Topic Overview

Manual therapy includes:

• Massage, which applies pressure to the soft tissues of the body, such as the muscles.
• Mobilization, which uses slow, measured movements to twist, pull, or push bones and joints.
• Manipulation, which uses rapid, forceful movements to move the bones and joints.

Chiropractors, osteopaths, massage therapists, and physical therapists sometimes use manual treatment.

Manual therapy is sometimes used for neck pain. A review of multiple studies shows that exercise and mobilization, either separate or used together, are likely to be helpful in the treatment of nonspecific neck pain. Manipulation is also likely to be helpful.¹

Rare problems, such as a herniated disc, may occur when chiropractic adjustment is used to treat neck or back pain. This can cause pain, weakness, and numbness in the buttocks and down the legs. And it may affect bladder and bowel control.

Before you try manual therapy for neck pain, think about the following:

• First try home treatment, like ice, heat, pain relievers, and mild exercise or stretching. These things may help your neck pain the best.
• Before you try manual therapy, see your regular doctor or physical therapist about your neck pain. He or she can look for signs of a serious problem.
• Good manual therapy will include information on self-care and strength exercises.
• If you choose to see a manual therapist, find one who is willing to work with your other doctors.

Do your research. Not all manual therapy is the same. And there isn't a good way to tell what will be helpful and what won't. Ask your doctor if it is safe for you to get manual therapy. If you decide to try it, talk to a couple of different therapists before you start seeing one. A good manual therapist will:

• Work with your other doctors on your treatment.
• Give you information about home treatment and exercises.
• Use slow, gentle manual therapy on your neck.
• Use massage, heat and cold, ultrasound, or electric current in your treatment. These are the usual things manual therapists do.

Don't see a manual therapist who:

• Wants you to have regular visits for a long time to prevent illness or other joint problems.
• Tries to sell you herbal or dietary supplements, counseling, or other services without any training in those areas.
• Wants to give you an X-ray right away without knowing anything else about your problem.
• Talks to you about "subluxation," which is the partial dislocation of two joint surfaces and is an unproven theory.