|
¢ There are two Z joints between each spinal bone and they guide their movement
¢ They can get damaged and stiff
¢ They are often overlooked as a cause of spinal problems
¢ Osteopaths are skilled in diagnosing and treating Z joint problems
These joints, sometimes called the Z joints for short, lie one on either side of the disc between each vertebra. They are small synovial joints, like the joints in your fingers. Synovial joints have a small cavity between the ends of the two bones that make up the joint, the surfaces of the bones being covered by smooth cartilage. The joint is contained in a bag called the joint capsule, the inside of which is lined by a delicate synovial membrane, which is well supplied by nerves and blood vessels and which secretes a synovial fluid into the joint cavity. The synovial fluid lubricates the joint rather like a film of oil. The fluid has some interesting properties, for example varying its viscosity in response to differing forces on the joint, and seeping in and out the cartilage in response to pressure changes.
The job of these joints in the spine is to guide and control movements of the vertebrae in relation to each other, Their orientation, which differs in the different areas of the spine, determines the directions in which the vertebra can move (for example, the low back has a lot of forward to backward movement but little rotation).
Osteopaths think these Z joints can often be overlooked in diagnosis and in fact can play a large role in the generation of pain and stiffness in many patients. Like any joint, the Z joints can be damaged or irritated by excessive strains. They can cause acute pain in the neck, mid or low back, which is worsened by movement. They can also become restricted in their mobility, causing the vertebrae between which they lie unable to move properly, In the later stages of spondylosis the Z joints can become weight bearing (the discs are meant to take most of the weight I the spine, not the Z joints) and themselves undergo osteoarthrotic degenerative change that can be a source of pain.
Freeing the Z joints can be effectively and rapidly accomplished with precise osteopathic techniques. One of these is the manipulation called a low-amplitude high-velocity thrust (LAHVT). Having identified the joint in trouble, it is carefully aligned by positioning the patient to ensure the right joint is targeted and the patient relaxed. At the correct point the osteopath puts a small quick movement through the joint to gap it and restore mobility to its normal range. Sometimes this is accompanied by a “crack” or “pop” sound.
Performed properly on the appropriate patient, this technique is effective, safe and painless. The aim is not to correct any displacement, misalignment or “subluxation” (partial dislocation) of bones , nor to “put a disc back in” (there is no such thing as a “slipped disc”), but to restore normal mobility to the joint. This technique is just one of a large range of techniques in the osteopath’s “toolbox”.
If the Z joint restriction is longstanding, the procedure may need to be repeated on subsequent visits. Before the LAHVT the osteopath will often use preparatory muscle relaxation techniques. After the LAHVT other joint mobilisation techniques may be used. As treatment proceeds, the osteopath uses the cues picked up by feeling the joint mobility to determine how the tissues are responding and so adapt the treatment. To help patient relaxation and ensure the patient is happy with the treatment an osteopath will inform the patient before an LAHVT what they intend to do
South Wales Osteopathic Society www.OsteopathyWales.com
|
