What is Manual Therapy?
Manual therapy, otherwise known as manipulative therapy is a form of physical therapy that is normally used by physiotherapist, massage therapist, chiropractors, osteopathic physicians, and occupational therapists. This form of therapy is commonly used in the treatment process of musculoskeletal pain and disability through manipulation and kneading of human muscles, joint manipulation and mobilization. The wide use of manual therapy has benefited numerous individuals and is being widely use globally. In definition, there are three major forms of manipulative therapy, such as mobilization, manipulation, and massage. The difference between mobilization and manipulation based upon the regulatory standpoint is that the first may be stopped by the practitioner once the recipient of the therapy decides to forgo the process, while on the other hand, the manipulation is unstoppable one the therapist or practitioner has started the procedure.
Furthermore manual therapy is also used in orthopedic manual physical therapy or OMPT (Mintken et al., 2008). Therefore, it can also be defined as a hands-on treatment that is normally done by physical therapist. There are various treatments that are included in the process, such as moving the joints using different speeds in specific directions. This is normally done in order to regain the person’s overall movement through joint manipulation and mobilization. Additionally, the process will enable the person to regain passive movements of different body parts, muscle stretching, and even enabling the patient to move his body parts against the practitioner’s resistance so as to improve the activation of muscles. Manipulative therapy also involves different techniques that are known to have diverse, rich, and effective outcomes in treating the patient’s mobilization issues.
Manual Therapy Techniques – Craniosacral Therapy
Craniosacral therapy is viewed by many individuals as a form of alternative medicine. It aims to relive pain as well as body tension through gentle manipulations being applied to human skull. It is regarded as a harmonious natural rhythm of the human’s central nervous system. Craniosacral therapy or CST was developed by John E. Upledger, an osteopathic physician who extensively studied the procedure between 1975 and 1983.
Craniosacral therapy is known to treat various medical issues, such as chronic neck pain, back pain, headaches due to migraine and disorders in central nervous system, orthopedic problems, and even traumatic brain injuries (Upledger Institute International, 2016). There are many patients who also benefited from Craniosacral Therapy, who were suffering from injuries of the spinal cord, scoliosis, learning disabilities, infantile disorders, chronic fatigue, emotional difficulties, and stress-related problems. Moreover, this form of therapy treats immune disorders, post-traumatic stress, and post-surgical dysfunction.
Although there are some claims that Craniosacral Therapy is not an effective form of treatment, there are still numerous claims from people who received the treatment, saying that the procedure actually provides relaxation and therapeutic effects. There is a therapeutic process, which is called SomatoEmotional Release or SER that expands the Craniosacral Therapy principles in order to get rid of the body and mind’s residual outcomes of trauma. Generally, this form of manual therapy is known for its benefits that help in relieving head, neck, and back pain through proper way of massaging the bones towards reduction of stress due to chronic injuries and other related head problems.
Manual Therapy Techniques – Acupressure
Acupressure is also viewed as another alternative medicine that is used for treating different medical problems. It is an ancient art of healing that uses fingers to by gradually pressing the specific healing point. The acupressure was originated in Asia more than five thousand years ago. Through the sensitivity and power of the hand, this therapy provides relief on stress-related disorders, thus it is an ideal self-treatment as well as preventive healthcare in order to improve the immune system.
Similar to other manual therapy techniques, the acupressure treats many disorders in the human body. Although only few research shows the health benefits of acupressure, there are numbers of health issues that were able to improve through acupressure. However, several researches support the acupressure in preventing and treatment of vomiting and nausea during spinal anesthesia, after surgery, after chemotherapy, and other events related pregnancy (webmd.com). Moreover, acupressure is also known for its benefits in reducing the symptoms of cancer and reduce the stress level of the patient who suffers from such disease. Several evidence also show that acupressure reduces the person’s suffering from back pain, headache, and postoperative pain. In some cases, patients who have arthritis seek the help of acupressure therapist as it also helps them in reducing the symptoms. In the process, acupressure enables the release of endorphins, which increases the anti-inflammatory effects resulting the reduction of physical pain due to arthritis. This therapy also relieves anxiety and depression as it improves the person’s mood and fatigue. Overall, acupressure is a safe procedure. If a person suffers from any of the diseases mentioned above, there is a high chance that acupressure can help them reduce the pain and promote healthier life due to the positive emotional and psychological effects.
Education, Scope of Practice, and Treatment Claims
There is a wide variety of education that manual therapy practitioners undertook. One of which is the osteopathic medicine. It is a distinct medical practice compared to other medical specialty in the United States. According to American Association of Colleges of Osteopathic Medicine or AACOM, Osteopathic medicine provides various benefits, such as surgery, prescription drugs, and even the utilization of technological advancement when it comes to diagnosing different diseases and evaluating the injury (AACOM, 2016). The education of osteopathic medicine provides knowledge about hand-on diagnosis using a system called osteopathic manipulative medicine, which can help individuals in achieving a high level of wellness through health promotion as well as disease prevention (AACOM, 2016).
When it comes to the scope of practice, the osteopathic medicine practitioners are also providers of primary care through strong foundation towards becoming better physicians. The curriculum of this manual therapy includes studying all the related subjects that a physician student would master. They normally take two hundred hours of training about the osteopathic manipulative medicine art (AACOM, 2016). The education of manual therapy practitioners has one common concept, which is the person’s body structure influences it function.
Conversely, manual therapy practitioners have different scope of practice based on the therapy they specialize. One of which is the physiotherapy that treats chronic back pain. Moseley (2002) said that the combination of education, exercise, and manual therapy relieves the chronic lower back pain. The scope of practice of manual therapy practitioners is known to provide a wide variety of treatments that numerous patients have benefited. Furthermore, the multidisciplinary programs for pain management focus on behavioral and cognitive aspects of the treatment process. This is known to reduce disability normalizing the pain cognitions, and promoting self-efficiency (Moseley, 2002).
The practitioners of manipulative therapy have also claimed many effective treatments that were provided to their patients. There are various reports showing the effectiveness of manipulative therapy Bronfort et al. (2010) presented a comprehensive scientific evidence about the effectiveness of the manipulative therapy when it comes to treating both musculoskeletal as well as the non-musculoskeletal health conditions. Based on the result of the clinical trials, 26 different medical conditions were treated using manual therapy. 13 of which were musculoskeletal-related, while 4 of the conditions were chronic head ache, thus, the nine remaining conditions were non-musculoskeletal. According to the outcomes, the mobilization and manipulation of such conditions were successfully managed using the manipulative therapy, which shows that the massage therapy is effective especially in adults that suffer low back pain as well as chronic neck pain (Bronfort et al., 2010).
Clar et al. (2014) presented the similar results for musculoskeletal conditions that were treated using manual therapy procedures. However, it was stated that although there were only narrow, high quality confirmation of manual therapy’s effectiveness, it still shows that a non-surgical procedure such as this can provide effective treatment to different medical conditions.
Apart from the mentioned conditions, there are other claims that the manipulative therapy can treat other conditions, such as cervicogenic dizziness, cervicogenic headache, and even numbers of lower and upper extremity joint problems. Thus, such claims show that this type of massage is effective treatment option for adults who have either chronic neck pain or lower back pain.
There are many cases showing how the manual therapy treats various medical conditions. However, to make the evidence more reliable, it is ideal to present a specific case report that will present an actual event in relation to the manipulative therapy’s effectiveness. According to the case study, the female patient is 49 years of age, who complaints about her left posterior thigh and left lower back pain (Chen et al., 2009). She was recruited to participate in the study of the manipulative therapy’s effectiveness and advised about the procedure in accordance with the informed consent prior the actual treatment.
The pain was due to self-administered event. The patient incurred an injury after falling from a bike that happened few days before the examination. In the process of actual treatment, the patient initially received a spine manipulation. Consecutive physical therapy sessions were conducted. After the sessions, the patient was asked to do some home exercises as a continuation of her therapy. Overall, the treatment process took 6 treatments within 21-day period.
Based on the reported outcome, the completed therapy sessions as well as the home exercises the reduction of lower back pain and lower left thigh pain (Chen et al., 2009). Thus, the report also concludes that the patient’s lessened dependence on therapy inside the clinic has improved self-efficiency in terms of the treatment process. The case study that was presented can be used in future research in relation to the development of further techniques when it comes to the application of different manipulative therapy methods. Thus, future research should also consider focusing on the patient’s ability to self-manage the symptoms that occurs along with the incurred injury. In that case, manual therapy will not only be provided by the therapists themselves, but patients will also learn how to administer it personally.
References
Acupressure Points and Massage Treatment for Pain, Nausea, and More. (n.d.). Retrieved from http://www.webmd.com/balance/guide/acupressure-points-and-massage-treatment?page=2
American Association of College of Osteopathic Medicine. (2016). What is Osteopathic Medicine. Retrieved from http://www.aacom.org/become-a-doctor/about-om
Bronfort, G., Haas, M., Evans, R., Leiniger, B., & Triano, J. (2010). Effectiveness of manual therapies: the UK evidence report. Chiropractic & Osteopathy, 18(1), 3.
Chen, J., Phillips, A., Ramsey, M., & Schenk, R. (2009). A Case Study Examining the Effectiveness of Mechanical Diagnosis and Therapy in a Patient who Met the Clinical Prediction Rule for Spinal Manipulation. Journal of Manual & Manipulative Therapy,17(4), 216-220.
Clar, C., Tsertsvadze, A., Court, R., Hundt, G., Clarke, A., & Sutcliffe, P. (2014). Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report.Chiropractic & Manual Therapies, 22(1), 12.
Mintken, P. E., Derosa, C., Little, T., & Smith, B. (2008). A Model for Standardizing Manipulation Terminology in Physical Therapy Practice. J Orthop Sports Phys Ther,38(3), A1-A6.
Moseley, L. (2002). Combined physiotherapy and education is efficacious for chronic low back pain. Australian Journal of Physiotherapy, 48(4), 297-302.
Upledger Institute International. (2016). Discover CranioSacral Therapy. Retrieved from http://upledger.com/therapies/index.php
