Reflex segmental massage for spinal osteochondrosis

Always start with working on the paravertebral zones, first massaging the caudal zones and only then eliminating the changes in the cranial ones. After working on the segmental roots, massage the zones located from the periphery to the spine, the limbs - from the distal to the proximal sections.

The procedure begins with a massage of the back muscles and the following techniques are performed sequentially:

• displacements;
• tension;
• massage around the shoulder blade;
• massage of the supraspinatus and infraspinatus muscles;
• vibration of the back muscles.

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Massage around the shoulder blade

The initial position of the patient is sitting or lying down. The left hand of the massage therapist is placed on the patient's right shoulder. The right hand is brought under the angle of the scapula, while the II-IV fingers of the hand should grasp a portion of the latissimus dorsi muscle (at the place of its attachment) and a massaging 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 angle). Then, with the thumb and index finger, grasp the lower angle of the scapula, vigorously lift the angle of the scapula and massage at the lower angle of the scapula. It is recommended to lift the angle of the scapula with the left hand. With the thumb of the right hand, perform the final rubbing along the medial edge of the scapula to shoulder level, then move on to rubbing with skin displacement and kneading a portion of the trapezius muscle (to the occipital region).

Massage of the supraspinatus and infraspinatus muscles

The initial position of the patient is sitting and lying. The masseur's hands are placed on the muscles, massage movements can be performed with one or both hands, simultaneously or alternately. The following technique is also recommended: the II-IV fingers of the masseur's hand, reinforced by the other hand (dosed resistance), perform small circular displacements of the skin from the lateral sections to the medial ones.

Massage of the front and side surfaces of the chest and shoulder

Massage of the sternum. The masseur stands behind the patient, who sits on the edge of the couch or chair (without a back). The masseur's fingers (II-IV) are tightly positioned in the area of the xiphoid process, slightly pull the skin in the cranial direction until it is somewhat tense and then massage the area of the sternum (to its handle) using the rubbing technique 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 metered pressure in the direction of the edge of the sternum. The procedure is completed with light stroking movements of the sternum area.

Massage of the muscles surrounding the shoulder joint

The initial position of the patient is lying down, the arm is maximally extended to the side and held by the assistant (muscles are relaxed). The masseur places the thumbs along the inner edge of the armpit, the remaining fingers grasp the muscles from the outside and perform stroking, kneading and stretching.

Massage of intercostal spaces

The patient's initial position is sitting. The masseur is behind him. Starting from the sternum to the spine, small circles of friction and stroking are performed in the intercostal spaces; with increased muscle tone, vibration with weak pressure is additionally possible. In order to be able to massage the distal and proximal intercostal spaces, the pectoralis major muscle is moved away from the shoulder with the fingertips. During the massage, the hand slides from the anterior surface of the chest to the armpit. It is recommended to massage the intercostal spaces located under the shoulder blades using the "subscapular technique".

Massage of the muscles of the forearm

The initial position of the patient is sitting or lying down. The techniques used are mainly rubbing with skin displacement and kneading with small circular movements with vibration.

Methodological instructions

1. The massage is performed in the patient's position - lying and sitting. In the lying position, the patient, relaxed, lies on his stomach, arms along the body, head turned to the side. In the sitting position, the patient sits on a stool with his back to the massage therapist, hands placed on the couch.
2. The massage begins with working on the paravertebral zones, as this achieves a reduction in peripheral reflex changes.
3. First, the caudal zones are massaged and only then are changes in the higher segments eliminated (massage of superficial tissues and moving on to deeply located ones).
4. After working through the segmental roots, massage the zones located from the periphery to the spine, and the limbs - from the distal to the proximal sections.
5. It is recommended to take into account individual dosing when performing massage, i.e. the adequacy of the massage dose to the patient's reactivity during the massage and the significance of individual reflex manifestations of the disease.
6. The dosage of the effect is determined by:
   • the general reaction of the patient (an increase in subjective disorders is a sign of irrational segmental massage);
   • vascular skin reaction (excessive skin reaction and hyperalgesia indicate an overdose);
   • painful sensations. Massage techniques should not cause pain;
   • in the acute course of the disease, small doses of exposure are used, in chronic cases - large doses;
   • in case of muscle hypertonus and superficial hyperalgesia, low-intensity effects are recommended; in case of muscle atrophy and hypotonia, intense effects are recommended;
   • the intensity of pressure should increase from the surface to the depth of the tissue and, conversely, decrease from the caudal-lateral to the cranial-medial areas; the intensity should be gradually increased from procedure to procedure;
   • the average duration of the massage is 20 minutes; in elderly patients, a longer massage is necessary, since the reaction speed of the nervous and vascular systems is reduced;
   • The massage is performed 2-3 times a week. Segmental massage should be stopped when all reflex manifestations are eliminated.