Medication or Manual Therapy?

Reaching first for pain relief medication is a habit in the United States. In fact, we Americans consume 80% of the global opioid supply. If this worldwide epidemic alarms you, you’ll be pleased to find out that you can get pain relief through manual therapy. It’s non-addicting, and there are no harmful side effects from manual therapy.

Have you ever rubbed your temples to seek relief from a headache? Have you instinctively squeezed your shoulder to relieve a twinge of pain? Have you ever pressed your knuckles into your lower back to ease the tension there? If so, you have used a form of manual therapy to relieve pain.

Humans have instinctively used the power of touch to assist the healing process. Now take those instinctive actions and add knowledge of the musculoskeletal system. Next add extensive training in specific techniques, and you have a clearer idea of what manual therapy is and what it can do for you.

A Professional Perspective

Within the field of physical therapy, manual therapy techniques are “skilled hand movements” intended to produce any or all of the following effects: improve tissue extensibility; increase range of motion of the joint complex; mobilize or manipulate soft tissues and joints; induce relaxation; change muscle function; modulate pain; and reduce soft tissue swelling, inflammation, or movement restriction.”

You might be thinking that manual therapy sounds no different than massage. While it’s true that both are used to relax tension and both manipulate soft tissues, there are important differences. While massage uses pressure on soft tissue to relieve stress, a physical therapist uses hands-on techniques to not only treat your condition, but also to assess it initially.

Using manual therapy techniques, your physical therapist will first assess the condition of your joints or tissues. Then your therapist can use manual therapy techniques to correct problems, such as swelling or misalignment. Used in conjunction with traditional physical therapy, your body could heal more quickly.

How physical therapy and manual therapy work together

Traditional physical therapy typically focuses on treating the symptom of a problem. Manual physical therapy aims at finding the SOURCE of the problem. Through specific evaluation techniques designed to isolate the underlying cause of the condition, your manual physical therapist will develop a program to address all the contributing factors.  

Where traditional physical therapy often uses exercise and modalities as the form of treatment, manual physical therapy incorporates exercise, neuromuscular re-education, and specific manual techniques to improve the problem.

Ailments that Particularly Benefit from Manual Therapy

At the most basic level, an ailment related to either soft tissues or joints is a candidate for treatment using manual therapy. This is only a partial list of health issues that we can treat you for, from head to toe:

  • Headaches and facial pain
  • TMJ, or jaw pain
  • Neck, shoulder, shoulder blade
  • Upper arm, elbow, lower arm, wrist and hand, finger
  • Rib cage, sternum
  • Intervertebral disc, back, pelvic, sacroiliac
  • Hip, buttock, thigh, knee, lower leg, ankle, foot, toe
  • Ligament, tendon, muscle, visceral (internal organ) pain, scarring

In other words, wherever you hurt, you can likely find pain relief through manual therapy techniques. Our therapists will assess your specific issue(s) to determine whether your condition can be improved by manual therapy.

Manual Therapy Techniques

Manual therapy techniques run the gamut from soft tissue techniques to joint techniques. Soft tissue mobilization, myofascial release, strain-counterstrain, muscle energy techniques, and joint mobilizations and manipulations are among the techniques most commonly used by physical therapists; this list, however, is not exhaustive.

Joint Mobilization/Joint Manipulation

These techniques use skilled passive movements to the joints as well as the soft tissues surrounding the joints. The therapist applies the technique at different speeds from slow to fast, and with various amplitudes, or distance. These techniques improve your range of motion. If you have pulled muscle in your back, but the pain returns after treating it with rest, ice and massage, it could be that your muscle spasm is in response to a restricted joint. This technique could benefit you.

Soft Tissue Mobilization/Manipulation

The goal of soft tissue mobilization is to break up stiff or fibrous muscle tissue, referred to as myofascial adhesions, such as scar tissue from a back injury. This procedure is commonly applied to muscles surrounding the spine, and consists of rhythmic stretching and deep pressure. When your muscles are tight and restricting your movement, these techniques focus on connective tissue to improve your range of motion. Soft Tissue Manipulation can assist with lengthening of the muscle tissue.

Myofascial Release

Myofascial tissues are the tough membranes that surround and support your muscles. When this tissue feels stiff and fixed instead of elastic and movable, you experience it as a pain “trigger point.”  Focused pressure and stretching used in myofascial release therapy loosens up your restricted movement, leading to reduced pain.


Unlike other manual therapy techniques, Strain-Counterstrain is a passive, rather than active, positional procedure. It also differs from other techniques because it is considered an indirect technique, making it gentle enough to be useful for back problems that are too acute or delicate to treat with other procedures.

CranioSacral Therapy

Physical therapists use this manual therapy technique to treat neck and back pain, migraines, TMJ Syndrome, and for chronic pain, such as fibromyalgia.

Muscle Energy Technique (MET)

This active technique, which uses a voluntary contraction of your muscles against a counterforce, is used to lengthen shortened muscles, reduce swelling, and mobilize restricted joints.

There are too many specific techniques to mention them all here. Your physical therapist will explain the specific technique that will be applied to resolve your underlying condition and the resulting pain it creates. Never hesitate to ask your therapist questions. We want you to understand what technique we are using and why it will benefit you.

Training in Manual Therapy

Not all physical therapists are trained in the specific techniques of manual therapy. Only those physical therapists who receive special training will provide you with this service.

We dedicate our careers to finding the most effective way to treat problems by participating in continuing education opportunities to stay current with evolving techniques, knowledge, and standards of treatment.

Don’t Settle for Living in Pain

Pain medications have their place in your recovery and management of pain. If you would like to be less reliant on pain medications, whether your concern is potential addiction to painkillers, adverse side effects from them, or dangerous drug interactions, come discuss your concern with a staff member at Midland Physical Therapy.

We provide you with information you need to make educated choices about your pain management treatments. We can assess your situation and walk you through your options. We will help you find the combination of approaches that will work for you. Call us today. You can find pain relief through manual therapy.