[Manual medicine in pain treatment].

To diagnose the source of pain, a very refined segmental technique is employed in manual medicine. The evaluation of static and dynamic functions is complemented by palpatory and functional testing of the joint mechanics. A reversible hypomobility of a joint causes a swelling of the surrounding soft tissue, a stiffening of the muscle tissue and a change in turgor and trophicism. The various techniques of manual medicine restore the physiological joint play, causing thereby reflectory phenomena, often the source of pain, to disappear quickly. Trivial trauma or inappropriate coordination of movement sequences interfere with joint mechanics. The nociceptive stimulus from all joint structures activates segmentally connected muscular fiber bundles through the posterior horn complex via alpha- and gamma-motoneurons. The joint play of other segments and/or peripheral components can be disturbed via interneurons and become a source of pain. Mobilisation of the joint activates inhibitory neurons, the normal joint mechanics are reestablished and the nociceptive stimulus reduced.