Manual Physical Therapy for Pain Relief

Manual Physical Therapy for Pain Relief Blog

Manual medicine is one of many physical therapy techniques used to help reduce muscle and joint pain, but it is not as common as the use of exercises or temperature therapy to help deal with these issues. While a practitioner may use heat packs and certain activities as a way of helping to treat muscle spasms and joint dysfunctions, those that use manual therapy often use those methods in conjunction with manual rehabilitation efforts.

Manual Physical Therapy

This type of therapy is one that involves practitioners using their hands instead of a machine or other device to apply pressure to muscles and joints. Varying types of mobilization and manipulation as well as soft tissue work are used to improve flexibility, reduce joint tension and ease pain.

These techniques have been found to be particularly helpful for individuals with joint problems and back pain resulting from injury or pulled ligaments. Although there is not extensive data from clinical studies about these methods, what information is available indicates that manual methods have been successful at relieving pain for some patients.

Manual Therapy Methods

Depending on the type of issue that a patient has, there are a number of techniques that may be employed to address their discomfort and the source of it. Techniques may include:

Soft Tissue Mobilization
Using soft tissue mobilization, practitioners will break up scar tissue, reduce tension in muscles and increase the motion of fluid. Scar tissue is often inelastic, which can reduce people’s range of motion and cause tension. Deep pressure and stretching in a rhythmic manner are often used during this process, and practitioners will go layer by layer to identify the areas of the most significant discomfort.

Joint Mobilization
Many of the treatments prescribed for pulled muscles, especially those in the back, only provide temporary relief. While rest, ice and massages may feel good, they do not address the restricted joints that cause muscle spasms. Loosening up a joint and increasing its range of motion is accomplished by a practitioner moving bone surfaces against each other in ways that a person wouldn’t be able to without the assistance of a practitioner.

Muscle Energy Techniques
Common issues that many patients have to deal with are joints that are restricted and muscles that are shortened. By using a counterforce that is put in a particular position and location, practitioners are able to use voluntary contractions of the muscles of a patient improve the mobility of joints and increase the length of muscles.

Strain-Counterstrain
Many individuals with abnormal nerve and muscle reflexes suffer from posture problems that create tender points. With strain-counterstrain techniques, a practitioner will have a patient find a comfortable position and use mild stretching to relax aberrant reflexes. This method of treatment is particularly useful for conditions that cannot be addressed by other methods due to the patient’s tenderness.

High Velocity, Low Amplitude Thrusting
When patients suffer from joint issues, this method of taking a joint to the restrictive barrier using thrusts of less than an eighth of an inch can help relieve pain and stiffness. This method does not take the joint beyond its limit, so there’s no damage to the joint, and it should increase joint mobility without causing pain.

 

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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