We love manual therapy in Singapore! Patients often come back asking for more. But this is not what we do at Square One. We often explain to patients that manual therapy does not have long-lasting effect on their symptoms. Yes, manual therapy can be excellent at manipulating your pain experience. After all, you DO feel a lot better straight after a massage. We are all familiar with that. The relief, however, is often temporary. While manual therapy still has a (small) role to play in pain management, it is important for you to understand how it works and to have the right expectations.

What is Manual Therapy?

So, what exactly is manual therapy? In clinical terms, manual therapy refers to any hands-on technique applied to joints or soft tissues for the purpose of pain relief. Common examples include chiropractic adjustments, massage, and even dry needling.

Non-manual therapy modalities include rehabilitation (exercise therapy) and electrotherapy (TENS, EMS. ultrasound).

How exactly does manual therapy work?

To be honest, we are not completely sure!

When mechanical stimulation (massage, chiropractic adjustment, etc) is applied applied to our skin, a whole lot of receptors are activated. We see a decrease in cytokines and substance p with an increase in endorphins and cannabinoids. These compounds work together to help us feel good.

From a muscular point of view, we see muscles with high activity decreasing towards normal and muscle with low activity increasing towards normal.

We are almost certain these manual therapy-associated changes are neurological in nature.

Breaking up scar tissue, correcting alignment, and putting your bone back into place are archaic and does not fit into the current evidence-based framework.

Effects of Chiropractic Adjustment Goes Beyond the Spine

Interesting enough, we are starting to see spinal manipulation works both locally (where the treatment is applied) and also remotely (at an area away from where the treatment was applied). In simpler words, if I were to apply a chiropractic adjustment to your low back, your pain tolerance at your shoulder blades and calves also increases (i.e. you feel less pain) – on top of your low back – pretty remarkable huh?

Of course more research is needed! But don’t worry, Dr. Sasha Dorron (the author of the paper below) is already working on her next randomised-controlled trial!

Reference: Effect of lumbar spinal manipulation on local and remote pressure pain threshold and pinprick sensitivity in asymptomatic individuals: a randomised trial

So Manual Therapy Works?

Yes, manual therapy works as an adjunct therapy (i.e. to be used concurrently with other treatment). No, it is not your long-term pain solution.

Manual therapy is at best second-line treatment as far as musculoskeletal care is concerned. The top choice for ALL clinical guidelines are exercise, advice, and education. This is exactly what we are about.

Anyone can do manual therapy

Don’t forget, anyone can do manual therapy! It doesn’t take a lot of effort for your parent or your spouse to give you a back rub. The blunt end of the butterknife could easy pass off any any IASTM (instrument assisted soft-tissue mobilisation) tool. Manual therapy is easy to perform and it doesn’t take you more than a weekend to become a certified massage therapist.

If you are planning to pay a lot of money for a clinical healthcare provider, choose someone who offers you more value for your money.

Yes, we offer manual therapy (i.e. chiropractic adjustments, dry needling, IASTM) at Square one. However, it is not a core part of your treatment approach. We much prefer to get you moving and get you pain-free with our own evidence-based Dynamic Functional Alignment.

Read More: Five Things to Consider Before Making a Chiropractic Booking With Us