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 pressure on a joint. It can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong, and from slow to rapid. Sometimes other joints of the body are also worked on to help treat the spine.

Chiropractors, osteopathic doctors, 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. (Pain is “nonspecific” when its cause isn’t clear.) A combination of exercise and manual therapy is likely to work the best.^{footnote 1} And manual therapy may be better than medicine for relieving nonspecific neck pain.^{footnote 2}

Manipulation is not recommended if you have nerve-related problems that are very severe or getting worse.

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

• First, try home treatment, like heat, ice, pain relievers, and mild exercise or stretching. These things may help your neck pain the best.
• If you have severe pain or your symptoms are getting worse, or if you’re getting new symptoms, consider talking to your doctor. Manipulation may not be the right treatment for you.
• Good manual therapy will include information on self-care and strength exercises.
• If you choose to see a health care provider who does manual therapy, find one who is willing to work with your other health care providers.

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. If you decide to try it, talk to a couple of different manual therapy providers before you choose and get treated by one.