Manual Therapies

Manual therapies (so I have recently learned) are those that use the hands to treat disorders of bones, muscles and joints. In this post I’ll look at physiotherapy, chiropractic, massage, and acupuncture. Although acupuncture is not a manual therapy (no direct use of hands) it fits in quite nicely with the others! It should be noted that although only physical symptoms are treated with these therapies, they can also promote mental and emotional wellbeing.

Both physiotherapy and chiropractic work with all ages of people. The treatments are most effective when the patient is actively involved in the process – when they listen to advice given and act on it. This means (for example) if you’re told to do certain exercises, then do them. If you don’t do the work you won’t see an improvement, and if you’re not going to follow the advice you’re given then why go?

“Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.” The Chartered Society of Physiotherapy.

Physiotherapists work in various settings including hospitals, health clinics, and sports centres. They help patients with various health conditions, including those affecting bones, joints and soft tissues; brain or nervous system; heart and circulation; lungs and breathing. Main approaches used are education and advice, tailored exercises, and manual therapy.

“Chiropractors are trained to diagnose, treat, manage and prevent disorders of the musculoskeletal system (bones, joints, and muscles), as well as the effects these disorders can have on the nervous system and general health.” British Chiropractic Association.

Chiropractors use a range of techniques to treat patients, focusing on gentle manipulation of joints and massage. Treatments can also include advice on diet, lifestyle, exercise and posture; assignment of exercises to do at home; use of ice, heat, ultrasound, and acupuncture. Because chiropractic is seen as a complementary/alternative medicine, it isn’t looked on favourably by the medical profession and is not commonly available on the NHS. This means you’ll probably have to pay for treatments privately.

Massage: “the rubbing and kneading of muscles and joints of the body with the hands, especially to relieve tension or pain”Google.

Massage is often viewed as an indulgence, but it can also be of benefit to your health and wellbeing – if done properly a good massage can significantly reduce pain and tension, and improve your mental state. It can be offered as part of other therapies, such as the Chiropractic, or it can be a treatment in itself – e.g. a sports massage. There are also different levels of treatment ranging from gentle and relaxing to a deep tissue massage that will probably leave you with a bright red back.

“Acupuncture is a treatment derived from ancient Chinese medicine. Fine needles are inserted at certain sites in the body for therapeutic or preventative purposes.” NHS.

Although acupuncture is a complementary/alternative therapy, it is becoming more accepted by the medical community and is available in some circumstances on the NHS. There are differences between Western uses and the traditional Eastern methods, and so you may wish to find a traditional practitioner to visit. Acupuncture is most commonly used to alleviate pain, although it also helps a variety of other symptoms. (A consultation will be required to determine the best course of treatment) As well as improving specific symptoms, it can produce a feeling of wellbeing.

A few words of warning:

  • If you seek treatment from a practitioner of any of these therapies it is up to you, the patient, to check their credentials. Look to see if there are certificates displayed (what for and where are they from), ask about their qualifications, do a bit of research on the practice beforehand. You are trusting these people and it’s not out of place to ask a few questions.
  • You may experience some pain after a treatment, however it shouldn’t last much beyond that day. Speak to the practitioner or a medical professional if you’re concerned.
  • Not all practitioners work in the same ways, even within a single discipline, so you may have to try several different practices before you find one that suits you.
  • Although physiotherapy and chiropractic sound similar in some ways, they are not the same.
  • Most of these treatments will require an initial consultation followed by a series of appointments.
  • Treatment can become expensive, especially if you go regularly.


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