A chiropractor – the specifics of a doctor’s work and what does he treat?

Manual therapy is a branch of professional medicine in which the doctor uses his hands to provide therapeutic effects on the patient’s joints, muscles, spinal column and other parts of the body. It is used as a primary or additional means of treatment, diagnosis and prevention of diseases of the musculoskeletal system.

Scope of activity of a chiropractor

The specialty “Manual therapy” appeared in Russia after 1997. The main task of this doctor is to eliminate pain, treat joints, including the spine, and diagnose diseases of the musculoskeletal system. At the same time, the basis of manual therapy is the impact of hands on different parts of the body:

• spine;
• muscles and fascia (muscular membranes);
• ligaments;
• bones;
• joints.

Different doctors can perform these tasks:

• therapist;
• orthopedist;
• neurologist;
• rheumatologist;
• pediatrician (children's therapist);
• sports doctor;
• reflexologist.

Specialists can work both in regular hospitals and in specialized manual therapy departments. Doctors also work in clinics and health resorts.

Features of follow-up and doctor’s recommendations

A specialist may recommend changing your physical activity and type of diet. It is also important to consider that:

• After the session, you should not get up suddenly; it is better to do it slowly.
• Within 24 hours after the procedure, you should avoid heavy lifting and avoid sports.
• After the session, hypothermia and overheating (drafts, hot bath) are unacceptable. The first can lead to spasm in areas of intense impact, the second can lead to swelling.

The doctors of our Clinic will never refuse you further consultations. They will recommend a follow-up date after treatment to assess effectiveness.

Indications and contraindications for visiting a chiropractor

A chiropractor works in different areas - diagnostic, therapeutic and preventive. It is necessary to contact him if pain, discomfort and other characteristic symptoms occur:

• pain in any joints;
• pain when bending or turning the head;
• numbness of the hands, feet, including fingers;
• pain in the neck, lower back or chest (along the spinal column);
• memory impairment;
• problems with vision or hearing.

It is also recommended to visit a specialist if you have the following diseases and disorders:

• lordosis, scoliosis and other postural disorders;
• intervertebral hernia;
• osteochondrosis;
• migraine;
• hypertension;
• vegetative-vascular dystonia;
• movement disorders;
• excessive muscle tension;
• local hypermobility;
• organic joint disorders;
• vertebral artery syndrome.

It is important to understand that manual therapy does not replace other methods of treatment, but only complements them. For example, it is impossible to cure osteoporosis or osteochondrosis with your hands. And many types of hernias can only be eliminated through surgery.

In addition, there is a fairly wide list of contraindications in which manual therapy is excluded:

• osteoporosis;
• oncological pathologies;
• neoplasms on the spine;
• systemic diseases;
• spine surgery;
• paresis;
• Bekhterev's disease;
• acute infectious diseases;
• vertebral dysplasia;
• osteomyelitis;
• entry of a blood clot into the lumen of the vertebral blood vessels;
• muscle atrophy;
• the presence of wide areas with lost sensitivity;
• acute circulatory disorders in the brain;
• general serious condition (for example, after a stroke or heart attack).

What to do if you have back problems?

If symptoms of osteochondrosis appear, then at the first stage it is necessary to be examined by a qualified specialist. This is necessary to determine neurological and orthopedic disorders, order the necessary studies for correct diagnosis and determine treatment tactics. An incorrect diagnosis can sometimes lead to very serious complications!

Most patients understand perfectly well that they will be treated not by the name of the technique or the name of the medical institution, but by an ordinary practicing doctor. The real result of treatment depends on his professional qualities. Hand healing usually requires experience and care. In some cases there are contraindications that need to be recognized and properly assessed.

In connection with the above, it is important to clearly understand that only a certified doctor who has undergone special training and has the appropriate certificate has the right to carry out such treatment.

How is an appointment and diagnosis with a chiropractor?

At the appointment, the doctor asks several questions regarding complaints, the course of the disease, the nature of the symptoms, the frequency of their manifestation, etc. A visual examination is carried out using the hands (palpation). The doctor palpates the spine, determines areas of deformation, muscle tone, and areas of increased tension. In this case, the doctor may ask the patient to take one or another position, bend over, turn, etc.

The main diagnostic methods of manual therapy are described in the table.

diagnostic method	description
palpation	feeling muscles, skin surface, joints with hands, determining the degree of pain, increased tone, functional disorders
push palpation	examination of joints using rhythmic, energetic thrusts
joint examination	assessment of joint movements, painful condition, dysfunction, specific phenomena, degree of blockade
stretching	studying the degree of extensibility of the paired muscle in comparison with its healthy counterpart on the other side

Along with these methods, instrumental diagnostic methods are also used:

• performing x-rays;
• MRI;
• electromyography;
• CT;
• TANK;
• HOW.

For additional consultation, you may need to see a neurologist, orthopedist or other specialists.

Possible complications

Manual therapy is a safe and effective method of treating diseases of the spine and internal organs. But if its techniques are performed incorrectly, dangerous complications may develop:

• ischemic stroke as a result of compression of the artery supplying the brain;
• poor circulation in internal organs;
• infringement of intervertebral hernia and nerve endings;
• muscle and ligament injuries;
• fractures of ribs and vertebrae;
• spinal deformity;
• the occurrence of increased mobility of spinal motion segments.

In many cases, it is only possible to correct the consequences of inept manual therapy sessions through surgery. To avoid such consequences, you should contact only highly qualified specialists with extensive practical experience who are licensed to conduct such treatment.

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Manual therapy treatment methods

To treat diseases of muscles, joints and bones, the doctor uses different techniques:

• mobilization - rhythmic and smooth movements in the joints to stretch the displaced component;
• relaxation – massage and other methods of muscle relaxation;
• manipulation – cycles of rapid movements and relaxations.

The techniques described are often used together rather than separately. In this case, manipulation involves more active movements of the doctor’s hands, while relaxation and mobilization are “softer” techniques. For treatment, the doctor also uses other techniques - for example, forceful traction (traction push). The following methods are also used:

• hit;
• push;
• extension;
• flexion;
• deflections;
• rotation (rotational movements);
• traction (traction);
• reduction (rehabilitation of relaxed muscles) and others.

Manual therapy comes down to a thorough diagnosis, treatment and prevention of disorders of muscles, bones, joints, including the spinal column. Thanks to this, it is possible not only to relieve pain, but also to restore lost mobility, prevent the development of pathologies and undergo successful rehabilitation after various surgical operations.

Features of the effect on different parts of the spine

For each patient, the technique and nature of the impact are selected individually depending on the type and severity of the existing disorders. However, there are some general rules that chiropractors adhere to.

1. Before the start of any active treatment, relaxation is carried out to achieve the desired level of muscle relaxation and prepare them and the skin for subsequent procedures. It is also used at the final stage of the session.
2. Work with the spine begins with exposure to the thoracic region, then moves to the lumbar and only then to the cervical.
3. If it is necessary to correct deformities of the cervical or lumbar spine, preference is usually given to rotational techniques. At the same time, pressure techniques are more often used to improve the condition of the thoracic spine.
4. Working with the cervical spine requires a particularly highly qualified chiropractor, since it is he who is most susceptible to damage and injury of various kinds.

The duration of treatment depends on the severity of the existing disease. As a rule, in mild cases, 3-4 sessions are required to achieve noticeable results; in advanced situations, more than 15 procedures will be required.

Treatment approaches

Before starting such treatment, it is imperative to diagnose the affected structures. Only after examination, clarification of complaints, X-rays, or MRI, sometimes ultrasound, can one see the presence of indications, the features of the course and the complexity of the process. This is why a true specialist will never work in isolation from a medical facility.

It is impossible to heal in one session. On the contrary, in most cases, after the first procedures, patients often feel a significant deterioration in their health, an exacerbation of the process. This is a normal reaction that goes away within a couple of days.

The main task of any doctor is to do no harm. Therefore, the specialist categorically avoids excessive, aggressive and dangerous influences. It has been proven that the maximum positive effect comes from a soft, osteopathic effect. The doctor works especially carefully with children and the elderly. Whatever the method, the patient is always fully monitored, and any changes in well-being are taken into account.

General information

Manual therapy is a set of practical methods that are used in the diagnosis and treatment of pathologies of the musculoskeletal system. The use of manual techniques involves treatment with the hands or with the use of auxiliary manual means (mechanical and hardware).

There is no single definition of the term “manual therapy”, since this term is used in relation to various therapeutic methods of alternative (auxiliary) medicine, but in a number of countries it is also used in neurology, orthopedics and other branches of evidence-based medicine.

Most often, a neurologist or surgeon who has mastered the appropriate methods and techniques becomes a chiropractor.

Hands are the main (and sometimes the only) instrument of influence not only of the chiropractor, but also of the osteopath and massage therapist, but if the osteopath’s scope of activity includes the entire body, then the chiropractor is focused on treating soft tissues, joints and the spine, and the task of the massage therapist is is the treatment of soft tissues.

A special type of massage is visceral therapy - massage of internal organs, which is performed by a visceral therapist (a chiropractor who uses visceral therapy techniques).

Children are treated by a pediatric chiropractor who, using gentle and gentle methods, restores the general condition of the newborn, and also eliminates pain, normalizes muscle tone and blood circulation, and restores the functioning of the musculoskeletal system in older children.

Consultation stages

The initial consultation with a chiropractor includes:

• studying the patient’s complaints and medical history, as well as the characteristics of the patient’s life (including physical activity, diet, workplace organization, etc.);
• diagnostic examination, which consists of a visual examination (posture, spinal curves, etc. are assessed), palpation of the back and spine, as well as functional tests;
• choice of treatment tactics.

In the presence of complex diseases, the chiropractor refers the patient for additional examinations.

When do children need to be examined by a pulmonologist?

Reasons for consultation are:

• frequent hacking cough without sputum discharge, which is accompanied by shortness of breath and a feeling of lack of air;
• prolonged cough of any nature;
• the appearance of sputum mixed with blood and pus when coughing;
• cough with pink foam;
• acute pain in the sternum, worsening with inhalation;
• any chest pain accompanied by difficulty breathing;
• cough against the background of obvious intoxication: fever, weakness, sweating;
• the appearance or intensification of a dry cough in the evening, at night;
• labored breathing;
• difficulty breathing, lack of air due to certain irritants - flowers, dust, in case of changes in air parameters;
• attacks of suffocation;
• heavy breathing with wheezing, whistling and other sounds;
• coughing and coughing that occurs in a healthy child after crying, screaming, active games, or sports activities.

The doctor’s scope of activity also includes the rehabilitation of young patients after severe forms of illness: pneumonia, obstructive bronchitis, bronchiotitis. During this period, the pediatric pulmonologist checks how the child’s body is recovering, clarifies what worries the patient or parents, and adjusts the treatment if necessary.

What is this

MT consists of massage plus pseudo-teaching about impaired movement of joints and soft tissues. Manipulative techniques (as well as massage itself) help a person relax, reduce muscle pain and, quite logically, improve their mood.

However, most followers of these manipulations claim overestimated effectiveness and results that go far beyond the scope of massage, which does not do them credit. As in the case of many other dubious areas, manual medicine foams at the mouth simply defending its right to exist, and does not try to systematically move the teaching towards science. The basic manipulations of MT have no scientific basis and show a complete lack of connection with basic academic ideas about pathophysiology, and when asked to explain such a discrepancy, a sensible opponent is accused of inertia and inaccessibility to understanding the sacred cows of knowledge.

When you read/listen to the tales of manual specialists, don’t be lazy at the same time remembering normal anatomy? - you will learn many new details from which Sinelnikov would commit suicide if he were alive. The perverted concept of anatomy and pathological changes allows one to unprovenly fantasize about the presence of adhesions/injuries/displacements without objective evidence of this (the technology itself allows this, see below), which is what all these doctors use in their daily practice.

Treatment methods

Therapy, carried out taking into account the physical and psychological condition of the patient, is aimed at eliminating pain, symptoms of the underlying disease, and restoring lost organ functionality.

The list of basic medical procedures includes:

• Positional mobilization (muscles located in the area of ​​painful joints are slowly and smoothly stretched).
• Push mobilization (performed for joint dislocations, for disc reduction).
• Rhythmic rotational mobilization (used for dysfunction of joints: shoulder, elbow, knee).
• Rhythmic stretch mobilization (joint stretching).
• Subcutaneous myofascial therapy (allows you to identify compactions, problem areas of the body, alleviate the symptoms of vascular and joint diseases). The result is ease of movement, straightening of posture, elimination of fatigue and pain.
• Cranial therapy (impact on the neck muscles and cranial joints). The result is improved brain function, activation of mental activity, minimization of tension in the neck, improved memory, reduction of intracranial pressure, elimination of dizziness and headaches.
• Visceral therapy (improves the functioning of the genital organs, intestines, spleen, heart, kidneys, lungs).
• Arthro-verbal therapy (used for joint damage in order to restore their functionality).

How a chiropractor defines osteochondrosis as below:

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Scope of competence

The doctor diagnoses diseases of the musculoskeletal system and nervous structures. The required volume of therapy is determined individually. This allows you to defeat the most severe lesions and prevent their relapses.

Procedures may be prescribed during the recovery period after surgery. This can significantly alleviate the condition and eliminate pain.

When should you see a doctor?

Disorders treated by manual therapy and osteopathy: pain in the head, back, neck, joints, and abdomen. Pain, for example, in the heart region, leg, arm, shoulder, may be caused by diseases of the spine. If you have the following symptoms, this is a reason to contact a chiropractor:

• Discomfort and pain syndromes that restrict movement in the lower back, shoulder, pelvic joints, elbows, knees
• Headache
• dizziness when moving the neck;
• visual impairment;
• problems falling asleep;

Manual therapy will improve the mobility of functional blocks, relieve pain, solve joint problems, and reduce the manifestations of vertebrogenic diseases associated with the spine, scoliosis, and hernia. If you notice such symptoms, we advise you to consult a doctor.

History

Adherents of this dark sect like to hush up the remarkable fact that MT originated from osteopathy only in the middle of the last century, when the Czech neurologist Karl Levit decided to make alternative medicine in the form of folk massage with medical science (in America at that time osteopathy and chiropractic). A little later, the plague took shape in the form of a textbook and spread to Eastern Europe and the entire Soviet Union, where it continues to infect the fragile minds of gullible citizens. [1]

Qualities a doctor should have

Not all manual technicians are excellent specialists. The master must have not only deep knowledge and understanding of his business. What is important for him are sensitive, strong hands, a penchant for this work, a good memory, a desire and the opportunity to expand his knowledge throughout his life.

It is extremely important that the doctor feels responsible and confident in his abilities. After all, the smallest wrong move can cost a person quite a lot.

A real specialist can be a neurologist or an orthopedist. After all, it is important not only to deeply understand the anatomical and physiological foundations, but also to master diagnostic and therapeutic methods. Often a specialist has to look at and evaluate radiographs, ultrasound reports, and cardiograms.

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In order to become a chiropractor, you must first graduate from a medical school. You will need to undergo specialization in neurology or traumatology with a course in orthopedics. In the future, you can master manual therapy.

Diagnostics

Diagnosis of pathologies of the back and spine, which is carried out by a chiropractor, consists of examination, palpation and functional tests.

For the examination, the patient must undress.

During a visual inspection, attention is focused on:

• posture and the presence of physiological curves of the spine;
• height of the shoulder line (its unevenness is a sign of scoliosis);
• presence/absence of stoop and distortion of the back (the presence of distortion is a sign of excessive muscle tension, which is observed with osteochondrosis);
• condition of the chest (if the costal arches do not move on one side when breathing, an inflammatory or tumor process in the lung tissue is suspected);
• condition of the skin (with hyperemia, an acute inflammatory process is assumed, with dryness and pale skin, a violation of blood circulation and the innervation process, etc.).

Further diagnostics include checking the Pasternatsky sign, which eliminates the possibility of renal pathology, and slightly bending the torso forward in a sitting position to exclude pain associated with the pancreas.

The patient is then asked to flex and rotate the torso to identify spinal curvatures.

During palpation, the doctor evaluates the uniformity and painlessness of the spinous processes of the spine, the presence of crunching or clicking sounds when pressing on the vertebrae, tension and uniformity of muscle development, etc.

Functional tests are performed to determine the mobility and flexibility of the spine.

Having made a preliminary diagnosis, the chiropractor refers the patient to an x-ray or MRI.

Additionally, a blood test for rheumatoid factor and a biochemical blood test, as well as arthroscopy, may be prescribed.

Brief information

A chiropractor is a specialized therapeutic specialist. Engaged in direct therapy of the spine, muscles, and joint apparatus. Affects painful structures exclusively through the hands. Similar methods of influence have been used for a long time, but they became a separate industry relatively recently. The name of the specialist has Greek roots. The literal translation is “hand therapy.”

The services of a chiropractor are unique in their kind. It is possible to eliminate symptoms that traditional, standard medicine had no effect on.

Pediatric pulmonologist: who is he, what does he do and what does he treat in children?

The doctor's specialization includes a huge number of pathologies from bronchitis to the detection of malformations of the respiratory tract. In some cases, for example, with tuberculosis, a pulmonologist can make a diagnosis, but another doctor, a phthisiatrician, will handle the treatment. A pulmonologist works closely with doctors from other fields - a pediatrician, an allergist, an ENT doctor, an immunologist, which allows him to evaluate the child’s disease from all sides and select the optimal treatment regimen.

What pathologies are within the competence of a pulmonologist for children:

• acute, obstructive and chronic bronchitis;
• pneumonia;
• pleurisy;
• alveolitis;
• bronchiolitis;
• asthmatic conditions;
• various fibroses;
• all kinds of abscesses and emphysema;
• chronic obstructive pulmonary disease (COPD).

In most cases, children are referred to a respiratory specialist for consultation by pediatricians or related physicians. Parents bring their children on their own much less often, since without medical knowledge and skills it is extremely difficult to distinguish a cough due to laryngitis from a cough due to pneumonia.