Manual Therapy: Art or Science?

Abstract

Manual Therapy is one of the most widely used therapeutic solutions in the treatment of pain and musculoskeletal disorders. Its evolution began several centuries ago and culminated in the modern reference methods in the field of physiotherapy, osteopathy, and chiropractic, which mainly address the treatment of joint and myofascial tissues. The advent of evidence-based medicine and the ever-growing literature available in the field of Manual Therapy has led this therapeutic approach to be heavily criticized on the basis of studies that have shown its limitations with regard to manual and palpatory assessment techniques, the poor biomechanical validity of therapeutic methods, and the poor long-term results in the treatment of patients with musculoskeletal pain. A better understanding of the mechanisms underlying the effectiveness of Manual Therapy, as well as of the mediators of the medium-and long-term effectiveness of musculoskeletal rehabilitation processes, has made it possible to reconsider the role of Manual Therapy and the healthcare professionals specializing in manipulative therapy within the framework of the biopsychosocial model, which focuses on the patient and their functionality.

Tension-Type Headache Management: A Systematic Review and Network Meta-analysis of Complementary and Alternative Medicine

“…It encompasses passive movements, joint manipulations, and techniques aimed at improving function and reducing pain. Often, it integrates a biopsychosocial model that considers psychological and social factors alongside biological aspects [23] Physical activity Any bodily movement produced by skeletal muscles that requires energy expenditure [24] Psychological treatment Any form of treatment for psychological, emotional, or behavioral disorders, where trained professionals establish a therapeutic relationship with one or more patients, with the aim of altering or eliminating existing symptoms and promoting personality growth [25] Traditional Chinese medicine A medical system that is at least 23 centuries old, originating from China, one of the world's oldest civilizations with a rich medical heritage. TCM aims to prevent or heal diseases by maintaining or restoring the balance between yin and yang, which are considered fundamental aspects of the human body and the universe in traditional Chinese philosophy [26] randomization method and allocation concealment were rated as low risk of bias, along with all other aspects receiving low-risk or unclear risk evaluations.…”

Orthopedic Joint Preservation: A Comprehensive Review

“…Physiotherapy techniques such as manual therapy play a role in joint preservation by addressing pain and improving function. Manual therapy involves the use of hands to stretch, mobilize, or manipulate the spinal column, paravertebral structures, or extremity joints [85]. Physiotherapy techniques such as modalities like ultrasound and electrical stimulation play a role in joint preservation.…”