload the musculoskeletal system 3. Irrational lighting. 4. Bad climate. How did this looks unsustainable working posture: 1) The bent back, his face in the monitor (with an overload of the cervical and upper-thoracic), or vice versa vossedanie in a deep armchair, on the sofa (with an overload of the lumbosacral) 2) Pose “The Steadfast Tin Soldier”, ie excessive candor and constant back muscle strain
3) Not a few people do not sit on the buttocks, and the sacrococcygeal junction or sacrum than call later pathology tailbone and various dysfunctions of the pelvis. 4) Long-term asymmetrical posture. No one will doubt bond neck pain and back pain after a long uncomfortable trip on a train or bus, when our attention is not keen on anything, but this is the connection disappears in the working atmosphere in the event of a workplace is not optimal and static overload, as a person in this process captivated the attention and it is steeped in the workflow. An example of optimal workplace:
In humans, the spine is adapted for movement in a large degree of freedom and varied postures at different angles, but the ligaments and the muscles are not designed to experience prolonged static load suboptimal conditions in the case of repetition leads to methodological malnutrition cartilage, ligaments and muscular . In the evolution of human physiology formed to facilitate bending of the spine in a vertical position of the body carries the load on the ligaments and muscles. If not optimal body position – we do not keep these physiological bends and optimum ergonomics of the focus on compliance with physiological principles.
Tips for optimizing your workspace:
When you use the keyboard, your shoulders should be relaxed. Shoulder and forearm should form an approximate right angle, wrist and arm should be approximately the same line. Change hand positions to avoid fatigue – because some users may receive the discomfort in the arms or wrists after intensive work without breaks. Place the mouse at the same height as the keyboard to work with it comfortably and not have to drag on. Use the special mouse pad or sew something for the wrist joint to prevent carpal tunnel syndrome. It is best to use adjustable chair that provides a rigid and comfortable support. Need to adjust the height of your chair so that your thighs are horizontal and your feet can reach the floor. The back of the chair should support the lower back. This must be achieved in order to avoid fatigue, too.
If the chair back under sub-optimal angle – use the land in a deep chair, so that the sacrum touching the chair back, just above the sacrum, place a pillow (you can do roll of plaid) – is necessary for the preservation of physiological lumbar lordosis. It should sit on the ischial tuberosity, and not on the tailbone or sacrum. You may have to lift the chair so that your forearms and hands are at the proper angle to the keyboard. If you can not provide a convenient location for the feet on the floor – use a footrest with adjustable height and tilt to make up the gap between the floor and your feet. If she uses shoes with long heels – should be sitting down at the workplace to change the shoes used shoes or slippers without heels. In addition, it is possible to lower the positioning of your chair, but you must remember the position of the hands. Alternatively, you can use a table with shelf for keyboard and mouse, which is slightly lower the input controller than on a normal working surface. The position at the table should not be much far off, so as not to stretch and bend to the table. You can optimize the position of sliding the chair on cam distance between the table and the abdomen, and the arms should not be on weight, and have focused on the forearm. Set the monitor is necessary so that the top of the screen is at eye level when a person is sitting at the keyboard (as a variation – a little above or below eye level). The monitor must be on a strictly against the person, and not at an angle from the side. The best distance from your eyes to the screen is 45-70 cm In addition, one should try to minimize glare and reflections on the screen from fluorescent lights and close the windows. You can also try to reduce the illumination by means of a screen or stand. Take a break every 25-45 minutes, to avoid over-voltage from static positions.
Possible optimization work on the notebook:
Position the monitor. The upper part of the screen should be at eye level and look at the center of the screen is directed at a slight downward angle. Place the keyboard on the same level with the elbows. During the printing on the keyboard keep your wrist straight. Keep your head and neck in a relaxed position. If you have a high chair leaning his head against the back and avoid excessive neck flexion or rotation. To back was straight, do not sit on a stool, use a chair and a chair with a high back. If your chair is adjustable for height, then make sure that your thighs are parallel to the floor or slightly above the knees and your feet flat on the floor. When you work at a desk, if possible, use an external keyboard and a more ergonomic mouse instead of the touchpad.
Take a break every 25-45 minutes, to avoid over-voltage from static positions. For the comfort of working at a laptop in an ergonomically correct position invented a special device – a special stand and folding tables for laptops
Doctors and patients is often underestimated role in the formation of flat feet pain syndromes and maladjustment of the body. Flatfoot has several varieties: transverse, longitudinal, combined (transverse and longitudinal) plane valgus feet. Flat feet is 3 degrees.
The longitudinal flat feet is characterized by a flat longitudinal arch, increased contact of the plantar surface of the foot to the floor. Foot length is slightly increased. First degree rarely worried man, periodically marked fatigue in the legs and pain in the feet during physical exertion. Second degree manifested amplifies pain in the legs, it’s hard to pick a comfortable shoes. The third degree of longitudinal flat characterized by frequent pain in the feet, shins, overload hip, low back pain, and the selection of shoes at this stage is much difficult.
The cross is characterized by a flattening of the flat transverse arch of the foot, foot length is slightly reduced. Hammer toes acquire the shape is deformed big toe. The cross flatfoot is more common in women aged 30-50 years. This type of flatfoot can progress in the investigation of wearing high heel shoes or overweight. May be exacerbated “corns” and the growth of bones of the big toe (hallux valgus). The first degree of cross-flatfoot is usually characterized by recurrent pain in the feet. Second degree brings pain localized in the forefoot and under the metatarsal heads medium. The third degree is manifested by frequent and severe pain under the metatarsal heads, corns may develop a deformity of the big toe.
Flat feet can be caused by a hereditary or acquired in the case of wearing uncomfortable shoes and long-term static loads on the legs, may be exacerbated deprive weight. Diagnosed with flat feet inspection, also using podimetr or test print of a wet foot on a piece of paper, can be used for X-ray examination.
Formed in adult flatfoot is incurable, but it is possible to stop the progression and eliminate complications (overload leg joints and the lumbar spine). In children, if the flat is not determined by genes, it can be monitored and treated. Alleviate the condition for flat feet can using orthotics, wear comfortable shoes.
It is also useful for flat-switch types of loads and perform physiotherapy exercises for the feet.
If the flat is not correct, it will progress and can cause tendinitis and arthritis joints of the feet, and Pain in the lumbar region.
In advanced stages, and the progression of hallux valgus flat foot can be treated surgically.
Orthopedic insoles are standard, and the average individual from a cast of the foot. In the manufacture of insoles individual patient may face the problem of inadequate selection: can not be considered the functionality of different length legs, pelvic dysfunctions in mind, there are paradoxical posturologicheskie results of the evaluation of data podimetra (when standing up, he shows that the length of one leg, and in the supine position when measuring ruler – other ). Also, if different length insoles do with not true functional shortening of the leg can be fixed and worsen pelvic dysfunction with resulting complications for the entire system of the musculoskeletal system. Thus, if the pick insoles without the osteopath, the best average in doing different insoles height – then the need to cooperate chiropodists (podiatrists) with osteopath. Just osteopath can help with flat feet relief eliminate muscle imbalances and decreased pain in the foot and lower leg to balance the tone of fascia and ligaments.
There are many approaches to beauty and aesthetic body care: fitness, SPA and beauty treatments, massages and hardware procedures. Osteopathy in this issue is no exception.
Osteopathy has to offer:
impact at a deep level to body systems and the interaction of internal organs
reduce swelling of tissues
detoxify the body
improve nutrition of tissues of the body and improvement of regional microcirculation,
increased tone and elasticity improvement of the skin without undue injury, and without pain (in contrast to common procedures, and in particular from the classic anti-cellulite massage),
restore and normalize the tone of the facial muscles.
Aesthetic direction in osteopathy focuses on techniques:
normalization of tone apertures
lymphatic drainage techniques
technology membranosa-fascial tension,
elements visceral therapy.
As you know, over the body, in which there is a pathological process that also changes the tone of the skin, in the skin appear painful fixation, which also violate local microcirculation. Eliminating the dysfunction of internal organs and balancing the harmony of its relationships, occurs as a direct effect on the skin and subcutaneous tissues over the body, and reflex effects on the condition and skin through the autonomic nervous system. The impact of soft osteopathic techniques on the skin may also have a reflex effect and multilateral influence on the entire fascial system, lymphatic system and relaxing effect on the nervous system.
the Advantage of osteopathy is that in addition to improving the aesthetics of the body, it also balances and helps the body to be more healthy in General.
Integral approach to human health when problems of the musculoskeletal system and myofascial syndrome (muscle pain) can not ignore the importance of a balanced diet.
Internal organs are linked to the spine through the autonomic nervous system, and there is a two-way relationship: the influence of the spine on them, and the influence of the internal organs of the spine. Also, there is a relationship between the internal organs and associated muscles. When an imbalance occurs in some organs muscle imbalance, in violation of motor organs twisted pelvis and there is an imbalance of diaphragms, under which the body just has to adjust. In this situation, muscle imbalance, pelvic torsion spasm and asymmetrical implementation diafrgam usual loads leads to severe congestion of certain muscles and hyper-load some of the ligaments and joints, which then is a disaster for the musculoskeletal system. Example: in disorders of the intestine and kidney dysfunction if you do the usual physical work can overload a square lumbar muscles and iliopsoas muscles, twisting the sacrum and ilium. As a consequence there reflex muscle strain, excessive load on the lumbosacral, and possible transformation of the existing protrusion of the intervertebral disc extrusion (hernia). This situation of course you can eliminate osteopathic techniques, but if you do not take into account and address the imbalance in power – the effect will be temporary. There are different approaches to nutrition and diet therapy. Well-proven approach to separate nutrition, diet Tibetan medicine, food in the 5 elements in Chinese medicine, the empirical approach and recommendations osteopaths. You can use the body’s reaction to the product through the changes of the craniosacral rhythm, or through muscle testing to find an individual diet particular person.
General recommendations for a balanced nutrition based on different approaches can also be useful.
General recommendations of empirically experience osteopathic doctor Jean Pierre Barral:
Unbalance of the liver – to minimize the consumption of alcohol, avoid drinking alcohol in the evening, to refrain from cool drinks in the afternoon, to increase fluid intake in between meals as decoctions. After osteopathic treatment beneficial use of lemon or grapefruit juice (diluted with water) before breakfast for 10 days. Refrain from drinking coffee in the afternoon. Artichokes and bitter salads are good hepatic bile stimulant. Minimize eating chocolate and white wine.
When bathygastry (drooping stomach) should eat food slowly to avoid rapid filling of the stomach. Must drink the sweet and warm and avoid cold drinks, especially in the afternoon. Before dinner, should make some slopes and accentuate the diaphragmatic breathing.
Dysfunction of the colon – to minimize meal in the evening and at night, to minimize the reception of fats, meat, flour and sugar. Increase in diet products of the long fibers (leek, spinach, celery, white beet, etc.). To include in the diet of olive oil and lemon juice.
When renal dysfunction – detachable empty stomach before meals. Increase the intake of fluids, to include in the diet of lemon juice, diluted with water.
Compatibility Chart separate food products of Western Diet:
Melonsnot compatible with any other products. Milkis better eaten separately from other foods.
Different products have different properties of digestion and assimilation. Joint use radically different products on the properties leads to nedoperivarivaniyu and further fermented some of incompatible products and as a consequence – the overload of the gastrointestinal tract and release toxins that are not indifferent to the liver.
Dietetics in Tibetan medicine.
In Tibetan medicine, there is the concept of the three vital principles, which have their own characteristics: Lung (wind) – neutral, Tripa (bile) – fever, Pequeno (mucus) – cold. Data types correspond to the vital principles of the constitution, there are also mixed types. Food should be chosen depending on the type of body of man and provide general advice on nutrition. Since the selection of diet by type constitution is not a simple process, consider a brief general advice.
In Tibetan medicine wrong combination of food is regarded as poisons. Taking these products within days allowed in between each other in 5-7 hours.
Incompatibility list of products according to Tibetan Medicine:
Fish with milk, meat, poultry, or eggs
Milk with fruit, or – with walnuts, radishes, garlic
Eggs and garlic
Lamb and cold drinks
Rabbit and Poultry
Sour milk (yogurt) and chicken
Yogurt, banana and pear simultaneously
Radishes with molasses
Meat with buckwheat
Do not put meat neostyvshee after cooking in a sealed container
Cooked beans with yogurt and sugar
Drinking yogurt with fresh or frozen
Sour alcoholic product with meat
Mushrooms with mustard oil
Chicken with yogurt, or with a mixture of honey and vegetable oil
Chicken meat with (white) dairy products
Meat with acidic foods or fried flour from grain
Not recommended simultaneous absorption of two different products of animal origin, or a combination of acids and starches.
Do not combine in one go “heavy” and “light” foods. In the summer – to increase fluid intake, and in winter – to reduce to prevent overloading of the kidney (not stimulate in the winter “cold” in the kidneys).
If we imagine that the various substances contained in food are different forms of information, which has to cope with the body, it becomes clear how a simple diet can protect the body from imbalances or incorrect “reading” of the information. Digestive heat can be balanced by the consumption of more simple combinations of ingredients. Starvation disbalansiruyuschee has a strong effect. Fasting is allowed only with the permission and under the supervision of an experienced physician. Products with a very cold and very hot active forces badly blended. The main laws are – simplicity, moderation and balance in lifestyle.
In keeping with the best poses and movements, people will minimize the risk of diseases of the musculoskeletal system, and in the presence of chronic disease – reduce the risk of relapse. It is necessary to observe the principle of ergonomics postures and movements in different situations, as a measure of prevention of diseases of the musculoskeletal system, improving the quality of work and quality of life.
Among tunnel syndrome tunnel syndrome is to provide upper and lower extremities, cranial tunnel syndrome, a syndrome of upper-thoracic and pelvic aperture tunnel syndrome.
Many doctors are faced with the complexity of managing patients with carpal tunnel syndrome, many patients are not faced with the effectiveness of drug therapy, with brevity and nezachitelnostyu results in local injection therapy and physiotherapy at the extremities tunnel syndrome, as well as the extremes of surgical treatment, with the complexities of doing cranial and pelvic tunnel syndrome.
With regard to osteopathic treatment it shows good results in soft not traumatic impact in conjunction with the recommendations described in ergonomics and motor.
How to sleep well? How to choose the optimal position of the body during sleep?
People often shift the responsibility for a comfortable sleeping on orthopedic pillow, but orthopedic pillow is not a guarantee of a comfortable sleep, it is important to learn to sleep on this pillow, , and it must be suitable individually for you. The recommendations are not absolute, but only a hint for a more comfortable sleep and prevent overloading of the cervical. Must adhere to the provisions of the physiological neck without extremes (so the head does not fall from the shoulder and neck pillow pererazgibat) not to accept the provisions on the pillow, which can ‘twist’ the neck. It should listen to the wisdom of the body and the optimality criterion is the well-being of man.
From the proper landing at the wheel depends on comfort, health and safety of the driver. Fatigue, pain in the neck and back, numb hands and feet – a criterion that your car seat is adjusted properly. Often after long journeys driver turns for help to a neurologist, orthopedist or chiropractor.
Most drivers sit too close to the steering wheel. This situation constrains freedom of action and does not react quickly in an emergency. Another common mistake – driving a car in a semi-recumbent position (strongly leaning back). Sometimes in the summer you can see the drivers traveling with his elbow sticking out of the window – Sit with your elbow up to the window is missing. When the seat is pushed too far forward, the driver has much to bend his arms and legs that interferes in a position to easily move his arms and leads to fatigue and discomfort. This is particularly evident on long journeys, as in this case, due to the long sub-optimal static forces overstretched muscles of the back and neck. Long asymmetrical loads are a common cause of pain syndromes. When placing the seat is too far away – the driver has to catch up ahead, holding the handlebars. However, his back is unsupported and her muscles tense all the time. The main burden falls on the relatively weak arm muscles. In such a situation deteriorate accuracy and speed control actions, as well as visibility.
Correct driving position behind the wheel
The optimal landing depends on growth driver and the length of his arms and legs. The rational behind the wheel fit not only ensures comfort for the driver, it is necessary for competent driving. Proper planting is characterized by the stable position of the body, the limbs of withholding exemption postures to perform the movements associated with the management. These provisions provide the most accurate driving, are most suitable for performing tricks and part of the “posture of readiness” to act in dangerous traffic situations. Properly seated in the car-racing drivers use rallisty. The driver of the car will feel comfortable behind the wheel when his hands are located in the middle position on the rim of the steering wheel slightly bent at the elbows, shoulders rest against the seat back and the leg in the hip area has a support on the seat. Thus midfoot right and left legs to pedal freely take out the entire range of movement of the latter. Sitting behind the wheel of need so that the back was almost flat, the backrest angle of 90-100 degrees, and Mezhuyev the knee joint and the edge of the palm rest away. The center of gravity must be located on the seat and not be on the weight. Straightened back and neck contribute to better coordination and orientation in space. You must pick a distance to the pedals so that legs were almost straightened by pressing the pedal to the end, but in the knee joints full extension should not be.
If you are not comfortable seat – use a small pillow just above the sacrum at the lumbar. When traveling long distances – make a break every 1-2 hours to avoid tensing your muscles and ligaments from static positions. Correct (a) and abnormal (b and c) the driving position behind the wheel of a car. Avoid prolonged stay in asymmetric postures while driving
There are many causes of chest pain. Most of all – it intercostal pain, pain associated with the spine or different or myofascial syndrome, but also to exclude cardiac, pulmonary pathology, and pathology of the breast.
Presque vu (“almost seen”), or the so called “tip of the tongue” effect, which is expressed in the inability to recall any familiar word, while the memory POPs up some information about the forgotten word. As long as we try to remember, there is a feeling that it will be found now and played, but, nevertheless, the word does not remember. It is sometimes painful and even haunting.
In childhood this effect happens rarely and quickens as they grow older.
An unambiguous explanation for this phenomenon, but there are a few assumptions:
1. The blocking information. This means that if you think of another word before that, which had to reproduce, then one blocks the extraction from the memory of the other.
2. In old age the reason is the reduced efficiency of retrieving information from memory, as well as a large amount of information, which may lead to difficulties in finding the right words.
3. Forgetting is associated with the phonological feature of the right words, which has a lower activation than the other words similar in meaning and sound.
Serotonin is often called the hormone of happiness, although actually it is a neurotransmitter in the brain which is produced in the pineal gland of man from the essential amino acid tryptophan. It supports transmission of signals from one part of the brain to another. As hormone serotonin acts when injected into the blood. It is associated with psychological and physical activity: mood, appetite, libido. Why they call it the hormone of mood, pleasure, happiness.
The main part of serotonin is concentrated in the gut. The hormone plays an important role in the regulation of motility and secretion of the gastrointestinal tract. So, when dysbacteriosis and many other diseases of the colon production of serotonin by the intestine is significantly reduced.
It should also be noted that reducing serotonin levels increases the sensitivity of the pain system of the body, even the weakest perceptible irritation causes pain.
One of the reasons for lowering the level of serotonin may be a lack of tryptophan. Of this amino acid is serotonin. The more notes this deficiency, the greater the likelihood of depression in humans. But has not been fully elucidated, or by the lack of serotonin causes depression, or depression itself is the cause of the decrease of serotonin.
a Signs of low serotonin levels are:
pessimism, bad mood, vulnerability, sadness, apathy, lack of energy, lack of interest in life, insomnia, fatigue.
the How to raise the level of this hormone?
-First of all to pay tribute to the sport. It was not conducted one study examining the relationship of training and their impact on mood. It turned out that this is a very effective way to normalize hormone levels.
-Also, on the hormone levels are influenced by sunlight. Accordingly, the more – the better our mood. That’s why in the cold season, when there is a lack of sun, people are more likely to experience depression.
-Hormone levels may be affected by some foods. Tryptophan rich bananas, dates, plums and figs. Contains milk and dark chocolate. Such food contributes to the biological synthesis of serotonin. Along with tryptophan to increase serotonin levels can help other substances of protein nature, contained in vegetable oils and nuts, sea fish.
-In addition to these natural ways of raising hormone levels, it should also be noted liking what you do. It could be painting, reading, cooking all sorts of Goodies, dancing, singing and so on. All that will bring you positive emotions, distract you from negative thoughts and change your perception that will certainly restore the decreased levels of the hormone.
-And of course to adjust the level of serotonin is possible drug medications. If you find it difficult to cope with depressed mood, you should see a specialist, who will prescribe either medication antidepressant or offer alternative therapies.
The autonomic nervous system of the person – this is a unique and complex structure of the nervous system, including the segmental level (the limbic system and reticular formation) and segmental level (the sympathetic and parasympathetic nervous system), which regulate most of the vital functions of the body.
Dysfunctions and disorders of the autonomic nervous system and have a wide variety of reasons, as well as different views on the interpretation of the diagnosis of the different schools of Neurology. There is in the post-diagnosis of “vegetative-vascular dystonia”, which is only used post-soviet schools of neurology and neurological considered by most of the world community is not quite correct.
Pathological conditions and complaints of patients with a diagnosis of vegetative-vascular dystonia may be reasons in various pathological conditions of the human body, such as hereditary diseases of the nervous system or postintoksikatsionnoe damage to the nervous system, hormonal disorders (diseases of the hypothalamic-pituitary, thyroid, adrenals, gonads ), cardiovascular disease, blood disorders, asthenic postinfectious states, state co-persistent chronic viral infection, but above all, the complaint and the state fall under the diagnosis of vegetative-vascular dystonia fall functional disorders of the nervous system, the state of chronic fatigue syndromes maladjustment in today’s tempo life, depression, anxiety and panic disorders, insomnia.
Given the above information it is clear that similar complaints can be at different somatic pathology, maladaptation syndrome or psycho-asthenic disorders, and methods of treatment for these pathologies will be completely different. If this is the somatic pathology (neurological, endocrine, cardiac, and other), the cure must be specific reasons for specific treatment regimens, not abstract diagnosis of vegetative-vascular dystonia. If the same causes in psychological dysfunction and maladjustment, then they should be treated forging lifestyle, schedule optimization robots and workloads, changing attitudes to stressful situations and changes in the usual way of thinking, if necessary, a psychologist or drug correction of psychological state of the patient. The clinical formulation of a working clinical diagnosis of dysfunction of the autonomic nervous system will be more correct and it should apply to those states that are not described in other nosology or diagnoses are similar in wording. Those states that do not have a specific somatic cause neurological shall not apply to the wording of autonomic dysfunction as an independent diagnosis.
The International Classification of Diseases revision 10, there are specific items relating to the diagnosis of dysfunction of the autonomic nervous system, encoded filed under Diseases of the nervous system and mental disorders.
The ICD-10 in the category of diseases of the nervous system accompanied by autonomic dysfunction: G90. Disorders of vegetative [autonomic] nervous system; G90.0 Idiopathic peripheral autonomic neuropathy; G90.1 Familial dysautonomia [Riley-Day]; G90.2 Horner’s syndrome; G31.2 Degeneration of nervous system due to alcohol – alcoholic cerebellar ataxia, degeneration, cerebral degeneration, encephalopathy; disorder vegetative [autonomic] nervous system caused by alcohol. There is also a neurological pathology, in which the vegetative disorders are minor and there are other more important symptoms of the pathology of the nervous system.
In ICD-10 rubric of mental and behavioral disorders are accompanied by autonomic dysfunction: F41.0 Panic disorder [episodic paroxysmal anxiety]; F32.0 Depressive episode mild; F43. Reaction to severe stress and adjustment disorders; F45.3 Somatoform dysfunction of the autonomic nervous system; F48.0 Neurasthenia; Sleep disorders F51 inorganic etiology.
The same group of autonomic dysfunction accompanying functional disorders related to the category M99.0 Segmental and somatic dysfunction. When autonomic dysfunction caused by somatic dysfunction can effectively help osteopathic methods as the primary method of treatment. When conditions related to the headings G and F in the ICD-10, osteopathy can be actively used as an auxiliary method to a neurologist or psychotherapist in treatment of autonomic dysfunction.
Thus the practitioner, excluding significant somatic pathology is not a neurological origin, can use diagnosis phrase “dysfunction of the autonomic nervous system” to clarify the nature and causes of (or an indication of neurological organic cause or an indication funktsianalnyh characteristics and causes, for example – on sympathadrenalic, vagoinsulyarnyh or mixed type, with vegetative-visceral, asthenic and asthenic-neurotic syndrome, the presence of insomnia or maladjustment syndrome) and more precisely prescribe treatment accordingly causes of the disease, and a diagnosis of vegetative-vascular dystonia is not quite accurate and correct should be out of use.
Treatment of pain syndromes and neurological disorders is divided into conservative and surgical treatment.
Indications for surgical treatment is divided into absolute and relative.
Absolute indications for surgical treatment for herniated disc – this 1) compression of the spinal cord herniation cervical or thoracic with the development of progressive myelopathy accompanied tetraparesis or paraparesis, violation of the pelvic organs; 2) compression “horse’s tail” in the lumbar ( “pony tail” – terminal strands of the lumbar spinal cord, forming the lumbar-sacral plexus) with the formation of the lower paraparesis and disturbance of pelvic organs;
3) To conditionally absolute indications include – not the effectiveness of conservative treatment for 1-1.5 months with progressive pain, radiculopathy with progressive paresis of the lower limbs with impaired foot function.
All other indications are relative, that is – the presence of a herniated disc pain and active desire of the patient to be operated.
Absolute indications for surgery are not more than 3-5% of all pain syndromes, and neurological disorders in the pathology of intervertebral disc hernia. In 95-97% of cases, the hernia pathology patients can successfully help the conservative therapy, subject to recommendations on patient orthopedic regime.
Pain and neurological disorders in a herniated disc, often are not caused directly by the herniation, and most are a consequence of aseptic inflammation and secondary autoimmune response with subsequent edema (vsledvtsii extruded nucleus pulposus outside the gap of the intervertebral disc annulus fibrosus, which is perceived by the immune system as endogenous antigen), trauma zadneprodolnoy ligament secondary compression venous plexus with subsequent venous stasis and edema, naruschenii korechka Biochemistry and axonal transport due to the presence of inflammatory mediators. All this irritates the nerve sinuvertebralny Lyushka, thus also formed a short spasm of deep paravertebral muscles with subsequent breach of the regional blood flow of the vertebral-motor segment.
Dizziness is a frequent complaint of patients, which can occur in various diseases that have different nature (pathology of nervous system structures, a psychological disorder, abnormality of the inner ear, stem ophthalmic and oculo-motor disorders, diseases of the cardiovascular system or blood, fatigue).
Dizziness – this is quite a subjective feeling of loss of balance, uncertainty of spatial position of the body or rotation of objects, the attack of General weakness, which is not easy to differentiate the cause of these complaints.
Dizziness (vertigo) neurological nature can be divided into Central and the peripheral.
Central vertigo is caused by diseases of the brain structures (types of migraines, intoxication, transient disruption of the blood supply, stroke, bleeding, CNS, demyelinating diseases [multiple sclerosis], craniovertebral anamalai, trauma, tumors).
the Peripheral vertigo:
1) pathology of the vestibular nerve (the portion predverno cranial nerve) occurs as a consequence of infectious or discirculation neuropathy, with demyelinating processes or tumors of the cerebellopontine angle;
2) pathology of the structures of the inner ear (labyrinthitis, Miniere disease, benign positional vertigo).
also dizziness can be divided into the system, not the system, disequilibrium, and psychogenic dizziness, cervicogenic dizziness.
vertigo (true vertigo) – the defeat of the vestibular apparatus or one of its systems (vestibular, visual or neuromuscular). This type of dizziness requires a thorough diagnosis. With vertigo the patient feels the rotation of his body and surrounding objects in the same plane; accompanied by nystagmus and vegetative symptoms, nausea, and in some cases disorder of motor coordination of the limbs.
1) physiological, which can be fatigue, stress, hunger, untrained vestibular apparatus, motion sickness. This type of dizziness does not require treatment;
2) pathological – presyncopal status (orthostatic hypotension, diseases of the cardiovascular system, hidden bleeding or blood disorders), somatogenically caused autonomic crises (endocrine pathology, autonomic dysfunction is the result of diseases of internal organs). When non-systemic vertigo, the patient feels instability, feeling of falling, weakness, blackouts, vegetative symptoms as a reaction to the recurrence of symptoms can be a feeling of fear.
disequilibrium (ataxia) can have many causes: such as the defeat of a worm of the cerebellum, impaired neural connections between the frontal lobes and cerebellum, pathology pathways of the spinal cord, polyneuropathy of the lower extremities with impaired sense of support. The ataxia must be differentiated from orthopaedic pathology, leading to poor stability because of deformity, pain and stiffness in the lower extremities.
Psychogenic dizziness (pseudo vertigo) develops in the structure of psychosomatic, depressive, panic or anxiety disorders. This type of pseudo-vertigo is accompanied by strong emotions, anxiety, fear of falling, feeling of faintness, General weakness, feeling of “fog” in my head.
as should be in a separate cervicogenic dizziness. the Cervicogenic dizziness (cervical vertigo) is caused by irritation of the sympathetic plexus of the back of the neck with subsequent reflex vascular reaction, and also due to the imbalance of proprioreceptive impulses from the vertebrae and neck muscles to visual and vestibular afferentation related to the position of the head. This type of dizziness occurs with the pathology of the cervical spine and cause pain in the neck and limitation of movement in the cervical spine.
Given the variety of causes of vertigo, as well as different forecasts of the probability of recovery or the severity of the disease in view of the different nature of reasons themselves, if you have any complaints on dizziness should seek help from a doctor. Given the frequency of dizziness with neurological disorders, examination of dizziness should start with a consultation with a medical neurologist, and if the neurologist considers it necessary, it may further recommend consultation with a cardiologist, otolaryngologist, ophthalmologist, prescribe blood tests, an MRI study of the blood vessels, if necessary – consultation of psychologist.
Neurological causes of dizziness treatment involved neurologist.
as should be in a separate group of vertigo in the structure of somatic dysfunction that may be due to genialnyh violations, in particular the strain (the strain with fixation) in occipital, the spheno-basilar synchondrosis the, the pyramid of the temporal bone or Tentorium of the cerebellum. In this type of dizziness will be effective mainly osteopathy.
Cervicogenic dizziness can be attributed both to the category of neurological diagnoses and in the somatic dysfunction section. In cervicogenic vertigo and some types of non-systemic physiological vertigo would be just as effective osteopathy as the primary method of treatment for this type of dizziness. In other types of dizziness osteopathy can help, but in this case it is more constructive to use it as an auxiliary method.