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Manual Therapy Techniques: How They Work and Why They're Prescribed

By Carolyn Heneghan August 22, 2017 Posted in: Personal Health , Article

For many individuals, pain can be debilitating and deteriorate their quality of life. Doctors and physical therapists increasingly use or prescribe manual therapy techniques to treat both acute and chronic pain. Different manual physical therapies are implemented for individual patients and their specific conditions, and these methods could help you or your loved ones reduce or avoid certain medications, surgery, or other treatments.

Why Health Care Practitioners Prescribe Manual Physical Therapy

The American Physical Therapy Association (APTA) defines manual therapy techniques as "skilled hand movements and skilled passive movements of joints and soft tissue." In other words, it's physical therapy that employs the practitioner's hands rather than machines. These techniques can be used to improve range of motion and tissue extensibility, mobilize or manipulate soft tissue and joints, control pain, reduce soft tissue swelling, inflammation, or restriction, and induce relaxation.

Before prescribing manual therapies, a doctor or physical therapist will take into account several factors surrounding the patient's condition, medical history, and outpatient care, according to the APTA. Factors that might influence decisions involving physical therapy include age, comorbidities, social support, the primary caregiver's expertise, the condition's stability, and environmental factors such as living situation. These factors can impact the types of physical therapy a patient might undergo, as well as whether the patient can or should undergo physical therapy at all.

Types of Manual Therapy Techniques

Physical therapists have many manual therapy techniques at their disposal, each of which target different types of the body and a range of conditions.

Chiropractic Therapy

Chiropractic therapy targets pain and movement issues in the musculoskeletal system, particularly for pain in the back, neck, arm or leg joints, and headaches, according to the American Chiropractic Association. One of the most common chiropractic therapies is spinal manipulation, sometimes called a chiropractic adjustment, where the practitioner applies controlled force to the spine at certain joints to restore mobility and decrease pain.


Massage can be similar to chiropractic therapy because it involves controlled pressure applied by the practitioner's hands to the patient's body. However, the parts of the body targeted by each method differ and so do the actual techniques themselves. Some massage therapy techniques include:

  • Stroking, kneading, or gliding
  • Percussion, friction, or vibration
  • Compression
  • Passive or active stretching within the normal anatomical range of movement
  • Effleurage—firm or light soothing, stroking movements, without dragging the skin, using either padded parts of the fingertips or palms
  • Petrissage—lifting or picking up muscles and rolling the folds of skin
  • Tapotement—rapid and repeated striking with the side of the hand, usually with partly flexed fingers

Massage can target soft tissue, such as muscles, nerves, and blood vessels, or connective tissue, such as tendons, ligaments, skin, and fat. Various physical and neurological pain conditions may improve from the implementation of regular, targeted massage therapies.

Physical therapists and doctors alike are seeing the potential manual therapy techniques have for individuals suffering from painful conditions. Because of physical therapy, health care professionals can prescribe fewer medications and other more invasive, costly treatment methods. If you or your loved one suffers from a pain-inducing condition, talk to your doctor about whether physical therapy could be an option.

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