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  • Writer's pictureAndrew Ivanchenko

Сhapter from the book "A Doctor's Notebook" (manual therapy)


Whether in a dungeon or in the limelight, Whether blissful or cursing your plight, You're just a mask the Almighty wears. To act in a comedy full of tears.

Manual therapy eliminates pain (mostly in the musculoskeletal system) with the help of special hand movements.

Manipulation with bare hands as a way of medical treatment has been known since the dawn of humanity, long before the surgical knife was invented. Now we think of it as something pretty marginal. Indeed, why bother if modern medicine is so powerful, if almost any sickness can be treated with a pill or, for that matter, with a knife?

Hold on - the Greek "chir" for hand is the root of the word "surgeon" (chirurgeon in old English) in many modern languages. Few people today realize that a surgeon was in fact called "the hand master". 

Good things are never really forgotten, though. Healing with hands made a comeback in our century as "manual therapy", a nice Latin-based name that does not remind us of painful and invasive surgery. 

What is manual therapy?

Manual therapy eliminates pain (mostly in the musculoskeletal system) with the help of special hand movements. These movements release blocked joints and relax muscular spasms, the true root source of pain, as opposed to bone spikes or inflammation.

Mechanical manipulation of a muscle spasm is the best way to treat it. Remember the age-old idiom "the healing hand?" To put it simply, manual therapy is what used to be practiced by traditional bonesetters, who have been replaced by specially trained doctors. It is something like bloodless surgery. Years ago, you had something traumatizing or displaced; now it hurts, damn it, and begs to be reset. You find a professional to fix it and get rid of your pain. That’s it.

Here’s a compelling analogy. Imagine your finger being caught in a closing door. Does it hurt? Sure, it does. Now treat it with a painkiller or physical therapy. Hypnosis also works well, they say. Or maybe it should be amputated, for the ultimate effect? Here’s a more sensible piece of advice: just try opening the door. Doesn’t it feel better now? Manual therapy is just like this: if something is pinched, squeezed, or compressed and the blood flow is obstructed, the therapy will stretch, turn, release, or whatever, and your pain will be gone for good.

What’s the difference between a manual therapist and a chiropractor?

I must tell you, it’s quite fundamental. Since the time the first person started a bone-setting practice, forcing patients’ bones to make a popping sound to relieve pain, it has been discovered that the issues involved are more complex. Popping is fine, but does it mean a long-term recovery? The risk of complications should make you think twice about the true benefits of chiropractic. 

Manual therapy is something else entirely. Officially called manual vertebrovascular medicine, it is a field of medical science at the crossroads between traumatology, neurology, orthopedics, and rehabilitation. It deals with joint and spine pain as well as the prevention of joint stiffness caused by aging. Manual therapy also helps control blood pressure, headaches, insomnia, prevent scoliosis, and much more. As incredible as it is, the source of a whole host of persistent medical conditions has been traced to muscle spasms and blocked joints. 

Manual therapy predecessors

I was born in Russia, where manual therapists learn many of their skills from chiropractic and osteopathy textbooks, and people often can’t tell the difference between the three disciplines. My move to America was an eye-opener. Here, a manual therapist is a full-fledged physician with a strong background in medical science, which he complements with elements of chiropractic, osteopathy, and other manual techniques to create his own original methodology. Moreover, this medical professional views the patient and his ailment as a complex, integrated system.

In 1958, doctors from Belgium, Great Britain, France, Germany, Switzerland, and Scandinavian countries founded the International Federation of Manual Medicine (FIMM) which held its first congress in September of 1965 in London.

A chiropractor, on the other hand, believes that all diseases stem from the herniation of nerve roots as a result of disc and/or vertebral displacement. I wish it were that simple. Yet the Russian school of vertebro-broneurology used this hypothesis as a starting point to develop a distinct theory of pathological changes in the spine and joints. This theory elicits no skeptical smiles from neurosurgeons and neuropathologists. Moreover, it produces outstanding results in the treatment of chronic pain of the musculoskeletal system as well as in the consequences of trauma and surgery.

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