An Introduction to Medical Manipulation

1 General Considerations.- Orthopaedic neurology 1 - how manipulation works.- Orthopaedic neurology 2 - a review of current ideas relating to manipulation.- Spinal mobility and its relevance to manipulation.- Incidence and aetiology of low back pain in general terms.- Referred pain, referred tenderness and back pain syndromes.- Trigger points.- Some psychological aspects of vertebral pain.- Indications, contraindications and dangers.- Clinical history and data recording.- Local examination.- Conventional radiology.- Posture and prophylaxis.- Spondylolisthesis and spinal stenosis.- Rheumatology and orthopaedics.- Lay manipulators.- Drug treatment of musculoskeletal problems.- Collars and corsets.- Traction.- Exercise and exercises.- Vertebral injections.- Electro-acupuncture and transcutaneous electrical nerve stimulation.- Rhizotomy and rhizolysis.- Sclerosant therapy.- Assessment of results and the associated difficulties.- The British Association of Manipulative Medicine, the International Federation of Manual Medicine, the British League Against Rheumatism and the Back Pain Association.- Conclusion.- 2 The cervical spine.- Functional anatomy.- Symptomatology.- Brachial and thoracic radiation.- Examination.- Conventional radiology.- Injections.- 3 The thoracic spine.- Functional anatomy.- Symptomatology.- Examination.- Conventional radiology.- Injections.- 4 The lumbar spine.- Functional anatomy.- A classification of low back pain.- Examination.- Conventional radiology.- Lumbar injections.- The pelvis.- The intervertebral disc.- 5 Peripheral joints.- The shoulder.- The elbow, wrist and hand.- The hip.- The knee and ankle.- The foot.- 6 Anatomical illustrations.- The mobile segment.- Cervical ligaments - C0-1-2 - sagittal view.- The vertebral artery.- 7Diagnostic techniques.- Apparent difference in leg length.- Skin drag.- Posterior skin rolling.- Anterior skin rolling.- Lateral spinous process pressure test.- Springing.- Muscle tone test.- Zygoapophyseal tenderness.- The bellpush sign of Maigne.- 8 Manipulative techniques.- Upper cervical rotation - supine.- Lower cervical rotation - supine.- Upper cervical rotation in traction - sitting 1.- Upper cervical rotation in traction - sitting 2.- Lower cervical rotation - sitting.- Cervical side-bending.- Prone cervical rotation - chin pivot.- Lower cervical rotation - prone.- Sternal thrust - standing.- Sternal thrust - sitting.- Sternal thrust - supine.- Crossed pisiform thrust - 1.- Crossed pisiform thrust - 2.- Knee in back.- Spinous process rotation.- Thoracic rotation - sitting.- Lumbar rotation.- Lumbosacral - prone 1.- Lumbar rotation - sitting.- Lumbar extension - sitting.- Lumbosacral forward thrust.- Lumbosacral longitudinal thrust.- Lumbosacral - prone 2.- Million dollar roll.- 9 Injections.- Occipital injections.- Cervical apophyseal injections.- Thoracic apophyseal joint injections.- Lumbar apophyseal injections.- Caudal epidural anaesthesia.- 10 Back exercises.- Lying exercise.- Standing exercise.- 11 Domiciliary traction.- Cervical autosuspension.- Lumbar autosuspension.- References.