What Is Manual Therapy?

Manual therapy, or manipulative therapy, is a physical therapy usually used by physical therapists, physiotherapists for the treatment of musculoskeletal pain and disability; it mostly involves muscle kneading and stimulation, joint mobilization and joint manipulation. It is also used by occupational therapists, athletic trainers, osteopaths and doctors. 

Manual therapy has a long tradition in the Physical Therapy field, and physical therapists have made a substantial contribution to the current variety of manual therapy methods and techniques. Mechanical theories have traditionally been used to describe the mechanisms by which manual therapy methods have succeeded, recent research has shown that complex neurophysiological mechanisms are also at action, and the positive psychological effects of hands-on assessment and intervention should not be overlooked.

The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) describes manual therapy techniques as: “Professional hand movements designed to achieve any or more of the following effects: enhance tissue extensibility; increase the range of motion of the joint complex; mobilize or control soft tissues and joints; promote relaxation; adjust muscle function; modulate pain; and minimizes.

According to the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) Definition of Advanced Specialty Practice (DASP), orthopaedic manual physical therapy (OMPT) is described as any “hands-on” care given by the physical therapist.

Treatment can involve shifting joints in various directions and at different speeds to restore mobility (joint mobilization and manipulation), muscle stretching, passive movements of the injured body part, or patient moving the body part against the therapist’s resistance to enhance muscle activation and pacing. Selected unique soft tissue techniques can also be used to enhance the mobility and function of tissues and muscles.”

Manual Physical Therapy may offer pain relief for Acute and Chronic Back Pain

Manual therapy can be helpful in the treatment of joints that lack sufficient mobility and range of motion in some musculoskeletal conditions. This restriction can cause discomfort, pain, and alteration of function, posture, and movement. Manual physical therapy includes restoring mobility to stiff joints and reducing muscle tension in order to return the patient to a more normal, pain-free movement. Manual physical therapy can also provide back pain relief for both patients with chronic back pain involving joint issues, such as sacroiliac joint dysfunction, and acute back pain due to soft tissue injuries, such as a back muscle strain or a pulled back ligament. While comprehensive clinical trials are yet to be undertaken in all areas of manual therapy, limited clinical evidence and patient reports support the claim that manual physical therapy may be successful in alleviating back pain in some patients.

Conditions That Can Be Treated with Manual Therapy

There are several problems that can be treated with manual therapy, including:

• Neck pain (muscle spasm, disc herniation, etc.)
• Lower back pain (disc herniation, facet joint restriction, spinal stenosis, etc.)
• Thoracic spine pain (disc herniation, rib restriction, etc.)
• Migraines/headaches
• Fibromyalgia
• Temporomandibular joint (TMJ) dysfunction
• Shoulder pain (impingement syndrome, frozen shoulder, rotator cuff injury, etc.)
• Hip pain (hip bursitis, post-surgical hip replacement, myofascial hip pain, hip impingement, etc.)
• Knee pain (iliotibial band syndrome, patellofemoral dysfunction, post-surgical knee replacement, etc.)
• Ankle pain (ankle sprains/strains, arthritis, etc.)