Myoskeletal medicine concerns all medical disciplines
27. 4. 2017
The main aim of intervention treatment for chronic pain is to improve the patient’s health by decreasing the pain’s intensity or eliminating it. Intervention treatment involves minimally invasive procedures, most commonly monitored using ultrasound or x-ray equipment, through which it is possible to diagnose and localise the place, or source of pain and provide appropriate therapy. The essence of these techniques is influencing the nerve structures that transmit pain perception or the painful structures directly. In relation to the interconnectedness of the skeletal and neuromuscular system, in the case of pain where intervention diagnostics do not clearly prove the source or the cause of the pain is not clear, it is possible to proceed to treatment in terms of myoskeletal (manual) medicine. This approach is used to realign an imbalance and attempt to correct it after helping the patient by eliminating the pain using intervention procedures (they do not feel pain or it is significantly reduced), and thus the patient’s ability to fully or at least partially rehabilitate is restored. In the context of a comprehensive therapeutic approach to the patient, some of the techniques of manual medicine can be recommended to patients at our selected workplaces.
Myoskeletal (musculoskeletal) or manual medicine can be easily applied in all clinical areas, mainly in connection with how the structural bases of functional changes and functional musculoskeletal disorders are understood. Its name is derived from the areas of interest (myos = muscle + skelet = skeleton). Myoskeletal medicine deals with the causes, i.e. the diagnosis of disorders of the spine, muscles and joints and their subsequent treatment. They are viewed from the aspect of their malfunction. Examination methods can detect blocks, immobility or spasms (spasms) in the areas affected, which can be released with the help of manual, i.e. of mobilization and manipulation techniques, in order to remove the pain or reduce its intensity. Myoskeletal medicine differs from classical massage by the fact that it considers these functional disorders to be manifestations of the illness, not the cause. Manual medicine techniques (e.g., mobilisation, soft techniques sensorimotor stimulation, visceral manipulation, craniosacral stimulation, etc.) given an adequate diagnosis, are suitable for the treatment of some types of acute and chronic pain in the spine, degenerative diseases of the spine and joints, diseases of the peripheral joints, neck pain and injuries, headaches and migraines, during instability of the musculoskeletal system, muscle imbalance and many other indications. The aim is, primarily, to improve posture and stabilization of the trunk, improve muscle coordination and balance leading to a reduction in pain.
Muscles, bones and joints form the structure of the human body. Their functions, in relation to other body systems, are very extensive. The skeletal system is primarily a support function, which is closely linked with the muscle system. The axis of the body is the backbone – the central support element of the human body, ensuring rotational and flexing movement in various angles. Connectedness with other organs allows the muscles, bones and joints to work properly under the assumption of a number of aspects such as regular and adequate motion, which reduces the risk of diseases of the bones and joints. The muscular system relies on precise interaction between all the muscle groups allowing a diverse range of movements to be carried out, that being under the assumption of a properly functioning nervous system, which incites, controls, and coordinates muscle activity.
Muscles and tendons work on the principle of flexing and contracting. In order to return to its original state, they must relax, whilst extending them stimulates other muscles to contract. The body’s muscles are arranged in pairs, so that one muscle is always in opposition to the other muscle. The muscle that is being contracted to carry out a specific movement is referred to as the agonist. The muscle that simultaneously relaxes and stretches is called the antagonist. In practice this coordination could be likened to a system of precisely working levers. Thanks to the muscle groups contractions of skeletal muscle and tendons ensures body movement, so as to achieve a precise movement including the requisite distance and angle.
Imbalance between the muscles, the search for the causes and therapeutic intervention is the essence of myoskeletal medicine. From the anatomical standpoint, modern approaches in myoskeletal medicine emphasize the existence of trigger points, painful points that are associated with the emergence of increased tension in the muscle fibres as a result of overloading the muscle and which affect muscle function in “muscle chains” throughout the body, including mobility, be that in a joint or the spine. Trigger points are sensitive points in skeletal muscle that are characterized by acute spontaneous pain, but they can be perceived in other areas of the body as referred pain.
Injury to muscles and tendons and the pain felt from this mostly occurs as a result of increased physical exertion or sudden sharp movements, whether in normal activities, sports or accidents (the most common include muscle strain and tearing, soft tissue inflammation, tendonitis, known as tennis elbow, carpal tunnel syndrome or a torn Achilles tendon). Another group is the pain caused by unilateral repetitive or long-term static loads, extreme working positions or heavy physical work associated with handling objects during employment.
Myoskeletal medicine is concerned with not just diagnosis and therapy, but the core of its nature makes it highly preventative and significantly affects the overall lifestyle of the patient via exercise recommendations and modifying physical activity so that the problems associated with pain, do no reoccur or at least not so at the original intensity. From the historical point of view, the name “Manual Medicine” was first coined in 1965, when “La Fédération International de Medicin Manuel” was founded in London. The founder and doyenne of modern manual medicine in the Czech Republic and Slovakia was the neurologist Prof. MUDr. Karel Lewit.
Author: MUDr. Robert Tirpak, ©EuroPainClinics®