Manipulation is defined as “Application of an accurately determined and specifically directed manual force to the body, in order to improve mobility in areas that are restricted; in joints, in connective tissues or in skeletal muscles.”

According to the Orthopaedic Manual Physical Therapy Description of Advanced Specialty Practice manual therapy is defined as a clinical approach utilizing specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.

A consensus study of US chiropractors  defined manual therapy (generally known as the “chiropractic adjustment” in the profession) as “Procedures by which the hands directly contact the body to treat the articulations and/or soft tissues.”

Manipulative therapies: chiropractic, osteopathy and manual medicine

Manipulative therapies include chiropractic, osteopathy and manual medicine. They’re used mainly for:

  • musculoskeletal problems, including spine, neck and shoulder disorders
  • joint, posture and muscle problems
  • sciatica
  • sports injuries
  • whiplash
  • repetitive strain injury (RSI).

The best-known technique is the ‘high-velocity thrust’ – a short, sharp movement, usually applied to joints in the spine, which often produces the sound of a joint ‘cracking’ – but many other methods are also used.

These therapies can be carried out by healthcare professionals including doctors, physiotherapists, osteopaths, and chiropractors.