Manual therapy

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See also: Bodywork (alternative medicine)

 

Manual therapy, manipulative therapy, or manual & manipulative therapy is a physical treatment primarily used by physiotherapists, massage therapists, chiropractors, and osteopaths to treat musculoskeletal pain and disability; it most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.[1]

 

Definitions

Manual therapy may be defined differently (according to the profession describing it for legal purposes) to state what is permitted within a practitioners scope of practice. Within the physical therapy profession, manual therapy is defined as a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.

A consensus study of US chiropractors [2] defined manual therapy as "Procedures by which the hands directly contact the body to treat the articulations and/or soft tissues."

Alternatively, Korr (1978) described manual therapy as the "Application of an accurately determined and specifically directed manual force to the body, in order to improve mobility in areas that are restricted; in joints, in connective tissues or in skeletal muscles."

Use

In Western Europe, North America and Australasia, manual therapy is usually practiced by members of specific health care professions (e.g. Chiropractors, Osteopaths, Osteopathic Physicians, Physiotherapists/Physical Therapists, and Physiatrists).[1] However, some lay practitioners (not members of a structured profession), such as bonesetters also provide some forms of manual therapy.

A survey released in May 2004 by the National Center for Complementary and Alternative Medicine focused on who used complementary and alternative medicine (CAM), what was used, and why it was used in the United States by adults age 18 years and over during 2002. According to this recent survey, manipulative therapy was the 3rd most commonly used NCCAM classification of CAM categories (10.9%) in the United States during 2002 ([1] table 4 on page 10) when all use of prayer was excluded. Consistent with previous studies, this study found that the majority of individuals (i.e., 54.9%) used CAM in conjunction with conventional medicine (page 6)

Information

A number of professional peer-reviewed journals specialize in the dissemination of information associated with manual therapy. The Journal of Manual and Manipulative Therapy, Manual Therapy, and the Journal of Manipulative and Physiological Therapeutics are PubMed indexed journals that have provided readers with useful research on manual therapy for over 15 years. Peer reviewed information has improved the quality of information that is provided to practicing clinicians and has dispelled a number of myths commonly associated with manual therapy.

 

Styles of manual therapy

There are many different styles of manual therapy. It is a fundamental feature of ayurvedic medicine, traditional Chinese medicine and some forms of New Age alternative medicine as well as being used by mainstream medical practitioners. In one form or another it is probably as old as human culture itself and is a feature to some degree of therapeutic interactions in traditional cultures around the world.

 

• Acupressure
• Anma
• Body work (alternative medicine)
• Bone setting
• Bowen Technique
• Chiropractic
• Cranio-sacral therapy
• Dorn method
• Joint manipulation
• Joint mobilization
• Spinal manipulation
• Spinal mobilization
• Massage therapy
• Manual lymphatic drainage
• Medical acupuncture
• Muscle energy technique
• Myofascial release(MFR)
  • Naprapathy
  • Osteopathic manipulative medicine
  • Polarity therapy
  • Rolfing Structural Integration
  • Seitai
  • Sotai
  • Shiatsu
  • Traction
  • Tui na

Frequently asked questions related to Physiotherapy

Today's post is dedicated to those frequently asked questions have about physiotherapy.

Q: What is physiotherapy?

Physiotherapy uses a variety of techniques to help your muscles and joints work to their full potential. It can help repair damage by speeding up the healing process and reducing pain and stiffness.

Physiotherapists also have an important role in rehabilitation, for example, helping people who have had strokes to relearn basic movements. However, physiotherapists don't just offer treatment, their advice can help you prevent problems returning or even happening in the first place.

Q: What types of problem can physiotherapy help?

Virtually any condition that affects your muscles, joints or nerves. Common problems that can be helped by physiotherapy include:

•   Painful conditions such as arthritis

•   Back and neck pain, including whiplash

•   Problems affecting children including cerebral palsy

•   Pregnancy related symptoms such as back pain and stress incontinence

•   Upper limb work related problems, also known as repetitive strain injury (RSI)

•   Asthma and other breathing difficulties

•   Sports injuries

•   Strokes and other neurological problems

•   Symptoms of stress and anxiety.

Q: What does the treatment involve?

Before any action is taken, the physiotherapist will assess your condition, diagnose the problem and help you understand what's wrong. They will work with you to develop an effective treatment plan that takes into account your lifestyle, leisure activities and general health. This will include advice on how you can help yourself, for example, you may be shown exercises that you can do between treatment sessions. Where appropriate, physiotherapists also advise carers how they can help.

Physiotherapists use a variety of treatments. For example:

•   Exercise programs - designed to improve mobility and strengthen muscles

•   Manipulation and mobilisation - to reduce pain and stiffness

•   Electrotherapy - for example, ultrasound to speed up the healing process

•   Acupuncture - used by some physiotherapists qualified to practice this technique

•   Hydrotherapy - exercise in water

•   Massage.

Q: What should I do if I injure myself? Do I need to be referred by a MD, or can I make an appointment to see a physiotherapist immediately?

If the nature or extent of your orthopedic injury is unclear, you must make an appointment for a consultation with your personal medical physician or specialist. The specialist may in turn recommend x-rays, medication or any other course of action, which is deemed appropriate, including perhaps physiotherapy.

If, however, you are very familiar with your injury, and you know that a physiotherapist can address it, you may choose to skip the medical consultation and make an appointment directly with our physiotherapy services. But remember, when in doubt about the nature of your injury, consult a physician. These consultations are fully covered by Medicare, so there's no need to gamble.

Q: How effective is physiotherapy?

Physiotherapists measure their clinical effectiveness by the same standards applied to other health professionals, including doctors and nurses. This is done through independent research to prove that physiotherapy works. For example, studies show that exercise-based cardiac rehabilitation, led by physiotherapists, results in a reduction of sudden death rates after a heart attack by 25 per cent. There is also strong evidence that physiotherapy is an effective treatment for back pain.

To ensure physiotherapists in Quebec apply equally high standards, the Order des Physiotherapeutic du Quebec, the professional body representing physiotherapists, circulates guidelines based on research to all its members.

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