2020年12月18日星期五

lidocaine for hemorrhoids,Lumbar adjustment technique

    Lumbar adjustment technique

    1. The distribution of lumbar spine nerves and their symptoms: (Figure 9-1)

    L1

    Colitis, constipation, pain, diarrhea, intestinal rupture, lower abdomen pain, low back pain, waist weakness, insomnia, thumb pain, uterus, large intestine, stomach, left and right liver, small intestine, hematopoietic function of interstitial membrane, thyroid, lateral Head sphenoid pain, pulsed platelets, emphysema, radial neuralgia (prolapse of ovaries, uterus, bladder, penis, large and small intestine)

    L2

    Appendicitis, constipation, cramping pain, dyspnea, dermatitis, varicose veins, small bowel prolapse, dissatisfaction with desire, incontinence, spleen, expression of love, shoulder pain, right lock, vagus nerve (uterus, ovary, oviduct, penis , Seminiferous tube) bison dorsal, brain center, osteoporosis, sensory disturbance, ventricle, spleen

    L3

    Bladder disease, irregular menstruation, miscarriage, knee pain and weakness, left lung pain, right small intestine, peripheral nerve abnormalities, sternoclavicular nerve, snail duct disorder (hard of hearing), amenorrhea, medulla oblongata (uterus, ovary, oviduct, prostate, Bladder, penis) abnormal uterine wall, weakened bronchi, weakened large arteries of the heart, abnormal blood CO2, abnormal white blood cells

    L4 Sciatica, femoral and foot pain, cystitis, dysuria, irregular menstruation, hemorrhoids, diarrhea, torticollis, constipation, left liver, right gallbladder, loss of mind, diaphragm, chills, hypobile function, Peptic ulcer, menopausal disorders (uterus, bladder, prostate, sigmoid colon, rectum, anus), skin swelling, warts, premature aging

    L5 Poor blood circulation in the legs and feet, leg numbness, toe numbness, ankle arthritis, poor urination, sciatica, growth arrest, lower extremity swelling, left bile, right liver, mouth corner erosion, alveolar leakage, tongue spots, somatic cell atrophy, reflex Arch tension (uterus, bladder, prostate, testis, sigmoid colon, rectum) proteinuria, gonadal atrophy, premature aging, personality changes

    Second, the characteristics and source of the lumbar spine

    (1) Diagnostic method of X-ray film mapping of lumbar spine:

    Description:

    1. Draw an extension line down the back of the vertebral body L1.

    2. Draw an extension line upward along the back of the vertebral body L5.

    3. The two extension lines must intersect at point a, and draw a horizontal line at point a.

    4. Find a point B from the front end of the bottom vertebra, draw an extension line perpendicular to the back of the vertebral body L-5, and then draw upwards, so the horizontal extension line of point a and the vertical extension line of point b intersect at point c, forming A 30-degree angle is called the waist bottom angle.

    If the lumbar bottom angle is greater than 30 degrees, it means that the vertebral vertebrae are warped and the intervertebral plate is herniated.

    If the lumbar bottom angle is less than 30 degrees, it means that the lumbar spine curve is too straight.

    If the angle a is greater than 35 degrees, it means that the lumbar spine is too curved.

    If the angle a is less than 35 degrees, the lumbar spine is too straight.

    (2) The characteristics and source of the lumbar spine:

    1. The lumbar spine is the place that bears the most weight, so the pressure on the intervertebral plates of the lumbar spine is also greater. The nucleus pulposus through orange is the back pain or nerve root disease caused by the exudation of the plate crack, which is one of the characteristics of lumbar spine disease.

    2. The nucleus pulposus in the intervertebral plate will disappear if people live over 60 years old.

    3. Patients over 60 years of age suffer from ‘intervertebral disc herniation’ which is about twice the disease caused by the nucleus pulposus.

    4. Lumbar spine nerves that are often compressed or stimulated are L4, L5, S1 and S2.

    5. The displacement of the intervertebral plate has a great chance of compressing the dura mater, which will cause reflex pain in any area from the back to the ankle.

    6. When the intervertebral plate between L5-S1 is herniated, it can be involved in the nerve roots of L5 and S1.

    7. Clinical experience has recorded that more than 70% of pain comes from intervertebral plates and facet joints.

    8. The length of the two legs is not equal, and it may not be painful. In 7% of the population, the difference between the length of the two legs is 1.2 cm, so it does not need to be regarded as the source of the disease.

    9. When the intervertebral plate of the fourth lumbar vertebra is diseased, the patient's body will be tilted to one side, resulting in side deviation.

    10. Patients with low back pain caused by spasm of the Erector muscle have a forward bent posture.

    11. If the spinal cord stops at the first vertebra (L1) of the lumbar spine, there will never be spinal cord lesions below L1.

    12. The herniated intervertebral plates of T12-L1 and L1-L2 can cause groin pain.

    L4-L5 herniated intervertebral plates can cause back pain.

    The herniated intervertebral plates of L5-S1 can cause leg pain.

    13. Acute low back pain is not suitable for corrective maneuvers. Soothing maneuvers should be used more.

    14. Anesthesia will over-relax the muscles, which will lead to locking (Locking).

    4. Repeat the procedure for 5-6 times.

    (3) Rib 4 to Rib 7, and Rib 7 to Rib 12 (Rib 4-Rib7 and Rib 7-Rib) ‘tied hands’ correction technique: (Figure 8-7)

    1. The doctor uses a ‘flat hand’ on the right hand (as shown in Figure 8-7). If used together, as shown in Figure 7-17, the thoracic vertebra T4 to the corrective technique can correct the misalignment of ribs 4 to 7.

    2. If the doctor uses a ‘flat hand’ with the right hand (as shown in Figure 8-7), if combined, as shown in Figure 7-23, the thoracic vertebra T7 to the corrective technique can be used to correct the misalignment of ribs 7 to 12.

    (4) Correction technique from rib 4 to rib 7 (Rib 4-Rib 7): (Figure 8-8)

    1. The patient lies prone.

    2. The doctor stands by the bed facing the patient.

    3. The left lenticular bone presses the misaligned ribs near the spine and presses in the direction of the ribs; the right lenticular bone presses on the transverse process on the opposite side of the misaligned vertebra, and applies vertical pressure.

    4. When the patient is exhaled, apply pressure with both hands at the same time, and you can hear a "card" sound to complete the correction.

    Note: The direction in which the left bean-shaped bone applies force is best to follow the direction of the ribs.

    (5) Correction technique from rib 10 to rib 12 (Rib 10-Rib 12): (Figure 8-9)

    1. The patient lies prone.

    2. The doctor stands by the bed facing the patient. The left hand grasps the front edge of the patient's left iliac bone (Asis); the palm base of the right hand bears against the misaligned ribs.

    3. The doctor’s left hand is gradually pulled upwards and inwards to form a rotational movement. At this time, the palm of the right hand is firmly "against" the inner end of the misaligned rib (that is, the rib joint is close to the spine's cost-transverse When the rotation movement reaches the limit and the patient finishes exhaling, the right hand suddenly exerts force downward along the direction of the ribs, and you can feel a "stick" sound, and the correction is completed.

    Chapter 9: Lumbar Spine

    1. The distribution of lumbar spine nerves and their symptoms: (Figure 9-1)

    L1 Colitis, constipation, pain, diarrhea, intestinal rupture, lower abdomen pain, low back pain, waist weakness, insomnia, thumb pain, uterus, large intestine, stomach, left and right liver, small intestine, interstitial hematopoietic function, thyroid, Lateral sphenoid bone pain, pulsed platelet, emphysema, radial neuralgia (prolapse of ovary, uterus, bladder, penis, large and small intestine)

    L2 Appendicitis, constipation, cramping pain, dyspnea, dermatitis, varicose veins, small intestine prolapse, dissatisfaction, incontinence, spleen, expression of love, shoulder pain, right lock, vagus nerve (uterus, ovary, oviduct, Penis, seminiferous duct) bison dorsal, brain center, osteoporosis, sensory disturbance, ventricle veins, spleen

    L3 Bladder disease, irregular menstruation, miscarriage, knee pain and weakness, left lung pain, right small intestine, peripheral nerve abnormality, sternoclavicular nerve, snail duct disorder (hard of hearing), amenorrhea, medulla oblongata (uterus, ovary, oviduct, prostate , Bladder, penis) abnormal uterine wall, weakened bronchi, weakened large arteries of the heart, abnormal blood CO2, abnormal white blood cells

    L4 Sciatica, femoral and foot pain, cystitis, dysuria, irregular menstruation, hemorrhoids, diarrhea, torticollis, constipation, left liver, right gallbladder, loss of mind, diaphragm, chills, hypobile function, Peptic ulcer, menopausal disorders (uterus, bladder, prostate, sigmoid colon, rectum, anus), skin swelling, warts, premature aging

    L5 Poor blood circulation in the legs and feet, leg numbness, toe numbness, ankle arthritis, poor urination, sciatica, growth arrest, lower extremity swelling, left bile, right liver, mouth corner erosion, alveolar leakage, tongue spots, somatic cell atrophy, reflex Arch tension (uterus, bladder, prostate, testis, sigmoid colon, rectum) proteinuria, gonadal atrophy, premature aging, personality changes

    Second, the characteristics and source of the lumbar spine

    (1) Diagnostic method of X-ray film mapping of lumbar spine:

    Description:

    1. Draw an extension line down the back of the vertebral body L1.

    2. Draw an extension line upward along the back of the vertebral body L5.

    3. The two extension lines must intersect at point a, and draw a horizontal line at point a.

    4. Find a point B from the front end of the bottom vertebra, draw an extension line perpendicular to the back of the vertebral body L-5, and then draw upwards, so the horizontal extension line of point a and the vertical extension line of point b intersect at point c, forming A 30-degree angle is called the waist bottom angle.

    If the lumbar bottom angle is greater than 30 degrees, it means that the vertebral vertebrae are warped and the intervertebral plate is herniated.

    If the lumbar bottom angle is less than 30 degrees, it means that the lumbar spine curve is too straight.

    If the angle a is greater than 35 degrees, it means that the lumbar spine is too curved.

    If the angle a is less than 35 degrees, the lumbar spine is too straight.

    (2) The characteristics and source of the lumbar spine:

    1. The lumbar spine is the place that bears the most weight, so the pressure on the intervertebral plates of the lumbar spine is also greater. The nucleus pulposus through orange is the back pain or nerve root disease caused by the exudation of the plate crack, which is one of the characteristics of lumbar spine disease.

    2. The nucleus pulposus in the intervertebral plate will disappear if people live over 60 years old.

    3. Patients over 60 years of age suffer from ‘intervertebral disc herniation’ which is about twice the disease caused by the nucleus pulposus.

    4. Lumbar spine nerves that are often compressed or stimulated are L4, L5, S1 and S2.

    5. The displacement of the intervertebral plate has a great chance of compressing the dura mater, which will cause reflex pain in any area from the back to the ankle.

    6. When the intervertebral plate between L5-S1 is herniated, it can be involved in the nerve roots of L5 and S1.

    7. Clinical experience has recorded that more than 70% of pain comes from intervertebral plates and facet joints.

    8. The length of the two legs is not equal, and it may not be painful. In 7% of the population, the difference between the length of the two legs is 1.2 cm, so it does not need to be regarded as the source of the disease.

    9. When the intervertebral plate of the fourth lumbar vertebra is diseased, the patient's body will be tilted to one side, resulting in side deviation.

    10. Patients with low back pain caused by spasm of the Erector muscle have a forward bent posture.

    11. If the spinal cord stops at the first vertebra (L1) of the lumbar spine, there will never be spinal cord lesions below L1.

    12. The herniated intervertebral plates of T12-L1 and L1-L2 can cause groin pain.

    L4-L5 herniated intervertebral plates can cause back pain.

    The herniated intervertebral plates of L5-S1 can cause leg pain.

    13. Acute low back pain is not suitable for corrective maneuvers. Soothing maneuvers should be used more.

    14. Anesthesia will over-relax the muscles, which will lead to locking (Locking).

    3. Lumbar examination:

    (1) Check the stiffness and tension of the lumbar spine muscles: (Figure 9-2)

    1. Lying on the patient's side, put a pillow under the head, and the side to be examined on the top.

    2. The doctor pulls the hand under the patient and makes the patient's upper chest turn upward slightly.

    3. Bend the patient's knees and hips, and use the doctor's abdomen to hold the patient's knees firmly.

    4. The doctor uses the abdomen to manipulate the patient’s knees, moving towards the doctor’s left (extend back) and right (forward bending). The index finger and middle finger of the doctor's hands are pressed in the space between the spinous processes, and the tension and movement of the muscles can be felt.

    5. After checking one side, you can check the other side.

    (2) Check one of the activities of the lumbar spine (joint): (Figure 9-3)

    (Same as the steps and actions above, you can also check the joint activity).

    (3) Check the activity of the lumbar spine II: (Figure 9-4)

    1. The patient lies down, the arms are bent over the forearms, and the patient's forehead is placed on the overlapping forearms.

    2. Place the forearm of one hand under the overlapping forearm of the patient and lift the upper body of the patient upward.

    3. At the same time, the doctor's other thumb presses on the spinous process of the lumbar spine. When the patient's upper body is lifted up, the thumb can feel the movement of the lumbar joints.

    (4) Check the activity of the lumbar spine (3): (Figure 9-5)

    The patient lies prone, the doctor puts the forearm of one hand under the leg of the patient, and the thumb of the other hand presses between the spinous processes of the lumbar spine. When the legs are raised, the doctor's other pair of hands pressing the lumbar vertebrae can feel the movement of the lumbar vertebrae with their thumbs.

    Fourth, the lumbar spine relief:

    The best treatment for acute low back pain is to soothe, each soothing action can be done for 30 to 60 seconds, and repeat the right two or three times.

    Soothing is also a must-do before correction.

    (1) Direct downward pressure to relieve the spinous process: (Figure 9-6)

    1. The patient lies prone.

    2. The lenticular bone of the doctor's right hand is on the spinous process, and his left hand is pressed on the back of his right hand. Press the spinous process under the combined force of both hands for about 30-60 seconds.

    3. The spinous processes of the anterior and posterior vertebrae should be pressed several times to achieve the purpose of regional relief.

    (2) Relieving method of spinous process by pushing left and right horizontally: (Figure 9-7)

    1. The patient lies prone.

    2. The physician stands on the side of the bed, overlaps the thumbs of the left and right hands facing the patient, and pushes the spinous process on the lateral side of the spinous process for about 30 to 60 seconds.

    3. The spinous processes of the anterior and posterior vertebrae should be pushed several times to achieve the purpose of regional relief.

    (3) Stretching the leg on the non-pain side to relieve the method: (Figure 9-8)

    1. The patient lies on his back.

    2. The doctor puts a waist belt on the patient's ankle with a figure of eight, and both hands pull the patient's painless leg.

    Note: 1) If increase-stop.

    If the pain decreases-continue pulling.

    If the pain does not change-strengthen the tension.

    2) Pull both legs first, and if it is invalid, pull one leg (leg that does not hurt).

    (4) Relief method of horizontal stretching of the erector muscles (Erector muscles): (Figure 9-9)

    1. Lie on the patient's side, bend the upper leg, and place the instep on the popliteal of the lower leg.

    2. The doctor’s knee presses on the patient’s knee, causing pressure on the erector muscles.

    3. The doctor's fingers press upwards from the lower part of the lumbar spine (apply the oil to avoid hurting the skin), and repeat the upward pressure about 20 times. At the same time, the doctor uses his knees to control the patient's knees, so that the erector muscles in the middle of the patient are loosened and tightened, which increases the soothing effect.

    (5) Lifting the legs and pressing the waist to relieve the law: (Figure 9-10)

    1. The patient lies prone.

    2. The doctor's left hand lenticular bone is placed on the spinous process of the restricted vertebral body, and the right hand is held on the upper part of the patient's knee.

    3. The physician's left hand exerts continuous pressure on the spinous process, and the right hand lifts up and pulls the painful leg until the patient feels a lot of pain.

    4. Repeat this 7 to 8 times.

    (6) Soothing method of pressing shoulders and pushing hips: (Figure 9-11)

    1. Lying on the patient's side, with the painless side down, face outward, with the upper leg bent, and place the instep on the knee popliteal of the calf.

    2. The doctor's right hand gently presses and pulls the patient's upper shoulder in his direction, so that the upper body rotates to the limit, that is, the shoulder is fixed.

    3. The doctor’s left hand is pressed on the patient’s buttocks and pushed outward. At the same time, the patient’s lower leg should be straightened and hung outside the bed.

    4. The doctor fixes the patient's upper shoulder and pushes the patient's buttocks to the limit gradually.

    5. In this way, repeat 7~8 times.

    Among the six waist relaxation methods mentioned above, the (sixth) method-"shoulder pressing and hip massage" is the most effective.

    (7) Twenty methods for treatment of waist soft tissue injury:

    1. The waist-lifting style at the bottom of the item: (Figure 9-12)

    The patient sits on a high stool and bends forward as much as possible. The doctor stands behind the patient, clasps the patient’s abdomen with his hands, and puts his knees against the patient’s bottom vertebrae. When the patient is almost exhaling, the doctor lifts up with both hands forcefully .

    Effective for acute lumbar sprains and facet joint disorders.

    2. Knee-lifting type: (Figure 9-13)

    The patient lies on his back on the bed. The doctor faces the patient, bent down, and put his hands near the painful area. The assistant presses the patient's legs, and the doctor does upward and backward pulling movements for 5-6 times.

    Effective for acute waist sprain and facet joint disorders.

    3. Waist-shouldering style: (Figure 9-14)

    The patient lies prone. The doctor stands on his side, pressing one hand on the painful waist, holding the patient's shoulder with the other hand, and slowly strengthening both hands at the same time, doing 5-6 times in a row.

    It is effective for dislocation of sternocostal joint, intercostal neuralgia (commonly known as anemia), back muscle strain, thoracolumbar sprain, etc.

    4. Knee-bending and hip-shaking pose: (Figure 9-15)

    The patient lies on his back with his legs bent. The doctor stands on its side, pressing the elbows above the knees with one hand, and grasping the outside of the knees with the fingers; holding the ankle of the patient with the other hand, rotate the pelvis and waist joints 8-10 times.

    It is also effective for low back joint pain, bottom iliac joint sprain and Leiform muscle strain.

    5. Push shoulder and pull knee style: (Figure 9-16)

    The patient lies on his back with his right leg bent. The physician stands on the opposite side (ie, the patient's left side). The doctor’s right hand pushes the patient’s left shoulder; while the left hand pulls the right knee, pushing and pulling in the opposite direction to make the lumbar spine feel twisted.

    6. Pull the knee and push the ankle: (Figure 9-17)

    The patient lies on his back, and the doctor stands beside him and lifts the patient's leg straight. The physician's hand is pushed up and forward on the knee, so that the patient's leg is as far forward as possible.

    It is effective for herniated intervertebral plates, lumbar nerve root adhesion, and sciatica.

    7. Pull the knees and press the soles of the feet: (Figure 9-18)

    The patient lies on his back, the physician stands on his side, and lifts and straightens the patient's leg. The doctor pulls one hand back during the knee treatment, and the other hand presses down on the forefoot of the patient's foot. Both hands are moved at the same time, and the affected foot is swayed back and forth, about 10 to 12 times.

    Effective for sciatic nerve adhesion and muscle spasm on the front side of the leg.

    8. Push hip and leg pull style: (Figure 9-19)

    The patient lies on his side and the doctor stands behind him. The root of one palm of the doctor's hand is against the pain in the waist; the other hand holds the ankle of the patient and pulls it back. Both hands slightly increase the strength to the limit.

    Effective for herniated intervertebral plates and muscle spasms on the front of the legs.

    9. Ankle-clamping and knee-pulling style: (Figure 9-20a and 9-20b)

    1) The patient lies on his back and the doctor stands on the affected side.

    2) The doctor clamps the ankle of the affected side under the armpit, and hugs the upper part of the affected knee with both hands.

    3) Bend forward and push the affected leg close to the patient's abdomen (Figure 9-20a).

    4) Instruct the patient to straighten (knock) his leg vigorously. When the patient straightens his leg to the limit, the physician promptly clamps the patient's ankle with his armpit, hugs the patient’s upper knee with both hands, and follows the kick Direction, suddenly jerk. (Figure 9-20b)

    10. Stretching the leg and tending style: (Figure 9-21)

    The patient lies on his side with the lower leg bent and the upper leg straight. The physician faces the patient, holding the ankle of the upper leg with one hand; tapping the patient's buttocks, thighs, and calves with a soft mallet in the other. Knock and pull with both hands, pull it to the limit and relax again, do it 5-6 times in total.

    It is effective for low back pain, which is usually painful ejaculation. I especially introduce it.

    11. Clamping legs and shaking hips: (Figure 9-22)

    The patient lies down with his legs straight. The physician faces the patient, kneels near the patient’s knee, and clamps the patient’s right leg to the calf of the physician’s right leg, causing the patient’s right side to hang in the air.

    The doctor shook the patient's buttocks to relax the waist and hip muscles and the dislocation of the waist bottom.

    12. Tuck your knees back and forth: (Figure 9-23)

    The patient lies on his back, flexing his hips and knees as much as possible, and hugs his knees with his hands.

    The physician faces the patient with one hand behind the patient; the other hand is placed in front of the patient’s knee. The doctor alternately pushes the patient with both hands, causing the patient to shake back and forth.

    It is mostly used for pain in the bottom iliac joint or waist joint.

    13. Cross pull type: (Figure 9-24) Yuan

    The patient sits on the bed with his legs stretched out and pressed against the doctor's abdomen. The physician's hands are crossed; the patient's left hand is pulled with the left; the patient's right hand is pulled with the right. The doctor uses interactive hands to pull the patient's wrist to make the patient's waist rotate left and right.

    It is mostly used for waist cramps, pain in reflection to the legs, and difficulty in bending the waist.

    14. Holding face and turning waist style: (Figure 9-25)

    The patient sits on a high stool. The assistant's hands hold the patient's knees to fix the patient's lower limbs. The doctor scratches the patient's upper chest with his hands under his armpit. The physician squatted backwards, causing traction on the patient's vertebrae. When the patient's body is level with the stool surface, the doctor rotates to the painless side to the limit. Which ones can be done 2~3 times.

    It is mostly used for dislocation of facet joints and stiffness of psoas muscles.

    15. Back-to-back hip style: (Figure 9-26)

    The patient and the doctor stood back to back, the doctor's elbows hooked the patient's elbows, bent over and lifted the patient up so that the buttocks stayed on the painful area. First turn the patient up and down a few times, and then swing the patient left and right. Then ask the patient to bend his legs on the doctor's back and kick his legs up to the sky three times.

    16. Waist pressing and elastic waist style: (Figure 9-27)

    The patient lies on his back with a pillow under the chest and pelvis. One of the two assistants pulls the patient's armpits with both hands; the other pulls the patient's ankles with both hands. With the two assistants pulling each other hard at the same time, the physician's hands are vertically pressed on the painful part of the patient's waist, pressing down to the limit. Suddenly relax the pressure for a while, causing the patient's waist to spring back suddenly. Do it for two minutes.

    It is mostly used for the dislocation of the facet joints of the waist and the injury of the waist muscles.

    17. Back support waist style: (Figure 9-28a and 9-28b)

    The patient sits on the bed with two or three pillows under his hips. The doctor stands on his side, holding his chest with one hand; with the other hand against the painful waist (see Figure 9-28a), he asks the patient to lean back, with the doctor’s head behind the patient. The hand supporting the waist is fixed on the bed with the dirty part. When the patient’s recline is greater, the strength of the top waist will be greater (Figure 9-28b). The palm of the top waist must rest on the next vertebra (L5) of the displaced vertebra (such as L4 displacement). Remember!

    It is mostly used for forward spondylolisthesis.

    18. Hold the ankle and swing the hips: (such as round 9-29)

    The patient lies down, with his legs slightly raised from the knees by about 35°~45°. The doctor stands on the head of the bed in the direction of the patient's feet, holds the patient's ankles with both hands, and rotates to the left to the limit. Then rotate to the right to the limit, so that the patient's waist and hips rotate to the left and right with the doctor's hands.

    It is mostly used for disorders of lumbar joints and bottom iliac joints.

    19. Pelvic shaking method: (Figure 9-30)

    1) The patient lies on his back, with both knees bent, and a triangular pad is placed under the patient's bottom vertebra to isolate the iliac bones on both sides from the bed surface.

    2) The doctor's thumbs on both hands are placed on the front edge of the ilium on both sides, and the remaining four fingers are supporting the patient's ilium on the back.

    3) The doctor’s thumbs gradually applied force to press down on the anterior edge of the patient’s ilium.

    4) The doctor’s elbows are pressed on the inside of the patient’s thighs. When the four fingers lift the ilium inward, the elbows also press the patient’s thigh outwards and downwards to form a leverage.

    5) Repeat the downward and upward movements, about 7 to 8 times.

    20. Pushing style with big waist hug: (Figure 9-31)

    1) The patient sits on the edge of the bed with both knees hanging down from the bed. The assistant presses the patient's knees on the edge of the bed.

    2) The physician stands on the patient’s back, carries the patient’s upper shoulders, pulls the patient’s waist backwards, and then turns to the limit on the painless side, suddenly exerting force on the limit, displacing the position with the strength of the soft tissue ligaments and muscles The lumbar spine returned to position.

    Lumbar correction

    (1) Preparatory actions for lumbar correction:

    1. The patient's posture: (Figure 9-32)

    2. Physician's posture:

    1) Shoulder squeeze leg style: (Figure 9-33a and 9-33b)

    a When the patient's shoulder is pushed back to the limit, it is fixed, which is called "shoulder fixation".

    Doctor B’s thigh is squeezed on the outside of the patient’s thigh; fixing the patient’s thigh on the side of the bed is called "squeezing the leg".

    Usually used in the push correction method.

    2) Shoulder and knee pressure type: (Figure 9-34a and 9-34b)

    a. Pushing the patient's shoulder back to the limit to fix it is called "shoulder fixation".

    b. The doctor raises the leg and presses the inner side of the knee against the outer side of the patient’s knee, which is called "knee pressing".

    It is usually used in push or pull correction methods.

    3) Pushing the shoulders and legs: (Figure 9-35)

    a. The thumb and index finger of both hands pinch the spinous processes of the vertebral bodies (such as L3 and L4). The right hand makes outward and downward movements; the left hand makes inward and upward movements.

    b. Physician’s elbows, simultaneously push outwards and pull inwards.

    Physician C’s weight was placed on the patient’s armpits and buttocks and pulled the patient’s buttocks inward. At this time, the doctor's abdomen is pressed tightly on the patient's knee, making a downward pressing motion.

    Usually used in the push & pull correction method.

    Note: The height of the correction bed should be below the doctor's knee and the upper end of the fibula.

    (2) Correction of lumbar spine:

    1. Push correction technique on the inside: (Figure 9-36)

    Take the L3-L4 lumbar joint with the painful (affected) side on the right as an example:

    1) The patient's left side is on the lower side, lying on the bed, facing the physician, with the right leg bent, and the elbow and right foot on the left knee and popliteal.

    2) The physician stands by the bed and faces the patient. Touch the L3-L4 interspinous ligament with the right hand, and lift the patient's upper leg with the left hand to bend forward (in the direction of the head). When the tense muscles reach the fingers of the right hand, the patient’s leg is placed outside the bed as a ‘Lumbar locking from below’.

    3) Change the left hand to touch the interspinous ligament of L2-L3, the doctor's right hand grips the patient's left arm and pulls up to cause rotation. When the tense muscle reaches the fingers of the left hand, the rotation will stop, as'top down Locking from above down to the lumbar region.

    4) The doctor’s left lenticular bone presses on the transverse process of the L4 vertebral body; the right hand slightly pushes the patient's right (upper) shoulder backwards, and then fixes its position to the limit.

    5) After asking the patient to take three deep breaths, the doctor suddenly exerts force with his left hand (the forearm is parallel to the bed and perpendicular to the vertebral body), and the correction can be completed by hearing a "stick".

    2. Pull correction method to the side: (Figure 9-37)

    1), 2), and 3) are the same as the action of the "Inside Push Correction Manipulation" in the previous paragraph.

    4) The doctor's right hand presses the patient's right shoulder and fixes it.

    5) The middle finger of the doctor's left hand deeply buckles the spinous process of L4.

    6) The patient takes three deep breaths.

    7) The doctor's right hand is pushed toward the head and fixed; the left middle finger pulls the spinous process; the left elbow pulls the affected buttocks; at this time, both hands produce traction and press the affected knee with the legs to rotate the buttocks to the limit. At the limit, when the left hand and left elbow pull inward at the same time, you can hear a "stick" sound to complete the correction.

    3. Inside push & pull correction technique: (Figure 9-38a and 9-38b)

    Take the L3-L4 lumbar joints as an example, and the painful (affected) side is on the right side.

    1), 2), 3) Same as the previous "Inside Push Correction Manipulation" action.

    4) The physician's right forearm passes under the patient's right armpit; the right elbow is pressed on the patient's right shoulder; and the right thumb is placed on the upper (right) side of the L3 spinous process.

    5) The doctor's left thumb and middle and index fingers pinch the spinous process of L4.

    6) After asking the patient to take three deep breaths, the doctor's right elbow is pushed; the left elbow is pulled to the limit, the right thumb is pushed down, and the index finger of the left hand is pulled up. When the four actions are performed at the same time, you can hear a "card" and complete the correction.

    If the strength of the left middle finger is insufficient, the index and middle finger can be overlapped to strengthen the tension. (Figure 9-38b)

    4. Sitting posture rotation correction technique: (Figure 9-39)

    1) The patient sits straddling the bench with his arms crossed in front of his chest. Put your right hand on your left shoulder; your left hand on your right shoulder.

    2) The physician stands behind the patient. Pull the patient's right arm from the left back; the root of the palm of the right hand (or bean bone) against the right transverse process of the restricted vertebral body, and the left and right hands exert force at the same time to form the limit of rotation.

    3) Tilt the patient's upper body slightly forward, that is, with a sudden force from the right hand, you can hear a "card" to complete the correction.

    This method is mostly used in low-cut or high-waist areas, and the effect is very good.

    5. Knee-shoulder pressure correction technique: (Figure 9-40)

    1) The patient lies on his back, the doctor stands on the healthy side, and the right hand fixes the patient's right shoulder on the bed without moving, and the left hand holds the affected knee so that the thigh and buttocks are at 90 degrees.

    2) The physician's left hand gradually rotates the patient's thigh inward to the limit.

    3) Suddenly exert force on the limit to complete the correction (THRUST), and sometimes one or several beeps can be heard.

    6. Correction of shoulder pressing and elbow: (Figure 9-41)

    1) The patient lies on his side with the affected side on top, the affected leg is bent, the instep is placed at the height of the knee of the healthy leg, and the knee of the affected leg is placed outside the edge of the bed.

    2) The doctor's left hand first pulls the patient's right hand inward and upward to rotate the patient's upper body, and then fixes the left hand on the patient's left shoulder and pushes it slightly backward (ie outward).

    3) The doctor’s right leg presses the patient’s knee on the edge of the bed.

    4) The doctor’s right elbow is pressed on the back of the patient’s left hip, gradually exerting force inward to produce rotation to the limit.

    5) At the limit, the right elbow suddenly exerts force inward and downward, which will produce a "stuck" sound on the patient's waist to complete the correction.

    6. The relationship between abnormal lumbar vertebral nerve and cutaneous ganglia and symptoms:

    (1) Abnormalities of the first lumbar vertebral nerve (L1): supervisor: ureter, quadriceps, anterior thigh muscles

    1. Symptoms-constipation, colitis, dysentery, diarrhea, hernia, weak waist, skin diseases, loss of libido, impotence, dysuria, harp, ureter.

    2. Painful symptoms——

    1) Cutaneous ganglion reflex pain area:

    L1 intervertebral plate problems are rare, so the nerve roots are rarely compressed, and the reflex pain area is quite painful (as shown in Figure 9-42).

    2) Local pain:

    There are tender points on both sides of L1.

    3) Local reflex pain:

    Pain in the lower abdomen, back pain, tingling from the groin to the knee.

    3. Restricted movement-

    The waist is difficult to bend, and it is difficult to raise the affected leg up (knee bending) when standing.

    4. Inspection method: The patient is lying prone. Check that the muscles on both sides of the patient's T10-L3 area feel tight, stiff or tender, and the restricted joints are at L1.

    5. Soothing methods-

    6. Correction technique——

    (2) Abnormalities of the second lumbar vertebral nerve (L2): supervisor: ovary, fallopian tube, vas deferens, front of thigh

    1. Symptoms-appendicitis, constipation, varicose veins, dyspnea, physical disorders, bladder disorders, uterine bleeding, infertility, nocturia, frequent farts, ovaries, fallopian tubes, vas deferens.

    If the L1-L2 spermatozoa is abnormal, there are symptoms of the right curve of the colon.

    2. Painful symptoms——

    1) Cutaneous ganglion reflex pain area:

    a The displacement of L2 is more than that of L1, but it is still not common in clinical cases.

    b The L2 reflex area is quite painful.

    2) Local pain:

    There are tender points on both sides of L2.

    3) Local reflex pain:

    a There is a tingling sensation from the groin to the knee.

    b There is also pain on the outside and front of the thigh.

    c Lumbago or thigh pain.

    3. Restricted movement-

    1) The psoas muscle (psoas) is weak.

    2) L2 spine movement is limited.

    3) It is difficult to move the muscles of the inner thigh when the affected leg is walking.

    4. Inspection method——

    1) The patient is lying down. The doctor looks for any tension, stiffness, or tenderness in the muscles on both sides of the patient's T11-L4 area? The joint limitation is at L2 (Figure 9-43b).

    2) The patient lies on his back and performs hip flexion movements on the hips. The physician imposes resistance. If the patient is unable to fight (Figure 9-43c), there is a problem with the L2 nerve root, and this rule can also be used to measure the problem with the L3 nerve root.

    5. Soothing technique——

    6. Correction technique——

    (3) Abnormalities of the third lumbar vertebral nerve (L3): main farmers and herdsmen: uterus, bladder, outer thigh, inner calf

    1. Symptoms-bladder, irregular menstruation, miscarriage, knee pain, physical pain, cold waist and feet, knee weakness, room loss, uterus.

    2. Painful symptoms——

    1) Pain in the cutaneous ganglion reflex area:

    a L3 intervertebral plates cause more lesions, but less than L4.

    b The cutaneous ganglion reflex area, which occasionally causes severe pain due to a certain action.

    2) Local pain:

    There is often tenderness on both sides of L3 joints and tight muscles.

    3) Local reflex pain:

    a Reflex pain when lying on the knees.

    b When the leg is raised, the front area of ​​the knee will be painful.

    c There is numbness from knee to foot.

    d When the thigh expires, the inner side of the calf will also reflect pain.

    3. Restricted movement-

    1) Weakness of quadriceps and difficulty in knee extension.

    2) Weakness of the psoas muscles and difficulty in flexion of the hip.

    3) L3 spine movement is limited.

    4. Inspection method——

    1) Delayed knee reflex or no response at all.

    2) Dorsiflexion can cause pain in the thigh.

    3) Chronic pain, tense and stiff muscles can be found between T12-L5.

    4) Acute pain, bright tenderness points can be found near both sides of L3.

    5) The patient lies on his back. The physician raises the lower part of the knee with one hand, and taps the lower part of the knee with the test mallet in the other hand (as shown in Figure 9-44b). If there is no response, there is a problem with L3.

    5. Soothing technique——

    6. Correction technique——

    (4) Abnormalities of the 4th lumbar vertebral nerve (L4): supervisor: lower back, knee, lateral calf, sciatic nerve

    1. Symptoms-frequent urination, dysuria, enteritis, cystitis, irregular menstruation, prostate, penis, seminiferous ducts, hemorrhoids, thigh atrophy.

    2. Painful symptoms——

    1) Pain in the cutaneous ganglion reflex area:

    a Sciatica: From the outside of the thigh, through the upper end of the ankle, extending to the hallux, there will be numbness.

    b If the L4 intervertebral plate naturally protrudes from the inner side of the ligament, it will press against the L5 nerve root, and at the same time it will affect the two nerves, L4 and L5, and even the single S2 nerve and the single S4 nerve.

    2) Local pain:

    There is often tenderness on both sides of the L4 joints and tension muscles.

    3) Local reflex pain:

    a Low back pain, knee and popliteal pain.

    b Painful urination, physical pain.

    c The muscles above the Sacrum are swollen and painful.

    3. Restricted movement-

    1) Due to the weakness of the tibialis anterior, the dorsiflexion of the foot is blocked.

    2) The dorsiflexion of the hallucinus is blocked due to weakness of the extensor hallucis.

    3) Difficulty in extending the affected leg.

    4. Inspection method

    1) The patient lies on his back, and the stretch-leg raise (straighe-leg raise) is limited due to pain.

    2) The reflection power has no effect.

    3) Chronic pain: Tension and stiffness will be found between L1-L5.

    4) Acute pain: Ming tender points will be found near both sides of L4.

    5) The patient's foot is under the resistance of the doctor to do dorsiflexion (see Figure 9-45b). Weakness indicates abnormal L4 nerve root.

    5. Soothing technique——

    6. Correction technique——

    (5) Abnormalities of the fifth lumbar vertebral nerve (L5): supervisor: bladder, uterus, rectum and feet

    1. Symptoms-poor blood circulation in the legs and feet, leg numbness, ankle arthritis, poor urination, uremia, urine protein, easy tearing, easy sweating, gluteal muscle atrophy, toe numbness, rectum, uterus, Hong Kong feet

    2. Painful symptoms——

    1) Pain in the cutaneous ganglion reflex area:

    a Sciatica: From the outside of the thigh to the ankle, through the back of the ankle to the inside thumb.

    The bL5 interlaminar is protruding and can be compressed to the following nerve roots, or multiple (multiple) root lesions may occur:

    a) Compress the L5 nerve root or affect both L5 and S1.

    b) Compress the S1 nerve root or affect both S1 and S2.

    c) Press to the S2 nerve root.

    d) Press to the S3 nerve root.

    e) Press down to the S4 nerve root.

    Therefore, the L5 intervertebral plate has the most complicated pathology and the most chance of protrusion. Sometimes there will be numbness on the instep.

    2) Local pain: the tenderness is the most intense on both sides of the L5 joint.

    3) Local reflex pain:

    a Buttock pain, calf pain, ankle pain or tingling.

    b Naturally on the outside, there is numbness in the three toes along the inside of the foot.

    c Pain is aggravated when you lean forward.

    3. Restricted movement-

    1) The peronei muscle (peronei) is weak, and the foot eversion (eversion) is difficult to move.

    2) Weakness of gluteus medius and difficulty in abduction of the thigh.

    3) Extensor hallucis is weak, and the extension of hallucis is difficult.

    4. Inspection method——

    1) The patient lies on his back and Straight-leg raise is limited due to pain (positive reaction).

    2) The ankle response is slow or disappears.

    3) Chronic pain: The muscles in the upper half of the L3 spine (Sacrum) may be tense and tender.

    4) Acute pain: The muscles in the upper half of the bottom vertebra of L3 show obvious tenderness.

    5) The patient lies on his knees or stands on the chair, and hits the upper part of the heel with the test mallet (Figure 9-46b). If there is no response, there is a problem with L5.

    5. Soothing technique——

    6. Correction technique——

    7. Is the centerline of the two base bones, the tip of the tail vertebra and the centerline of the bottom vertebra, and the spinous process connected in a line, is it vertical? Are the bottom vertebrae, tail vertebrae, and bottom bones displaced?

    8. Is the subiliac joint (SIJ) too wide?

    9. Is the spine rotated or skewed?

    10. Is the big rotor the same height? (Figure 11)

    11. Is the entire thoracic and lumbar spine surrounded by white and formed into a banboo? To decide whether to have ankylosing arthritis? (Figure 12

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