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Manual Therapy

August 17th, 2020
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Manual therapy is widespread in many countries of the world and consists in the use of different alternative techniques for healing patients. Massage, acupuncture, spinal manipulation, manual physical therapy, spinal mobilization and osteopathic manipulation are the main types of manual therapy helping in the treatment of back pain, headache, and others. It appeared many years ago and involved many methods and techniques for effective treatment of people.

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History of Manual Therapy

The first historical reference to manual or manipulative therapy in Europe appeared in 400 BCE (Pettman, 2007). Over the centuries, this treatment form was not approved by traditional medicine, and most people did not trust manual practitioners. Additionally, manual therapy was a basis of chiropractic and osteopathy, health care techniques founded in the nineteenth century. Furthermore, over time, it became a physical therapy profession, and physical therapists received rights to have legally regulated scope of practice.

The Meaning of Manual Therapy

Physicians concentrate on restoring soft tissues and the right movement of joints by means of precise hand placement. According to the article The Evidence-Based Practice (2016), Manual therapy is defined as the skilled passive movement of joints (joint mobilization/manipulation) and soft tissues (soft tissue mobilization/specific localized massage). Physicians put central focus on limb gross motions and the specific movement of joint surfaces.

Manual therapists use mechanical, biochemical, neurophysiological and psychological manipulation effects. The mechanical method includes the passive motion of the surrounding muscles adjacent to joint stretches, joint capsule, and ligaments. Moreover, this type of manual therapy may break scar tissues or adhesions and results in the increased range of movements. The biochemical effect uses joint manipulation and is based on endogenous opiate system activation. The use of neurophysiological mechanisms has not been explored; however, physicians state that such treatment can make an inhibitory effect on spinal cord pain and additionally on the injury place. The psychological technique is aimed at achieving positive outcomes of this kind of therapy among patients.

Each patient who has joint pain can receive additional treatment with the use of manual therapy because its contraindications are absent. Nevertheless, various precautions, including hemarthrosis, hypermobile joints, muscle holding, joint replacements, and other diseases exist (The Evidence-Based Practice, 2016). In addition, manual physicians treat spine pain, as well as elbows, shoulders, hands, knees and other joints. Furthermore, their techniques are directed at eliminating muscle spasms and increasing joint mobility.

Soft Tissue Work

Massage and soft tissue work belong to manual treatment techniques. Practitioners of manual physical therapy that use the soft tissue work technique apply hands to put pressure and force on muscle tissues. They manipulate joints for reducing back pain caused by muscle tension and joint dysfunction. The limited range of movements under some muscle-skeletal conditions is the main reason for manual physical therapy treatment. These conditions are characterized by discomfort, pain, alteration in functions, movement and posture of the patient. Thus, this therapy treats patients from chronic back pain caused by sacroiliac joint dysfunction. Moreover, soft tissue injuries (a pulled back ligament or a back muscle strain) result in acute back pain, and manual physical therapy relieves these symptoms.

Soft tissue work is based on relaxing tense spine muscles and limited joints for increased flexibility and a reduction of back pain. It is achieved by exerting pressure on muscles. Moreover, it helps relax soft tissues of the body, augment circulation, ease pain and break up scar tissues.


Massage is another technique of manual therapy that has ancient history. It includes acting on the body with pressure using unstructured, moving, structured or stationary tension, vibration or motion manually or with mechanical aids. The success of massage practitioners may be due primarily to the effects of pressure on muscle knots, a ubiquitous phenomenon and likely factor in many common pain problems (Ingraham, 2016). Additionally, masseurs use hands, elbows, knees, fingers, feet, forearms or some massage devices as means of influencing. Massage results in well-being, relaxation and recreational activity. Furthermore, sick people should lie on the massage table, or sit in a chair for massage. Moreover, they can lie on a mat on the floor; therefore, in amateur settings, the floor or bed is mostly used as place for the procedure. Additionally, recipients of aquatic massage have their treatment in a warm-water therapy pool. Massage clients may be uncovered or partially or fully covered. Furthermore, massage therapy also includes such types as anma massage, ayurvedic, Balinese, biodynamic, champrissage, hilot, infant, or medical massage and others.

Education, Scope of Practice and Treatment Claims

Any physical therapist should have unique training before the treatment of patients. The primary concern of practice scope is public protection. Moreover, nearly 80% of entry-level practicing physicians have received at least some basic education in manual therapy while in physical therapy school (The Evidence-Based Practice, 2016). Additionally, therapists have an opportunity to graduate from universities for obtaining a certificate in manual therapy. Several educational institutions of manual therapy exist, which operate in a similar direction of normal joint restoration and the mobility of soft tissues. For example, The Manual Therapy Institute, PLLC is located in Livonia and prepares a clinician in the subspecialty of orthopedic manual physical therapy (MTI, 2016). Its didactic and clinical training includes extensive clinical experience in treating the appropriate and sufficient population of patients for the creation of an environment necessary for building and improving advanced clinical skills. Additionally, treatment claims of different manual practitioners are not rather specific. Therapists state that any person can have manual treatment. Therefore, if an individual has such diseases as diabetes, low immune function, systemic arthritis, high blood pressure, heart disease and others, manual practitioners should alter the course of healing to make it maximally adapted to patients health conditions. Moreover, the manual therapist profession has not been studied thoroughly, and practitioners should demonstrate their professionalism regularly.

Positive Effects of Manual Therapy

Manual therapy treatment of infertility results in rather positive effects. According to Kramp (2012), 6.7 million women aged 15 to 44 years have impaired fecundity, and 1.5 million married women are infertile. Acupuncture and physical therapy are types of manual therapy techniques used by physicians for the fight against infertility. The human body includes lymphatic, venous and arterial types of circulation, which are interrelated. The lymphatic system transfers 10% of the fluid transported by arteries to lymph nodes for filtering (Kramp, 2012). Particularly, 250 lymph nodes are located in the pelvis and the abdomen, particularly in vessels of uterine tubes, uterus, and ovaries. Hence, techniques of manual therapy are direct at the lymphatic system decongestion, cervix internal mobilization, reproductive organs vascularization, and mobilizing cellular waste and fluid out of the pelvic cavity. Hence, the treatment of ten barren women by manual therapy administered to the pelvic region resulted in positive effects. For six of those women in the present report, fertility rates improved and progressed after using manual techniques directed at the pelvic part of the body. Additionally, one woman got one session of treatment, three of them received two, four females had four courses, and two received six. Therefore, six females had singleton pregnancies delivered at term.


Manual therapy includes different techniques and has many positive results. Manual therapists treat various types of pain and other diseases, including infertility. They should be well-educated and have an original certificate in the field. Hence, manual therapy is needed and has to exist at one time with traditional medicine.

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