Reflex-segmental massage for osteochondrosis of the spine

They always start with the development of paravertebral zones, first they massage the caudal zones and only then eliminate the changes in the cranial zones. After the development of segmental roots, the zones from the periphery to the spine are massaged, and the extremities from the distal to the proximal parts.

The procedure starts with a massage of the back muscles and consistently follows the following techniques:

• offsets;
• tension;
• massage around the scapula;
• massage of the supra- and subacute muscles;
• vibration of the back muscles.

[1], [2]

Massage around the scapula

The starting position of the patient is sitting or lying down. The left hand of the masseur is located on the right shoulder of the patient. The right hand is inserted under the angle of the scapula. In this case, a handful of the latissimus muscle (at the point of attachment) should be taken with the fingers of the hand and a massing movement is performed with a slight displacement and tension of the skin in the lateral direction (along the lateral edge of the scapula to its lower corner). Then the thumb and forefinger grasp the lower angle of the scapula, with vigorous movement raise the angle of the scapula and massage at the lower corner of the scapula. Raise the angle of the scapula is recommended with your left hand. With the thumb of the right hand, the final grinding along the medial edge of the scapula to the level of the shoulders is carried out, then they proceed to grinding with a shift of the skin and kneading the portion of the trapezius muscle (to the occipital region).

Massage of supra- and subacute muscles

The patient's starting position is sitting and lying down. The hands of the masseur are located on the muscles, massage movements can be performed with one or two hands, simultaneously or alternately. It is recommended and this method: II-IV fingers of the masseur hand, reinforced with the other hand (dosed resistance), perform small circular displacements of the skin from the lateral parts to the medial.

Massage of the anterior and lateral surface of the chest and shoulder

Massage of the sternum. The masseur is behind the patient who sits on the edge of the couch or chair (without back). The fingers of the massage therapist (II-IV) are densely located in the area of the xiphoid process, several stretch the skin in the cranial direction to a certain tension and then massage the sternum region (up to its handle) by rubbing with oppositely directed movements. Then the fingers are placed at the lower edge of the sternum: from each intercostal space, rubbing is carried out with the dosage pressure towards the edge of the sternum. Finish procedure with light stroking movements of the sternum area.

Massage of muscles surrounding the shoulder joint

The starting position of the patient lying down, the arm is maximally set aside and held by the assistant (the muscles are relaxed). The masseur places his thumbs along the inner edge of the axillary fossa, the remaining fingers grasp the muscles from the outside and perform stroking, kneading and stretching.

Massage of intercostal spaces

The patient's starting position is sitting. The masseur is behind him. Starting from the sternum to the spine in the intercostal spaces, rubbing in small circles and stroking; With increased muscle tone, vibration with low pressure is additionally possible. In order to be able to massage in the distal and proximal intercostal spaces, the pads of the fingers shift the large pectoral muscle from the shoulder. During the massage, the brush slides from the front surface of the chest to the armpit. Intercostal spaces located under the shoulder blades are recommended to be massaged with a "scapular technique".

Massage of the muscles of the forearm

The patient's starting position is sitting, lying down. Used mainly tricks in the form of rubbing with a shift of the skin and kneading in small circular motions with vibration.

Methodical instructions

1. Massage is performed in the patient's position - while lying and sitting. When lying, the patient relaxes, lies on his stomach, hands along the trunk, his head is turned to the side. When sitting, the patient sits on the stool with his back to the masseur, hands on the couch.
2. Massage begins with the development of the paravertebral zones, as this reduces the peripheral reflex changes.
3. First, the caudal zones are massaged and only then the changes in the higher segments are eliminated (massage of the surface tissues with the transition to the deeply located ones).
4. After the development of segmental roots, the zones from the periphery to the spine are massaged, the extremities from the distal to the proximal parts.
5. It is recommended to consider individual dosing during the massage, i.e. The adequacy of the dose of the massage effect of the patient's reactivity during the exposure and significance of certain reflex manifestations of the disease.
6. The dosage of exposure is determined by:
   • general reaction of the patient (strengthening of subjective disorders is a sign of irrationally performed segmental massage);
   • vascular reaction of the skin (excessive skin reaction and hyperalgesia indicates overdose);
   • painful sensations. Massage techniques should not cause pain;
   • in the acute course of the disease, small doses of exposure are used, in case of chronic - significant;
   • in muscle hypertension and superficial hyperalgesia, nonintensive effects are recommended; with muscular atrophy and hypotension - intense exposure;
   • the intensity of pressure should increase from the surface to the depth of the tissues and, conversely, decrease from the caudal-lateral to the cranial-medial sites; The intensity should be gradually increased from procedure to procedure;
   • duration of massage on average is 20 minutes; in elderly patients it is necessary to carry out a more prolonged massage, since the rate of reactions of the nervous and vascular systems is reduced;
   • massage is carried out 2-3 times a week. Segmental massage should be stopped when all reflex manifestations are eliminated.