Hands on treatment or manual therapy can help you get to your goals, it has an important place in physiotherapy treatment when used in the right way, at the right time, with the right person.
Hands on treatment is a component of physiotherapy that can be used in conjunction with other treatment options such as exercise therapy. The ultimate goal of physiotherapy is to help and guide you toward achieving your individual goals.
How does it work?
The current thought process is that that hands on treatment primarily affects your nervous system and not just the local tissues themselves.
The effects occur at a peripheral level (all nerves outside your brain and spinal cord) and a central level (your brain and spinal cord)
This has a knock on effect on many things such as the local tissue, pain levels, muscle activity and can help to reduce muscle spasm and improve range of motion.
At the peripheral level the nervous system (all nerves that are not in your spinal cord or brain) is stimulated by manual therapy to release inflammatory mediators (messengers that act on blood vessels and/or cells to promote an inflammatory response to help the tissue).
Centrally at spinal cord and brain level, things get complicated!
A whole host of proposed mechanisms happen at this central level, including changes in your pain levels, changes in muscle activity in the treated area, an autonomic nervous system response causing changes in hormonal levels ( in particular cortisol-the stress hormone), skin temperature, heart rate, endorphin and opioid responses. Centrally manual therapy can also cause psychological changes such as changing fear of movement, expectations, and even the placebo effect.
Manual therapy or hands on treatment is your physiotherapist’s nervous system talking to your nervous system with the aim of helping you back to what you love to do.
So as we can see, hands on treatment can be helpful at a tissue level but the real impact of manual therapy is on your nervous system.
Research is continuing in this area so we can better understand how manual therapy or hands on treatment can help you.
The most important thing is after your physiotherapist performs the personalised manual therapy to you, you typically feel better!
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