Minimize Pain with Manual Therapy

Posted on August 14 2017

After coping with pain for an extended period of time, it can almost seem like magic when the pain sensation is alleviated. This can be the case for physical therapy patients who see major relief after a few PT sessions.

I’ve seen this first hand at the Fit Physical Therapy, Trails Clinic. Often, after applying a hands-on technique that helps decrease a patient’s pain they ask, “how did you do that?” as if it were magic.

Well, physical therapists are not magic wizards. However, we are technically trained to understand the human body, the nervous system, and how the two work in tandem. Still, many patients leave physical therapy (PT) with some confusion about how our hands-on technique (manual therapy) actually works. In consideration of full disclosure, this topic is highly discussed in PT circles, as well. The question being:“Manual therapy can be an effective treatment, but how does it work?”

How Does Manual Therapy Work?

How manual therapy works is still a little bit of a mystery, but not a complete mystery. Some researchers (Biolsky et al., 2009) have noted mechanisms that make people feel better without actually making a lasting structural change to tissues. Most likely, there is a calming of nerves around the immediate area where manual therapy occurs; in the spinal cord; and in the brain itself. Isn’t that amazing?!

Someone putting their hands on you can help calm your nervous system down – from the region of the sensitive tissues – all the way up to the brain!

Additionally, there is an expectation bias. Meaning, for example, that if someone expects there to be a benefit, there is a greater chance there will be one! There are also psychological benefits, shown in areas of the brain related to fear. So, someone putting their hands on you in a respectful, caring, and confident manner, may actually decrease a fear response, which might decrease pain… Seems reasonable, right?

Why Does it Matter?

You might be wondering, “does it really matter WHY manual therapy works?” In general, if something is beneficial, that should be enough to rationalize proceeding with the care. However, sometimes the explanations that are given can change how we view our bodies. For example, if someone told you that they “fixed” something, it might cause you to view your body as fragile resulting in an increased frequency to be “fixed.” On the other hand, if someone explains that the pain you are feeling is actually pretty normal and a little bit of hands-on care may simply help calm down a sensitive area – allowing you to resume your daily activities – it may help you to feel more empowered.

Physical Therapy – Based on Science. We Leave the Wizardry to Dumbledore

In conclusion, there is scientific evidence that manual therapy may be a tool to minimize pain. Even though our patients are excited and feel that we have the magic touch, PT’s are not wizards with power to fix people’s structures. Rather, physical therapists are trained in a variety of techniques and a progression of therapeutic exercises to decrease pain and empower people to get back to moving normal and doing what they love.

If it’s any consolation – we think our patients are pretty magical… they blow us away daily with their focus on healing and their hard work to increase mobility and improve their life’s quality. If we can play a role in that outcome, it is our honor.

Yours for self-empowerment,

Emily Kelly, DPT




Bialosky, J. E., Bishop, M. D., Price, D. D., Robinson, M. E., & George, S. Z. (2009). The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model. Manual Therapy14(5), 531–538.




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