• Dr. Judy Spilka, PT

The benefits of manual therapy -- A hands on approach to pain management


Physical therapists have an all encompassing approach to patients’ recovery from injury and pain. One of the fundamental components that I love to add to patients care is the use of “manual therapy” or the skilled “hands-on” approach. Types of manual therapy that are applied by the therapist to the patient are myofascial release, stretching, IASTM “scraping”, or cupping therapy. The main purpose of manual therapy is to decrease pain, spasm, and/ or stiffness to improve the body’s ability to facilitate movement. Essentially manual therapy helps muscles relax, decreases the patient’s perception of pain towards movement, improves flexibility of a muscle, or helps muscle have better contractibility. People call this the passive approach to therapy, but the research supports much more that is going on with our nervous and hormonal systems (neurohormonal system) with the application of therapy. The neurohormonal system is what drives patient’s pain experience.



A majority of our patients come into Fitness Forum with an experience of pain. Pain is an unpleasant sensory and emotional experience. This may or may not relate to actual tissue damage but pain is always subjective to each patient. Immediate affect post manual therapy is shown in research to reduce inflammatory markers and decrease spinal/ nervous system excitability (hypersensitivity) (Bishop et al., 2015). At times, a patient cannot perform a certain movement pattern or task until I provide manual therapy to help decrease a painful muscle spasm so the patient can feel the improvement to be able to move. Every patient has a different experience with each method so each patient needs to be independently evaluated for which treatment is the most effective for that person.



Overall, manual therapy is an effective treatment but should always be included in a multimodal approach including strength training to get the patient back to their functional movement. If you’re seeking manual therapy for any reason, please call us at Fitness Forum so you can be set up with a specialist to see if that’s exactly what you need and to create an individual plan specifically for you.



References:


Bishop, M. B., Torres-Cueco, R. T. C., Gay, C. G., Lluch-Girbés, E. L. G., & Beneciuk, J. B. (2015). What effect can manual therapy have on a patient’s pain experience? Pain Management, 5(6), 455–464. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976880/pdf/pmt-05-455.pdf

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