Manual medicine: assessing mobility and providing targeted treatment

Depending on where your symptoms are, we ask specifically about when they began, previous injuries and operations, and your experiences so far. Tell us if you have osteoporosis, an inflammatory condition, a known vascular condition or other relevant medical conditions. Medication, particularly blood thinners, is also part of the assessment. These details help us weigh up benefits and risks for your situation. We then examine the affected region and, where necessary, neighbouring areas. We take existing images and reports into account. Additional imaging is not automatically required before every manual treatment. It is considered when a specific medical question, an unusual course of symptoms or warning signs make it necessary. Please do not arrange a new X-ray simply because you would like manual treatment.

Mobilisation treats a joint with carefully controlled movements. Manipulation, by contrast, uses a brief, targeted thrust. Other techniques work on muscles and other soft tissues. The suitable option depends on the examination findings, existing health conditions and your wishes. Not every manual treatment includes a rapid thrust. Before carrying out an appropriate treatment, we discuss its goal, possible risks and alternatives with you. You can ask questions, decline a technique or request a pause. During treatment, tell us if a movement causes unusually sharp pain or new symptoms. Treatment does not become better because you endure as much as possible. A sound is not a reliable measure of its success.

Moving more comfortably immediately after a manual technique can be encouraging. For daily life, however, what matters is whether the relief lasts and can be put to use. We therefore discuss which activities you would like to resume, what suitable movement might involve and which responses to look out for. Your own activity is part of the treatment approach for non-specific neck symptoms. Manual treatment and physiotherapy can serve different purposes. Manual medicine practised by a doctor combines examination with a medical decision about suitable techniques. Manual therapy can also form part of physiotherapy. Such a prescription and active exercises are planned according to the individual situation. ‘Movement and exercise’ explains more about bringing goals and activity levels together. The term ‘blockage’ does not determine a fixed course of treatment. If the hoped-for benefit does not occur or lasts only a very short time, we should review together whether the previous explanation still holds and whether another measure would be more helpful. A previous positive experience is also something to discuss, not an automatic indication for treatment. If marked muscle tension is involved, additional physical treatment on the Evocell bed can be discussed. Its aim is muscle relaxation, coordinated with the rest of the treatment plan. The effects of manual techniques and treatment on the bed are assessed separately.

Manual examinations and treatments at OrthoCoast are provided by Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. Dipl. med. Matthias Dallmann also provides manual medicine; we arrange appointments during his locum work personally. First, we assess your symptoms and clarify the treatment goal. We discuss whether a specific service can be billed to German statutory health insurance (GKV) or would need to be self-funded according to your situation. If you have statutory health insurance and wish to pay yourself for a service your insurer does not cover, you receive a cost estimate beforehand. Its scope and expected cost are discussed with you. We provide this self-funded service only after you have signed to confirm that you want the treatment and accept its cost. You can also take time after the appointment to make your decision.