Manipulative Physiotherapy

Physiotherapists with Post Graduate Manual Levels or Title have advanced training in the assessment and treatment and diagnosis of musculoskeletal conditions and complex pain syndromes. By employing the most advanced techniques our physiotherapists at Back in Action can help you move well and stay well by:

  • Providing rapid and effective drug-free pain relief through the treatment of underlying problems through joint and soft tissue manipulation and mobilization
  • Assessing and correcting movement dysfunction and faulty spinal mechanics leading to smoother pain free movement
  • Prescribing customized exercise programs to improve and restore optimal stability and movement strategies with the overall goal of preventing injury recurrence.

The physio profession recognizes the importance of evidence based practice and actively encourages practitioners to consider the scientific evidence when developing management programs. So what is the evidence for manipulative physiotherapy practice?

Manipulative physiotherapy works!!!

Manipulative physiotherapists are highly trained in assessing musculoskeletal disorders. The clinical reasoning processes employed by manipulative physiotherapists enables them to reach a diagnosis consistent with the findings of the clinical examination.

Research has shown that manipulative physiotherapists are highly skilled in their examination such that they are able to form a diagnosis similar to or better than those determined by sophisticated imaging processes. For example, studies have shown that manipulative physiotherapists are skilled in the diagnosis of symptomatic facet joints (Philips and Twomey 1996), symptomatic inter-vertebral discs (Donelson et al 1997) and lumbar instability (Avery 1997).

Benefits of manipulative physiotherapy

Manipulative physiotherapists have advanced skills in the assessment, diagnosis and management of musculoskeletal conditions. These skills assist the medical practitioner with accurate, cost effective diagnosis and appropriate evidence based management. Manipulative physiotherapists have world leading expertise in the effective management of pain and other disorders related to the musculoskeletal system.

Evidence on the effectiveness of physical treatments as practiced by manipulative physio is constantly being reviewed. The Physio association of BC recently reviewed the effectiveness of Manipulative therapy for low back pain based on level I evidence (systematic reviews) and level II evidence (randomized controlled trials). One of our back in action Physiotherapists, Bianca Matheson was on the review panel to produce guidelines for all therapists in Canada.

Spinal manipulative therapy (SMT – including both passive mobilization and manipulation), McKenzie therapy and promoting early activity is effective in the short-term management of low back pain (ACHPR 1994, van Tulder et al 1997). General exercise programs designed and supervised by physiotherapists result in reduced disability, reduced absenteeism and faster return to work rate compared to control groups (Frost et al 1995, Gundewall et al 1993, Kellett et al 1991, Mitchell et al 1990, Moffett et al 1999).

Physiotherapists are also pioneering investigations of the proposed mechanisms contributing to chronic and recurrent low back pain by evaluating the effects of specific exercise programs. Evidence to support their efficacy is mounting (O’Sullivan et al 1997). There is strong evidence that SMT is more effective in the management of chronic low back pain than bed rest, analgesics, and massage, with six out of eight trials supporting this evidence (van Tulder et al). More importantly, the combination of SMT and exercise has increasing support in the management of low back pain (Ottenbacher and Difabio 1994, Scheer et al 1995).