Manipulation and Massage for Pain Management

Manipulation and massage therapy can help more than sore neck or back muscles. Learn about the types of doctors and tools that can help treat your chronic pain.

When it comes to treating chronic pain, how it is treated depends on numerous factors, including the condition your pain is associated with as well as any other symptoms. Manipulation and massage are two types of pain management techniques that can help to manage pain. Manipulation involves a therapist using their hands or a small tool to manipulate your muscles and other soft tissues. Manipulations are delivered either manually or instrument-assisted, such as an activator gun and/or drop table assist. This works out more than just the knots and kinks in your muscles—it’s a therapeutic approach to treating your pain.

What Types of Doctors Offer Manipulation and Massage Therapy?

The three types of professions that can perform manipulation are: chiropractors, osteopathic doctors, and physical therapists (PTs). All three are reimbursed by Medicare and commercial healthcare providers; there are no universal exclusions for PTs. Osteopathic manipulation is what PT typically align with.

A physical therapist, chiropractor, or osteopathic doctor can provide pain-relieving manipulation and massage therapies.(Source: 123RF)

The two main types of manipulation—osteopathic and chiropractic—are commonly used to treat:

  • headaches
  • low back pain
  • neck pain
  • sports injuries.

Similarly, massage therapists (MTs) use massage to reduce chronic aches and pains associated with a wide variety of conditions where the soft tissues are contributing to the pain. Massage also has universal usage within the previous three professions already mentioned—however, the MT is the massage specialist. 

The main goals of manipulation and massage are to relieve pain and improve range of motion (ROM) to help you increase daily activities. These treatments are generally safe and can be very effective.  And any mild soreness or discomfort, such as fatigue and dizziness, typically goes away in less than two days. 

What is Osteopathic Manipulation?

Osteopathic manipulation is performed by doctors who apply manual pressure or force to treat certain musculoskeletal disorders and to restore overall health in the body.

This type of manipulation uses various techniques to specifically address pain associated with your muscles and other soft tissues.

  • Counterstrain technique: This technique helps improve comfort in certain positions and is good for treating muscles spasms and acute muscle pain.
  • Muscle energy technique: With the muscle energy technique, you’ll move in a specific position and direction against a counterforce applied by the doctor.
  • Soft tissue technique: With this approach, your doctor applies stretching, pressure (trigger points), and traction to the muscles near the spine.
  • Thrust technique: This technique uses force to restore motion to a joint. The thrust technique is most known for the “cracking” and “popping” sounds your joints make when moved this way.

Although these osteopathic manipulation techniques can help address chronic pain, certain people should avoid osteopathic manipulation: those who have bone cancer or osteoporosis and those who’ve had a spinal fusion, for example.

What is Chiropractic Manipulation?

Chiropractic manipulation—also known as spinal manipulation and chiropractic adjustment—is a very common treatment for low back pain and neck pain. It involves realigning the joints and moving them within or beyond their normal range of motion.

This treatment is also commonly used to reduce muscle spasms and alleviate pressure on your spinal nerves.

Chiropractic manipulation involves a couple of key techniques.

  • Low-velocity adjustments: This approach applies slow stretching, pulling, or pushing forces.
  • High-velocity adjustments: With this technique, the chiropractor applies firm pressure and moves the joint through its full range of motion and then delivers a quick manual thrust in a precise direction to increase joint mobility.

What is Massage Therapy?

There are many massage techniques available—from Swedish massage to deep tissue massage. However, they each share common benefits, including to:

  • improve overall sense of well-being and quality of sleep
  • increase blood flow to specific areas of the body
  • promote relaxation
  • reduce stress, depression, and anxiety
  • relieve tense muscles.

How Often Should I Have a Manipulation and Massage Treatment?

The number of osteopathic or chiropractic manipulation sessions or massages you need depends on the severity of your pain and other symptoms. Your doctor, chiropractor, or massage therapist will let you know how many treatment sessions are right for you to help you manage your pain. You may need to have these treatments on an ongoing basis in order for them to be effective.


-Dr. Marvino reviewed and updated this treatment center in Spring 2019.

Updated on: 04/05/19
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