Manual Therapy in the Management of Lumbar Discopathies - Hybrid: Webinar (theory)

Mario Luis González, MSc -Eur Ost DO (Belgium-Spain), a well known European specialist in lumbar discopathy management, teaching his knoweldges and manipulative skills in Europe and South America,  invites you to enroll in this exclusive and exciting Hybrid course that he will give in two parts: Theory (webinar, 2-day Nov. 5-6 2022), Practice (onsite 3-day, Jan 6-8 2023). Course will be given in French with English translation.

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 therapist.

The high incidence of herniated discs and the growing demand for a conservative treatment avoiding surgery, invites the patient to come to osteopathic consultations.

These pathologies are the local consequence of a series of alterations in the global physiological patterns.

The management of disc pathology and its multiple variants requires the therapist to previously establish a critical and precise differential diagnosis.

This is why we present this 24-hour theoretical and practical postgraduate course.

We will cover in a practical way fundamental concepts of physiology, biomechanics of the pelvis and vertebral and disc kinematics directly in relation to the different lesional presentations.

Understanding this concept leads us to conservatively manage this pathology based on the integration of multiple assessment and therapeutic strategies in coherence with clinical evidence and diagnostic imaging.

We will review fundamental knowledge to build a personalised approach in the three planes of space and depending on the patient's characteristics and imbalances.

We will acquire specific manual skills to improve accuracy, specificity and localisation when addressing disc and neuropathic symptomatology.

This course provides an integrative framework for the management and treatment of lumbar disc disorder and its consequences through the use of specific manual tools as well as the use of non-invasive superficial flexion-distraction or neuromodulation.

We will develop classical approaches adapted to this problem such as specific techniques by typology, myofacial approaches in relation to dysfunctional synergies, adapted visceral techniques, chiropractic block methods, semi-direct hvla techniques and their reabsorption modalities, etc.

An essential point is the correct evaluation of the symptomatology and adapted therapeutic management.

The programme of this course will include a total of 25 hours of teaching, during which a manual clinical reasoning of the lumbar disc pathology will be developed and appropriate manipulative techniques will be shown.

We are waiting for you!

This course is designed for osteopaths, physiotherapists, chiropractors

TOTAL CEUs EARNED at the end of the course (theroy+practice): 2 CEUs (21h) with a certificate issued at the end of the course (theory + practice).

Note: language will be French with English translation.

- Theorical (webinar: 2 days. 5h/day. Nov. 5-6. 2022).

Use Coupon Code: OsteoDH2022 before Oct. 10. to receive 15% reduction!

- Practice (onsite: 3 days. 8h/day. Jan. 6-8. 2023). The program is further detailed (See "Our Courses").

SKILLS THAT WILL BE ACQUIRED

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

Theorical introduction

• Refresh knowledge regarding the physiology and biomechanics of the lumbar spine and pelvis.
• Understand the physiological processes leading to disc deterioration.
• To enable the correct performance of clinical tests for the establishment of a differential diagnosis.
• Visualise and understand the symptomatology, multiple mechanisms, aetiology and types of disc degeneration.
• Identify the most important red flags.
• Approach the different postural and myofascial typologies to understand their relevance in dysfunctional processes.
• To recognise by images the types of degenerative processes.
• Introduce an orderly system of three-dimensional assessment that allows you to highlight the load zone, segmental hypo and/or hyperfunctions.
• Recognise the biomechanical, spinal and supraspinal effects that best explain the effects of manipulation.
• To have control and specificity in performing HVLA manipulation techniques on the lumbar spine.
• To integrate myotensive and myofascial treatment methods for dysfunctions in correlation with disc pathology.
• To remember the surgical possibilities if necessary.
• Approach an osteopathic consultation with an acute or sub-acute patient with confidence.

Covers:

ONLINE PART (2 x 5 Hours)

POINTS TO BE ADDRESSED IN THE ONLINE COURSE

1. introduction

• Epidemiology
• Basic differential diagnosis
• Evidence-based clinical assessment of the lumbar spine
• Biopsychosocial assessment
• Sensitisation phenomenon
• Disc immune response and neuropathy
• Physiological inflammatory reaction
• Spontaneous regression of herniations
• Effect of herniations on neural roots and radiculopathy
• Influence and relationship of posture on disc pathology

2. The intervertebral disc

• Macroscopic and microscopic structure of the healthy disc
• Irrigation and innervation of the disc
• Physiological characteristics of the disc
• Pathophysiology of the disc and its modifications
• Relationship of the disc to the neural roots
• Discogenic pain and its difference with other nociceptive, referred and projected pain

3. Clinical physiology and biomechanics of the lumbar spine and pelvis

• Basic concepts of biomechanics as applied to the lumbar spine
• Physiological ranges of motion and lumbosacral segmental patterns
• Static and dynamic sagittal rhythms and load distribution
• Lumbar spine and motor control
• Dysfunctional models in osteopathy, how to understand them in relation to current knowledge in biomechanics

4. Lumbar and disc mechanics

• Biomechanics and disc kinematics
• Spinal and pelvic kinematics and biomechanics and impact on the disc
• Impact of movement on disc mobility
• Lumbar spine and motor control

5. Disc injury and degeneration

• Aetiologies
• Pathophysiology of lumbar disc degeneration
• Effect of compressive forces on the intervertebral disc
• Degeneration and ageing.
• Types and updated nomenclature of disc disorders

6. Influence of posture and typology on disc disease

• Presentation of the different typologies involved with the vertebral axis.
• The balance of the myofascial synergic chains and their relationship with disc pathology
• Introduction to the treatment strategy in the different typologies

7. Interpretation of current clinical guidelines on lumbar and disc pathology

8. Introduction to the practical part of the course, with a focus on the Polymodality of the treatment

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.