Manual Therapy

What is manual therapy and who can perform it?

In Hungary, manual therapy can only be used by doctors and physiotherapists to assess and treat reversible, functional changes in the musculoskeletal system. Knowing this avoids any misconceptions that manual therapy is the same as massage or chiropractic. Manual therapy is actually a combination of manual techniques:

  1. mobilisation
  2. soft tissue techniques (combination of massage and mobilisation)
  3. manipulation (medical competence!)

There are several types of manual therapy. In our practice, we mainly use the Barvicsenko (Lewit) manual therapy, which is a 2-year accredited training course of Semmelweis University. The therapy is not painful. It is preceded by a detailed assessment, which includes a thorough history taking, posture examination in underwear, examination of spinal movements, segmental examination of the vertebrae or other joints (shoulder, hip, elbow, etc.) and soft tissues (muscles, connective tissue) in 80 minutes.

What is the purpose of manual therapy?

To restore reversible changes to the musculoskeletal system and its function:

  1. release of joint blocks (limb joints, pelvis, spine) that cause movement restriction
  2. elimination of painful muscle tensions, trigger points 
  3. relief of painful joints

What problems can be treated with manual therapy?

  • spinal and muscular neck, back and lower back pain
  • scoliosis
  • pain and numbness radiating to the extremities associated with spinal disorders
  • disc disorders
  • postural problems
  • Scheurmann’s disease
  • slipped vertebrae
  • scapulothoracic, shoulder (e.g. frozen shoulder), elbow (e.g. tennis elbow, golf elbow) and hand (tunnel syndromes) complaints
  • hip joint pain, knee joint pain (arthrosis), ankle joint pain and foot pain (bunions – hallux valgus)
  • intercostal pain (when breathing in or out)
  • musculoskeletal headaches, dizziness
  • tense, cramped muscles
  • pubic bone pain (during pregnancy – don’t wait for pain, after childbirth)
  • tailbone pain (after falling on it, after childbirth, in case of tight pelvic floor muscles)

(The list is not complete.)

When should manual therapy not be used?

  • cancer
  • heart and lung disease
  • severe osteoporosis
  • acute arthritis
  • rheumatoid arthritis (RA)
  • atlantoaxial subluxation
  • in vertebrobasilar insufficiency certain neck techniques are prohibited

How do we use manual therapy in practice?

Manual therapy, like all manual techniques, is used in combination with individualised physiotherapy and patient education.