Manipulative Treatments for Chronic Pain

The musculoskeletal system consists of the bones, muscles, tendons, nerves, ligaments, and connective tissues that reinforce the skeletal system. It allows the human body to perform movements and create leverage, as well as protect the organs and ensure stability and form. To function properly, it simultaneously interacts with other organs and systems of the body such as the nervous, circulatory and endocrine systems. Whole body wellness requires a healthy musculoskeletal system, which may be achieved through manipulative treatments.

What are manipulative treatments for chronic pain? 

Manipulative treatments are an effective and non-invasive option for those suffering from many forms of chronic and acute pain. Manipulative therapy is administered by chiropractors, physical therapists, and Osteopathic Physicians (D.O.). It restores physical functioning and relieves pain in the affected area by using the hands to apply controlled force and mobilization of the body.

Manipulative therapy is useful in treating back pain, migraines, neck pain, and joint pain. Ideally, pain will be relieved through proper balance of tissue and muscle mechanics. One year-long study that randomly assigned patients into three groups receiving manipulative therapy, physical therapy, or continuous care with a general practitioner found that manipulative therapy caused the greatest reduction in pain and recovery of function. It is also a low risk treatment, especially in comparison to allopathic medical treatments such as opioid therapy.

Chiropractic spinal manipulation treatments and mobilization

The most frequently used chiropractic treatment is spinal manipulation. There are hundreds of manipulative treatments; however most of them employ a high-velocity force targeted at a specific joint in the spine. This causes the cracking or popping sound commonly associated with the practice of chiropractic medicine. It is used to relieve pressure from joints where tissue injury has occurred, either from repetitive stresses or a single inciting event.

For those who require a gentler approach due to conditions such as osteoporosis, spinal mobilization is preferred, which utilizes passive movements over segments of the spine. These techniques are also often used in physical therapy as well.

Osteopathic manipulative treatments

Doctors of Osteopathic Medicine are fully licensed practitioners who receive training for osteopathic diagnosis and manipulation in addition to conventional medical training. Osteopathic medicine embraces the concept that there is an interconnection between the anatomy and physiology of the body. Osteopathic physicians often take a holistic approach to patient care, and therefore integrate manipulative treatments into their therapies for musculoskeletal disorders.

There are numerous manipulative techniques used by D.O.s, however a few common ones include counterstrain, muscle energy, thrust, and soft tissue techniques.

The counterstrain technique relieves pain by positioning and holding the patient in a painless position before slowly returning them to a neutral position. The purpose of this movement is to relax spasming muscles and reduce tone to normal levels so that movement is not restricted.

The muscle energy technique is also used to relax spasming muscles by asking the patient to apply a force against a counterforce in a specific position and direction.

The thrust technique is the “cracking” technique that restores motion to joints and realigns skeletal framework, and the soft tissue technique consists of rhythmic traction, pressure, and stretching of the muscles around the spine.

Finding relief with manipulative treatments

Manipulative treatments provide many patients with effective pain relief. Arizona Pain supports a multi-modal approach to patient care that includes manipulative treatments such as chiropractic therapy. This can be utilized on its own or in conjunction with other forms of care such as interventional pain procedures, behavioral therapy, physical therapy and medications.

Brynna Henwood graduated from Northern Arizona University in May 2015 with a B.S. in Biomedical Sciences. She has coauthored a medical textbook chapter on complex regional pain syndrome and is currently applying to medical school.

Ted Swing has more than 11 years of research experience in psychology and pain medicine and four years of teaching experience, has published in top psychology and medical journals, and has presented his research at major conferences. He received his Ph.D. in Social Psychology from Iowa State University and has been the Research Director at Arizona Pain since May 2012.