The two basic principles of diagnosis (both developed by Cyriax) are that:
- Referred pain is common. This occurs when the brain (which receives and interprets pain signals) is unable to identify the exact location of the problem. As a result, the pain associated with a specific disorder is often not centred on the cause.However, referred pain still obeys certain, clearly defined rules. If these are understood (typically by a person skilled in orthopaedic medicine) an accurate diagnosis is still possible. Referred pain is extremely important during the diagnosis of spinal disorders.
- If the soft tissues associated with the musculoskeletal system (e.g. muscles, ligaments, joint capsules, bursae) are damaged, the patient will experience pain, whether it is referred or not. The pain itself may be intermittent, but if the tissue is pulled (that is, put under tension) the pain can be reproduced.The different types of soft tissue produce pain in response to different types of tension and they do so reliably, allowing an accurate diagnosis to be made. This system of diagnosis is known as ‘Examination by Selective Tissue Tension’.
Once the damaged structure has been correctly identified, the treatment is targeted, specifically at that structure. This is important, because the underlying cause of the problem is treated. As a result, not only are the symptoms addressed (such as pain and stiffness), they are also far less likely to return.
Orthopaedic medicine encompasses several treatments. However, with respect to back pain, mobilisation (which is notably different from osteopathic and/or chiropractic manipulation) is by far the most effective. It is also extremely safe and widely applicable: up to 98% of all spinal conditions will respond favourably to this technique.
Mobilisation works by restoring the passive mobility of the spinal joints. This is done via carefully applied pressure and/or oscillatory movement.
However, the mobilisation that is applied to each region of the spine is subtly different.
For example, when applied to the lumbar region, the procedure involves a small oscillatory movement, combined with some distraction (rotation and manual traction).
However, when applied to the cervical spine, pressure and distraction are applied separately.
Joints in the human body normally move in response to active, muscle contraction. This is referred to as active mobility; however, they can also be moved by an external force, for example by a practitioner using physical procedures. This is referred to as passive mobility.In theory, if a patient were trained in orthopaedic medicine, they could mobilise some of their own joints; however, due to its location, it is physically impossible for anyone to mobilise their own spine [without the intervention of the Backrack™].
All aspects of the treatment can be focussed very precisely, and safely, on individual joints and soft tissue. Furthermore, the exact level of force is carefully selected by the practitioner, depending on the nature and severity of the patient’s condition (and the extent to which the patient has improved in previous sessions).
There are no sudden, violent movements. Contrast this, for example, with osteopathic and/or chiropractic manipulations. In relative terms, these are violent, clumsy and poorly targeted.