Manipulation: Overview

Alternative names: Manual Therapy

Physical Manipulation is the use of deep massage, spinal alignment, and joint manipulation to stimulate tissues.  Manual Therapy involves the assessment and treatment of various ailments through hands-on intervention.

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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.  It may rely partially upon the placebo effect and can be effective in providing both short and long term relief.


Manipulation is practiced by people within various health care professions, including Chiropractors, Physiotherapists/Physical Therapists, Massage Therapists, Occupational Therapists, Osteopaths, Physiatrists.  Different forms of manipulative therapy are available to choose from:

  • Acupressure
  • Amma Therapy
  • Anma
  • Body work
  • Bone setting
  • Bowen Technique
  • Dorn method
  • Joint manipulation
  • Spinal manipulation
  • Massage therapy
  • Medical acupuncture
  • Myofascial Release (MFR)
  • Naprapathy
  • Osteopathy
  • Rolfing
  • Seitai
  • Shiatsu
  • Traction
  • Tui Na
  • Zheng Gu or Chinese bone setting


Manual Assessment uses a variety of hands-on tests in an effort to determine which structure may be responsible for the pain in question.  Unfortunately, there are no reliability studies demonstrating the ability of such tests to accurately determine the structure responsible for the pain.  Medical literature has shown that palpation as a manual assessment tool is unreliable and that the underlying cause of 85% of lower back pain can not be determined by any means.  Several manual tests that provoke or relieve pain have been shown to be reliable.

Treatment includes, but is not limited to, soft tissue mobilization, various connective tissue techniques, myofascial release, craniosacral mobilizations, mobilization of joints or spinal segments, mobilization of neural tissue, visceral mobilization, strain and counterstrain, and Integrative Manual Therapy.  Advocates of the therapy claim that these techniques, when correctly applied, often result in dramatic improvement of the patient's signs and symptoms.

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Manipulation can help with the following:


Premature/Signs of Aging

Chiropractic or osteopathic manipulation, massage, hydromassage, and mind/body therapies can also reduce the chronic stress on the body that interferes with normal functioning and contributes to premature aging.

Osteopathic manipulation can reduce the chronic stress on the body that interferes with normal functioning and contributes to premature aging.


Attention Deficit Hyperactivity Disorder (ADHD)

Some chiropractors believe that ADD is commonly caused by an occiput that is jammed too far forward on the cranial base, caused as a common result of any sort of birth trauma, even when minor.  As many as 60% of children with ADD are claimed to have this mechanical problem and a high percentage experience improvement with adjustment.


In cases of BPPV (calcium carbonate crystals moving into the inner ear), Dr. Peter West, consultant audiological physician at the Queen Alexandra Hospital in Portsmouth, England, has stated that using a simple technique to manipulate the head and return the loose crystals to their correct position is for many a permanent cure.  "It is just like maneuvering marbles round a tray in a child's toy."  Others who suffer continued episodes of BPPV can have repeat treatments.



Physical therapy is an important part of the treatment of polymyositis.  When to begin, and the continued degree of exercise and range of motion of extremities is customized for different patients.

Neck / Spine

Neck Pain

Acute neck pain may be relieved by manipulation, especially if the pain is due to a spinal "fixation" or "subluxation" which often requires adjustment for rapid relief.

Simply extending the head back for 30 second periods may improve disc position and assist water flow into dehydrated discs.  This may also be performed while lying on your back in bed.  Hang your head over the edge, toward the floor.  Every thirty seconds or so bring your chin up to your chest and then back down again.  Mobility exercises help maintain neck flexibility.

Low Back Pain

Spinal adjustment can help in acute cases, but not in chronic cases unless a single adjustment proves helpful.

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