Manual medicine: one of a kind

medicina manuale

The Manual of Medicine belongs to the family of alternative medicines, or that group of therapeutic and diagnostic practices are not placed in the context of conventional medicine, since they are characterized by unconventional methods.

Unlike other therapies, however, the Manual of Medicine is also allowed among the generally verified methods, which represents a unique one in this category.

It was impossible not to take into account, in fact, the empirical evidence and optimal results obtained for the treatment of pain syndromes of the locomotor system.

Manual of Medicine and historical notes

Manual medicine is, therefore, considered an integral part of conventional medicine, or medical treatments practiced by professionals in healthcare.
The first coding of the manipulation techniques went up to H. Ling, the Swedish inventor of gymnastics and master of weapons from which he then redefined specific types of therapies used for the resolution of various evils.

The lawyer, however, modern manipulative therapy was AT However, an American doctor who pioneered a series of manipulative techniques of the spine and was convinced, first of all, that the well-known medicine until now was unable to address the real need for resolution of the disease.

Precisely for this reason he became the founder of a new medical-philosophical doctrine that he called osteopathy in which he identified the osteopathic lesion as the cause of the loss of defenses and immunity organs, making them powerless against the disease.

The manual therapy in Europe took place during the twenties through the work of JB Mennel in England, while his successor, J. Ciriax, was able to develop a therapeutic system for limb injuries based on manipulations, infiltration , deep massage (orthopedic medicine).

But it was around 1960 that, thanks to Maigne, it was possible to transform Manual Medicine into a well-established and well-recognized international science.

Rejecting the existence of vertebral subluxations and blocks, Maigne saw a specific clinical syndrome defined Invertebrale Minor Noise (DIM), the disorder compared to a mini-chronic distortion of the spine and tried to codify a direct semiotics to detect the vertebral segment pathological and depending on the provocation of pain as a diagnostic test.

Spinal manipulation before, during and after the treatment

The manipulation, in fact, is a therapeutic medical gesture and as such must previously define the patient’s condition through an anamnestic and general objective examination, based on certain semiological compound elements:

    1. general diagnosis in a way that prevents major injuries such as inflammatory and / or macro traumatic that may initially manifest only with the signals of a DIM.
    2. Local diagnosis to understand the type of manipulation to be carried out and the medical indication, according to general and local reasons, such as age and general condition
    3. Diagnosis of technical indication, that is, if Maigne’s non-pain rule and the opposite movement is really applicable. If this is not possible, the maneuver could not be executed.


After the initial in-depth study and the part and / or discomfort in which to intervene, real therapy can begin.
In general, the treatment of manual medicine is carried out in three stages:

      1. The start-up of the patient and the position of the operator. Not only does the patient need to take an adequate position in such a way as to facilitate maneuvers, but also the operator in such a way as not to cause possible harm to the client / patient.
      2. The tensioning. Having identified the segment to be treated, this is passively mobilized by the operator until a resistance is encountered. It is precisely in this resistance that the operator will have to insist without going back.
      3. From the tensioning part, the movement ends with a brief impulse, a fast and very limited movement that gains in joint resistance and will have to cease immediately not to determine a dislocation of the joint.

Manual medicine and the classification of manipulations

The handling can be classified as:

        • Direct manipulations, performed by direct pressure on transverse and spine vertebral bone eminences
        • Indirect manipulations, made with natural levers formed by head, shoulders and limbs through which the pinion can be moved
        • Semi-indirect manipulations,
          the manipulations carried out with two points of support are divided into:
        • Assisted manipulations also use the lever arm beyond the spine and are generally the most powerful;
        • contrariety manipulations that restrict the main movement and allow it to protect the loin portion above or below the level at which the maneuver is carried out.

Manual medicine and pain location

When we feel pain it is very difficult to explain to the doctor the exact area in which we feel the discomfort: this is because the intervertebral disorder can generate local disorders, pain and / or even the motors in the areas corresponding to the root of the spinal nerve, the so-called referred pain.
The referred pain or cellular periosteal myalgia syndrome is, in other words, the pain perceived in other parts of its point of origin in the absence of nerve pathways in the skin and the periosteum where it can be easily detected muscle contractions captabili through the palpation

Through the vertebral physiology, the doctor can easily understand where the pain is generated. To do this, you must consider two important elements:

        1. The movement of a disturbed mobile segment (DIM) is not always similar to the corresponding physiological movement;
        2. The use of semi-indirect or assisted contrariety technique allows you to locate with great precision the handling, without being linked to the initial position, except those related to the “Rule of no pain”: that is, to the freedom to use making it more suitable for the semiological finding.

Manual medication for which malevolence is indicated

In this blog, we have often talked about the manipulation of vertebrae and the resolution of diseases through them.
Manual medicine is the mother of vertebral manipulations and, for this same reason, this practice adapts to the symptoms listed in the previous articles, such as:

          • Headache originating in the cervix;
          • Cervical and cervical brachialgia possible with pain referred to trapezius, scapula, shoulder, epicondyle, carpal tunnel;
          • Dorsalgias of cervical origin, of thoracic origin and of cost-vertebral origin;
          • Low lumbar, inferior cruralgia and sciatic disorders of low lumbar and lower thorax;
          • Coccigodinie

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