Does Manual Therapy Really Work?
Does Research Evidence Support The Use of Manual Therapy?
(Part 2 of a series of 3 blogs)
There are numerous systematic reviews, randomized controlled trails, and evidence based clinical guidelines the support the use of manual therapy for the treatment of musculoskeletal (orthopedic) conditions. A general summary of these conclusions include:
- Research supports the use of manual therapy (manipulations & mobilizations) for treating all stages of musculoskeletal injuries or ailments (Acute, Subacute, Chronic).
- Thrust manipulation and non-thrust joint mobilization techniques, which are both considered manual therapy techniques, are both effective and supported by research. Your physical therapist may choose one technique versus the other or a combination of both types of techniques based on their experience and their evaluation of your individual problems.
- Research supports that manual therapy treatment effects include: reduced pain, improved function, improved motion, improved neurodynamics (nerve mobility), and increase water diffusion into the nucleus of the intervertebral disc.
- Manual therapy & exercise are both effective and supported by research for treating musculoskeletal conditions but both are better when combined. Find a physical therapist that is proficient at both manual therapy and exercise prescription.
The American Physical Therapy Association (APTA) has clinical guidelines for various musculoskeletal conditions that have been published in The Journal of Orthopedic and Sports Physical Therapy (JOSPT). Manual therapy is considered to have strong evidence supporting its use for cervical pain, low back pain, subacute and chronic ankle instability/sprains, and heal pain/plantar fasciitis. Manual therapy is also considered to have moderate evidence supporting its use for hip pain/osteoarthritis and acute ankle sprains. There is less support for the use of manual therapy with non-arthritic hip pain, shoulder adhesive capsulitis (frozen shoulder), Achilles pain/tendinitis, and knee pain due to osteoarthritis/meniscus injury. Manual therapy can still be effective with these conditions but should be combined with other more strongly supported interventions if available.
For all musculoskeletal conditions, manual therapy, patient education, and appropriate exercise should be used as part of a comprehensive, multi-modal physical therapy plan of care that is tailored to an individual patient based on their impairments in order to ensure the best patient outcome possible. Physical therapist should also collaborate with other health care providers if the patient would benefit from care that is not within the scope of practice for Physical Therapy.
If you are having pain and/or limited function, please call OSI Physical Therapy to make an appointment.
Steve Schneider, PT, MS, PT, CMPT.