Manual Manipulative Management in Lumbar Discopathy - Onsite New Date!!.

Mario Luis González, MSc -Eur Ost DO (Belgium-Spain), invites you to this exclusive and exciting onsite 3-day practice course that has been re-scheduled in June 23-25, 2023. Location Truro, Legge Clinic, NS

OBJECTIVES, PURPOSE, RELEVANCE FOR THE PUBLIC TO WHICH THE COURSE IS REFLECTED

Low back pain and neuropathy of disc origin are pathologies of great recurrence in all medical, physiotherapy and osteopathic consultations.

Among the wide range of therapies available for this condition, osteopathy and its different models have proven to be clinically effective and can be an initial and long-term alternative to surgery.

This requires the therapist to be highly specialised in the specific diagnostic models and treatment strategies.

Being effective while being aware of contraindications when treating different types of low back pain is a major challenge.

Specific lumbar and disc biomechanics and kinematics, disc pathophysiology, and assessment strategies in the three planes of space will be described in order to tailor treatment according to local or global causal patterns.

We will summarise the different types of pain and briefly review the basic clinical reasoning for low back pain in order to rule out non-disc conditions that may confuse the practitioner.

In this module, we will focus on myofascial alterations in static and dynamic sagittal balance and present different work modalities, with specific HVLA, distraction and disc resorption techniques as well as myofascial, myotensive and visceral techniques.

The programme of this course will include a total of 25 hours of teaching, during which an osteopathic clinical reasoning of the lumbar disc pathology will be developed.

TOTAL CEUs EARNED: 21h

Note: language will be French with English translation.

SKILLS THAT WILL BE ACQUIRED

At the end of the course the participant will be able to:

THEORY

• To update knowledge in relation to the physiology and biomechanics of the lumbar spine and pelvis.
• To understand the physiological processes that lead to disc deterioration.
• To enable the correct performance of clinical tests for the establishment of a differential diagnosis.
• To integrate and recognize the various types of degenerative processes and their visualization by images.
• To visualize and understand the symptomatology, the multiple mechanisms, the etiology and the types of disc degeneration.
• Identification of Red Flags
• Integrate the various postural and myofascial typologies and understand their osteopathic contributions to the degenerative processes
• Recognize the biomechanical, spinal and supra-spinal effects that best explain the effects of the manipulations.

PRACTICE

• Set up a simple and reproducible test plan and protocol
• Manual localisation of the floors and segments of functional surgarges in the three planes of space
• Establish a strategy of local and/or global osteopathic treatment according to the etiology
• Integrate new and different evaluation tools in the pain processes of disc origin.
• To visit the classical approaches in a perspective centered on the refunctionalization of the vertebral axis.
• To Afinner and reconceptualize the techniques of HVLA manipulations of the lumbar spine, giving importance to the correct focus of the gesture.
• To approach an osteopathic consultation with an acute or sub-acute patient with tranquillity and security.
• To know the medical and surgical possibilities if necessary.

Day 1 (8 hours: from 9 am to 11 am; from 11:15 am to 1 pm; from 2 pm to 4 pm; from 4:15 pm to 6:30 pm).

Introduction

The intervertebral disc

Clinical physiology and biomechanics of the lumbar spine and pelvis

Lumbar and disc mechanics

Disc injury and degeneration

Influence of posture and typology on disc disease

Interpretation of current clinical guidelines on lumbar and disc pathology.

Three-dimensional test plan and protocol in an orderly, simple and reproducible manner.

Specific analysis of posture and myofascial synergies.

Specific manual localisation of the vertebral segments in dysfunction in the three planes of space.

Specific functional examination of the elements of the pelvic girdle.

Final considerations and summary of the day

Day 2 (8 hours: from 9 am to 11 am; from 11:15 am to 1 pm; from 2 pm to 4 pm; from 4:15 pm to 6:00 pm)

Assessment of the respiratory pattern and its impact on pressure distribution and haemodynamics.

Functionalisation of the sacrum and sacro-iliacs

Mobilisation techniques and HVLA manipulations of the lumbar spine

Final considerations and summary of the day

Day 3 (8 hours: from 9 am to 11 am; from 11:15 am to 1 pm; from 2 pm to 4 pm; from 4:15 pm to 5:00 pm).

Neurological examination and assessment of neuropathy

Functionalisation of the coxofemoral bones

Manual axial decompression and disc reapsorption techniques

Osteopathic interpretation of imaging tests

Summary of the day

SELECTED READINGS

Licciardone JC, Schultz MJ, Amen B. Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives. J Pain Res. 2020;13:1839-1847 https://doi.org/10.2147/JPR.S183170

S Demaille-Wlodyka, M.-M Lefevre-Colau, S Poiraudeau, M Revel,

Sciatalgies et autres irradiations non discales,

EMC - Rhumatologie-Orthopédie,

Volume 1, Issue 2, 2004, Pages 117-129, ISSN 1762-4207,

https://doi.org/10.1016/j.emcrho.2003.12.004.

Sertac Kirnaz, Charisse Capadona, Taylor Wong, Jacob L. Goldberg, Branden Medary, Fabian Sommer, Lynn B. McGrath, Roger Härtl,

Fundamentals of Intervertebral Disc Degeneration,

World Neurosurgery,

Volume 157,2022,Pages 264-273,

ISSN 1878-8750,

https://doi.org/10.1016/j.wneu.2021.09.066.

Fulvio Dal Farra, Roberta Giulia Risio, Luca Vismara, Andrea Bergna,

Effectiveness of osteopathic interventions in chronic non-specific low back pain: A systematic review and meta-analysis,

Complementary Therapies in Medicine,

Volume 56,2021,102616, ISSN 0965-2299,

https://doi.org/10.1016/j.ctim.2020.102616.

Iván Cosamalón-Gan, Tatiana Cosamalón-Gan, Giancarlo Mattos-Piaggio, Vega Villar-Suárez, José García-Cosamalón, José Antonio Vega-Álvarez,

Inflammation in the intervertebral disc herniation,

Neurocirugía (English Edition),

Volume 32, Issue 1, 2021,Pages 21-35, ISSN 2529-8496,

https://doi.org/10.1016/j.neucie.2020.04.001.

Annen M, Peterson C, Leemann S, Schmid C, Anklin B, Humphreys BK. Comparison of Outcomes in MRI Confirmed Lumbar Disc Herniation Patients With and Without Modic Changes Treated With High Velocity, Low Amplitude Spinal Manipulation. J Manipulative Physiol Ther. 2016 Mar-Apr;39(3):200-9.

https://doi: 10.1016/j.jmpt.2016.02.012. Epub 2016 Apr 1. PMID: 27046146.