Manipulative Physiotherapy

Manipulation is a commonly used technique in the field of manual therapy and its origins can be traced back to the time of Hippocrates in 400BC.

Physiotherapists are armed with an array of treatment techniques and skills each aimed at achieving specific results depending on the desired goal.

The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints (usually spinal) that have become stiff (hypomobile) or restricted in their movement as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy embed, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time.

Manipulation of a joint is often accompanied by a clicking or popping sound, which is thought to be gas bubbles collapsing in the synovial fluid of the joint. You may have experienced this when people ‘crack their knuckles’.

It is usual in physiotherapy for manipulation to be used in association with other forms of treatment such as, joint and soft tissue mobilisations which aim to alleviate pain and muscle tightness allowing tissues to heal. Specific exercises are usually prescribed to maintain the improvements that have come about through treatment.

None of the above techniques are used unless a full clinical examination has taken place and the BWT Physiotherapist feels that Manipulation would be a safe and effective treatment of choice.

In clinical trials, manipulation was found to be safe and as effective as "conventional" treatments (e.g. pain medication, rest, exercise). (1)

A Cochrane review found that mobilisation and/or manipulation when used with exercise are beneficial for persistent mechanical neck disorders with or without headache. (2)

(1) Cherkin, DC, Sherman, KJ, Deyo, RA, Shekelle, PG. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Ann Intern Med 2003; 138:898.

(2) Gross AR, Hoving JL, Haines TA, et al, A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine. 2004 Jul 15;29(14):1541-8.