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We believe Physical Therapy should include Manual Therapy treatments for several reasons.

Research (Balthazard 2012) shows that Manual Therapy combined with exercises is better than either treatment by itself and according to research by Puentedura (2011), manual therapy reduces fear avoidance behaviors as well.
Looking at evidence based treatment options for low back pain, research shows that manual therapy, like manipulation, is indicated for acute (Fritz 2011, Alrwaily 2016) and chronic conditions (Coulter 2018).
Finally, research (Cook 2017) also shows that patients with chronic low back pain who reported more than 33% pain reduction after 2 weeks with manual therapy had better long term outcomes.

So, the use of manual therapy is indicated to treat acute and chronic pain and should at the very minimum be used for differential diagnosis and early treatment to assess its effect on the patient’s symptoms.

Furthermore it is paramount that Manual Therapy is coupled with Exercises, for it to be truly effective. So when you come to see us, you can expect hands-on treatment in combination with a solid exercise program that is rooted in the most current evidence and based on years of experience treating people with pain movement disorders.

  1. Cook et al. Physiother Theory Pract. 2017. Sep;39 (9): 716-724. Epub Jul 20.
  2. Pierre Balthazard, Pierre de Goumoens, Gilles Rivier, Philippe Demeulenaere, Pierluigi Ballabeni and Olivier Dériaz. BMC Musculoskeletal Disorders. 2012.13:162
  3. Puentedura EJ, Landers MR, Cleland JA, Mintken PE, Huijbregts P, Fernandezde-Las-Penas
    C. Thoracic spine thrust manipulation versus cervical spine thrust manipulation in patients with acute neck pain: a randomized clinical trial. J Ortho Sports Phys Ther. 2011;41(4):208-220.
  4. Coulter et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal 18 (2018) 866–879
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