What is it?

The term ‘manipulation’ comes from the Latin manipulare, meaning ‘to handle’. It covers a range of techniques that use the hands to realign the structural system of the body, relax muscles and improve circulation.

The most common forms of manipulation practised in complementary medicine are osteopathy and chiropractic. Physiotherapists also use manipulation techniques.
History and theory

Therapeutic touch has been used for healing since ancient times. Manipulation was practised in ancient Greece and ‘bonesetters’ were part of all early Eastern and European medical traditions.

Osteopathy and chiropractic both originated in the US in the late 1800s and early 1900s. Dr Andrew Taylor Still devised a system of manipulation techniques known as osteopathy (osteo means ‘bone’ and pathos means ‘disease’) to rebalance the framework of the body, improve joint mobility and allow proper function of the internal organs.

Daniel David Palmer, a gifted lay practitioner, developed chiropractic techniques (chiro is Greek for ‘hand’ and practicos means ‘done by’) for relaxing the spinal muscles and freeing the body’s healing energy.

According to osteopathic theory, the body’s structure and function are closely connected. This means spinal imbalance or restriction of movement not only can cause pain and discomfort but may also interfere with internal organ function. Correcting the imbalance and improving the range of movement can therefore both ease pain and improve organ function.

Chiropractic focuses on the links between the spine and nervous system. Corrections of spinal imbalance are believed to help restore the nervous system and improve internal organ function.
What’s it good for?

The techniques used in osteopathy and chiropractic release muscle tension, reduce joint stiffness and improve circulation. The techniques may also alter the sensory input to the brain, changing the sensations and perception of pain.

Some benefits are also thought to be due to the therapeutic effect of touch. Direct techniques include high- and low-velocity thrusts and gentle rotations designed to increase range of movement, relax the muscles and increase circulation.

Subtle ‘cranial’ techniques are used to regulate the ebb and flow of cerebrospinal fluid (the fluid that flows within the spinal cord) at the cranium (head) and sacrum (tailbone) in order to influence the nervous system.

Chiropractors generally use more direct manipulation techniques; osteopaths also use direct techniques but often favour gentle manipulations, soft-tissue massage and subtle cranial techniques.

Manipulation has been shown to be beneficial for joint and back problems, especially low back pain, neck stiffness and pain, and knee problems. It can also help to relieveheadaches and ear, nose and throat problems caused by restriction of the spine and muscle tension. Some osteopaths and chiropractors also treat general health problems such as digestive disorders, menstrual imbalance and urinary disturbance.
Finding a practitioner

Osteopaths and chiropractors have statutory registration procedures in place. Since May 2000, all osteopaths have had to belong to the General Osteopathic Council, which oversees training and practice standards. Membership entitles practitioners to use ‘osteopath’ or ‘registered osteopath’ after their name. or call 020 7357 6655 for details of a registered practitioner near you.

Since June 2002, all chiropractors have had to register with the General Chiropractic Council. Visit or call 020 7713 5155 for details.
Take care

Manipulation techniques should be used with care during pregnancy and shouldn’t be used in case of bone cancers or bone or joint infections.

This article was last medically reviewed by Dr Stephen Hopwood in April 2009.

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