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Manual therapies for back pain

On November 28th and 29th, Swiss Alp Health took part in the Swiss Congress of Manual Medicine SAMM (Schweizerische Ärztegesellschaft für Manuelle Medizin) in Interlaken, as manual therapies and certain dietary supplements work in tandem for the maintenance of mobility.

Manipulations in manual therapy

According to Dr. Med. Melchior Huggler, a specialist in physical medicine and rehabilitation in Brienz, the basics of manipulative therapy date from 1959. Today, the many advances in medicine and imaging have made possible the specifications and improvement of the manipulations, thanks to a better knowledge of anatomy, pain management, neuropsychology and movement science. He thinks, with advances in artificial intelligence and robotics, the efficiency and safety of techniques will increase further. Thus, thanks to their specificity and adaptability to each patient, these manual techniques will always be actual to treat movement disorders.

Many doctors have presented, throughout this congress, suggested manipulations in specific clinical cases, using certain impulses, myofascial points (Trigger point), stretching, mobilizations, stabilisation techniques … These techniques are adapted by a specialist doctor to each patient.

Acupuncture in the treatment of pain

Prof. Dr. med. Konrad Streitberger, who practices at the University Hospital in Bern, points out that acupuncture may help reduce pain. However, is it thanks to a specific effect or only a placebo effect? The placebo effect stems from the patient’s belief in the treatment’s effectiveness, which triggers the activation of certain areas of the brain, the secretion of neurotransmitters, and thus a real improvement of the symptoms. Prof. Dr. med. Streitberger points out that acupuncture may have a greater placebo effect than taking medication, but studies show that stimulation of specific acupuncture points produces a higher specific effect. These characteristic points (on the body, ear, hand, skull …) come from traditional Chinese medicine, used since the 11th century BC. The positive effects of acupuncture have been proven on knee osteoarthritis, with a much greater effect than analgesics, on back pain (compared to analgesics + physiotherapy), migraines, shoulder pain … So, while mixing specific effect and placebo effect, acupuncture can be beneficial no matter what type of pain!

Pilates for a healthy back

Alexander Bohlander, physiotherapist, naturopath and osteopath in Germany (Cologne, Polestar clinic) presented the principles of Pilates, created by Joseph (Joe) Hubertus Pilates in the early XXth. Guided by a qualified person, the Pilates helps relieve chronic back pain, mobilise the body properly and have a healthy posture, while connecting the body and mind.

Breathing: The movement favours the breathing and conversely, thus breathing occupies an important place in this practice. A costo-lateral (thoracic) breathing is often favoured according to a well-defined technique synchronised to the movements, which facilitates and improves them.

Centring: Our trunk forms a supporting cylinder, the “Pilates Powerhouse”, where many muscles (diaphragm, abdominal strap, para vertebral muscles, pelvic floor muscles…) can couple their forces. Pilates aims to strengthen and stabilise this center. By focusing on extension, alignment, decompression and trunk control before starting movement, the centre is better maintained and limbs can move more freely, controlled and safe.

Control, fluidity, precision and concentration: The integration of movements in their entirety is essential. Control allows motor learning and enhancement of coordination skills. Thus, nothing is left to chance, which avoids the risk of injury. The movement distribution on several segments of the column makes possible to distribute the force and to improve the sports performances. The head’s position, neck and shoulders must be effective, stable and suitable for movement, as well as the direction and alignment of the limbs. The transitions are fluid and relaxed, without rupturing the joints, and the exercises aim to be slow, gentle, precise and applied. To make work all that must work, and only what must work, advocating a great muscular independence. This improvement can be achieved through a great concentration, where the mind focuses and guides each movement. The body is conditioned and these movements become functional, allowing their transfer in everyday life.

Dr. Bohlander points out that there are different phases in the rehabilitation of chronic back pain: 1- pain control, 2- learning of non-harmful movements, 3- proprioception and kinetic training, 4- boundary setting and analysis. Using Pilates in this intervention allows a physiological, structural, functional, environmental, social, personal and psychological improvement of the patient.

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All presentations can be viewed at https://www.samm.ch/en/samm-kongress/praesentationen.html

 

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