Specially-trained physicians perform manual/musculoskeletal medicine. Based on a general medical physical examination, a neurological examination and a manual/musculoskeletal examination, these physicians come to both a normal medical and a manual/musculoskeletal diagnosis. The latter can lead to specific manual/musculoskeletal treatment.
The manual/musculoskeletal diagnostic procedure checks for general motion restriction in both the spine and the extremities (legs and arms), and segmental motion restriction in the spine (between two vertebrae). The latter is known as segmental dysfunction or, less frequently, as segmental blockage.
Based on a normal medical diagnosis and a manual/musculoskeletal diagnosis, the physician decides on whether there is any indication for manual/musculoskeletal treatment, or whether there is a medical reason for referral to a hospital specialist.
This means that any abnormalities found during the manual/musculoskeletal examination do not necessarily form a reason for manual/musculoskeletal treatment.
The normal medical diagnosis forms an indication for further somatic diagnostic procedures, which in some cases will be performed by a different medical discipline.
Characteristic manual/musculoskeletal treatment consists of the manipulation and mobilisation of the joints of the spine and extremities, sometimes in combination with exercises.
In principle, first of all, the manual/musculoskeletal physician carries out a test treatment in order to be able later to control the effect on the previously-found motion restrictions and/or complaints.
In case of recurrent complaints and motion restriction, the manual/musculoskeletal physician always carries out another manual/musculoskeletal examination in order to discover the reason for this recurrence.
The reason for recurrence can be located either inside (inflammations, radicular involvement, intervertebral disc diseases, arthritis, etc.) or outside (internal, neurological and gynaecological diseases, etc.) the locomotor system.
In order to trace these diseases, as the reason for the recurrence of pain and/or motion restriction, the manual/musculoskeletal specialist, by definition, must always be a physician.
Based on diagnostic reassessment, an indication is given for additional treatment (local injections in soft tissue inflammations) or evaluation by a medical specialist.
Manual/musculoskeletal medicine mainly consists of a continuous diagnostic process. Tracing the reasons for the recurrence of such pain complaints and motion restriction is of the utmost importance in manual/musculoskeletal medicine. The characteristic treatments performed, although always used correctly and safely, are only a small part of the manual/musculoskeletal medical branch.