PainScience.com • Good advice for aches, pains & injuries

Manual therapy: process or product?

updated

Tags: manual therapy, physical therapy, politics, treatment

Three articles on PainSci cite Silvernail 2012: (1) Pseudo-Quackery in the Treatment of Pain(2) Science versus Experience in Musculoskeletal Medicine(3) Reassurance for Massage Therapists

PainSci summary of Silvernail 2012: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.

Selected quotes:

Published trials of an impairment-based manual therapy approach where the treatment is provided by highly-trained clinicians using manual therapy in the context of a systematic, hypothesis-based clinical reasoning process have consistently shown large effect sizes in validated outcome measures relative to other interventions.

Manual therapy is not, as is sometimes believed, simply the application of manipulative techniques for the treatment of painful problems. A manipulative procedure is not the same as a manual therapy approach, just as extension exercises do not represent the MDT approach. The manual therapy approach is a ‘process’ of care centred on a reasoning model, not a ‘product’ consisting of one or more manipulative techniques.

Anyone can show a patient a few press-ups or twist someone’s spine. It takes a skilled and well-trained clinician to use a systematic reasoning model to arrive at the appropriate treatment decision, and that clinical process leads to the positive results seen in published randomized trials. These are results that last and produce meaningful improvement in our patients’ lives — using low cost, low risk, non-invasive care.

~ Paul Ingraham

related content

This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights: