Orthopaedic Manipulation: Manual Therapy
Manual therapy includes manipulation and mobilization. This therapy involves restoring mobility (eg range of motion) to stiff joints and alleviating pain. Manipulation is a passive, specifically controlled, quick movement to release a joint back into correct position and/or reduce muscle spasms that may cause or contribute to spinal nerve irritation.
Prior to manual therapy, a passive therapy may be given. Passive therapy might include application of heat, ultrasound and/or electrical stimulation. These therapies relax and warm underlying soft tissue allowing joints to be more easily manipulated.
Electrical stimulation is also known as Transcutaneous Electrical Nerve Stimulation (TENS). TENS delivers a painless electrical current through the patient's skin to specific nerves. The current produces mild heat that works to relieve stiffness and pain and helps to improve range of motion (mobility).This treatment is non-invasive with no known side effects. It may be used to control acute pain and chronic pain.
Fascia is a sheath of connective tissue that supports muscles, bone, and organs. Stress from injury or poor posture causes the fascia to tighten. As the fascia constricts, muscles and bones may be pulled out of place causing pain. The physical therapist uses his or her fingers, palms, elbows and forearms to firmly and gently stretch the fascia.
Ultrasound is a common non-invasive therapy used to treat back and neck pain, tendon and ligament injury, muscle spasms, joint problems and other spine related conditions.
The physical therapist applies gel to the patient's skin to create a friction free surface and the ultrasound probe is gently swirled over the area. Ultrasound uses high-frequency sound waves to deliver heat deep into tissues (eg muscles). This therapy promotes circulation and healing, relaxes muscle spasm, decreases inflammation and helps to alleviate pain.
Ice and Heat Therapies
Cold treatments are never applied directly to the skin, because excessive cold can injure skin tissue. A barrier such as toweling is placed between the skin and the cold source. Ice helps to reduce blood flow thereby decreasing swelling, inflammation and pain.
Heat therapy options include heat packs (plus skin barrier) and ultrasound. Warm moist heat increases circulation to the affected area. Blood carries needed nutrients to the area and helps to flush away toxins. Heat helps to relax stiff, sore muscles.