Manual Physical Therapy is the premier method for the treatment of acute back and neck pain. In simplest terms a manual therapist is a physical therapist who utilizes skilled hand movements to diagnose and treat his or her patients’ soft tissue dysfunctions. These hands-on techniques are applied with the goals of improving tissue extensibility, increasing range of motion, inducing relaxation, modulating pain, reducing soft tissue inflammation, optimizing posture and improving function. In reality, good manual technique requires considerable experience and talent to develop. The therapist must learn to move the small joints, discs and soft tissues in the spine, perceive the subtle differences in joint resistance and mobility through the fingertips and localize the areas of soft tissue and joint dysfunction. He or she then must create an individualized treatment plan to improve overall function through a series of passive mobilizations to the affected tissues and active exercise. Ultimately, the therapist then must educate the patient to understand the processes at play and create an exercise program to permit that patient to independently maintain long term spine health.

The generally accepted fathers of modern manual physical therapy technique include Geoffrey Maitland from Australia, Robin McKenzie from New Zealand, and F. Kaltenborn from Norway. They have published extensively on manual technique, taking the science to an unprecedented level. Manual therapy is becoming more widely utilized within the USA and over the last decade has become a critical part of the undergraduate curricula of major Physical Therapy schools5. In modern practice, qualified manual physical therapists often use an eclectic assortment of techniques to best treat their patients, with contributions from Maitland, Paris, Kaltenborn, McKenzie, Mulligan and others.

In the Mid-south, there are numerous excellent physiotherapists focusing upon sports medicine, total joint and upper extremity rehabilitation, however the percentage of therapists credentialed to perform manual therapy and mobilizations is even lower than the national norm, creating very real concern over the quality of spinal therapy available in our community. Although many may claim they use manual techniques, few can show certified training in proper technique.