Therapy for functional pain
Therapy for functional pain
The fundamental aim of functional pain therapy is to normalise faulty neuronal control processes in the cybernetic system of the human body and thus make it possible to reduce the functional nociception of the musculoskeletal system by stabilising the motor function. Treatment does not focus primarily on the painful area.
The therapeutic strategy presented below is made up of three stages of therapy and is attributable to the Czech doctor and student of the Prague School for Function Pathology, Dr Eugen Rašev. Observing the three stages in chronological order is essential if the therapy is to be successful.
The therapeutic stage concept
The first stage of functional pain therapy involves optimising the afferent input. The aim is to remove excess spinal reciprocal inhibition. This is done by means of local or reciprocal inhibition or facilitation techniques. These techniques optimise the distribution of stimuli to the alpha motor neurons for bipedal posture against gravity and thus reduce the activity of the tonic alpha motor neurons in the spinal anterior horn. This reduces the functional nociceptive afferent nerve pathways, which can lead to the elimination of the posturally induced pain.
The measures of this first therapy stage normalise postural reactions in roughly 30% of patients, based on clinical experience. In some cases, the measures of this therapy stage improve the subcortical control system and stabilisation is once again optimised. The techniques of this first therapy stage are a prerequisite for the second stage, as they are responsible for improving the afferent nerve pathway pattern.
The second stage of functional pain therapy involves optimising posture by means of facilitation with reciprocal inhibition in functional movement chains. The aim is to activate the inhibited supraspinal control system and thus eliminate postural dysfunctions. The postural programme is better facilitated. The position of the body in the vertical direction with the belt regions still and correctly adjusted while the movement is being performed is important. The techniques and exercises normalise postural reactions in a further 30–40% of patients, based on clinical experience. The success of the second stage depends highly on the therapist’s ability to provide the right resistance for the right muscle chains.
The third therapy stage is used for roughly 30–40% of patients for whom the first two stages fail to adequately eliminate the postural dysfunction or fail to sufficiently activate the postural stabilisation. The third stage involves direct and targeted activation of the functional postural stabilisation (activation of the segmental coordination). This segmental stabilisation is performed by means of special exercise techniques on the BIOSWING Posturomed® and with the BIOSWING Propriomed®. The patient should begin with the third therapy stage in an optimally prepared condition from the first two therapy stages, in order to automate the uninhibited cybernetic mechanisms of the first two stages for the segmental coordination. It is important for the stabilising therapy techniques and the synergistic activities thus brought about to be aimed at a specific goal (e.g. office worker vs. manual worker vs. athlete).
Dr Eugen Rašev, University of Prague, specialist physician for rehabilitation and physical medicine – invented, and lectures in, the concept of postural pain therapy.
The postural therapy of functional pain (postural pain therapy), which I devised and which has been taught since the mid-1990s, has become an indispensable part of physiotherapy and neuro-orthopaedic rehabilitation. The functional disorders of the musculoskeletal system are treated with great success in several thousand practices and rehabilitation centres with the BIOSWING Posturomed and the BIOSWING Propriomed. Along with observing the three therapy stages, a crucial factor is the damped oscillation characteristics of Posturomed and Propriomed that make the therapy more efficient and targeted. And with that, I would like to invite you to my further training courses in postural pain therapy!
The sensomotor prevention, therapy and diagnostic device. The therapy platform is suspended from a double swinging mechanism that can enables regulated damped pendulum movements.
The sensomotor swing stick with damping elements and adjustable frequency regulators for optimal dosing of the exercise intensity.
on postural pain therapy based on the work of Dr Eugen Rašev can be found here.
The instructions for the postural therapy of Dr Eugen Rašev:
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Otte, C.; Rašev, E.: Postural aspects of pain therapy of the locomotor system.
Manuelle Medizin 2010 · 48: 267-274
The therapy of functional pain calls for a fundamental approach and a clear, neurophysiologically oriented strategy. The three-stage concept based on Dr. Rašev’s work meets these requirements. The first two therapy stages of functional pain therapy disinhibit the postural programme and thus prepare for the direct, metered activation of the postural reactions in the third therapy stage with the BIOSWING Posturomed® and the BIOSWING Propriomed®. The therapy stages have a different weighting in the course of the functional pain therapy depending on the severity of the motor disorder.