What are manipulative and body-based practices?

Quick Answer
Manual techniques that release muscle tension and increase circulation to stimulate the body’s natural healing abilities.
Expert Answers
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Manipulative and body-based therapies use manual pressure to effect changes in a body’s physical state. Some techniques release muscle tension, some stimulate nerve pathways, and some aim to balance a body’s vital energy. All of these practices are intended to restore the body to a natural state of balance and to encourage its innate healing abilities.

Mechanism of Action

Acupressure is the technique of applying pressure with the fingertips to specific trigger points on the body to discharge muscle tension and release the body’s obstructed energy. Acupuncture is the insertion of needles into these trigger points and along energy meridians to disrupt neurological signals and relieve pain.

The Bowen technique is a method of gently rolling muscles and tissues with the fingers and thumbs. These moves produce energy surges that stimulate the body to reset and heal itself. Bowen therapy also incorporates periods of rest during the treatment to allow the body to find balance.

Chiropractic is a method of practicing medicine that heals without the use of surgery or pharmaceuticals. One element of chiropractic is manipulation of the spine to restore posture, balance, and freedom from pain. Other elements of chiropractic include electrical muscle stimulation, traction, and therapeutic ultrasound.

Massage therapy is the kneading of the superficial muscles to bring more oxygen to tissues and clear waste products to reduce pain and stiffness throughout the body. It creates relaxation and enhances immune function.

Physical therapy is a treatment plan of body manipulations and exercises designed to maximize mobility and limb function impaired by injury, disease, or birth defect or disorder. Progress can be measured as increased strength, range of motion, and time of unsupported balance.

Reflexology is a technique of applying manual pressure to specific sites on the hands and feet that trigger physical changes in related parts of the body. This technique targets pressure sensors in the hands and feet to disrupt reflexive stress signals and allow the body to return to a natural state.

Shiatsu is similar to acupressure in that pressure is applied with the fingertips to specific targets to clear obstructions in the body’s vital energy. This energy travels along pathways called meridians. Shiatsu differs from acupressure in that a continuous meridian, rather than a discrete trigger point, is the target.

Uses and Applications

Acupressure involves gradually increasing finger pressure on a specific point on the body, typically applied for three minutes. The amount of pressure, the duration of pressure, and the choice of points depend upon the present condition of the body. Acupressure has been shown to bring effective pain relief in cases of migraines, cluster headaches, neuralgias, and childbirth.

The Bowen technique involves a gentle rolling of muscles and connective tissues, yet it targets the nervous and bioenergy systems to boost the body’s natural ability to heal and balance itself. Bowen therapy has been shown to bring effective pain relief in cases of fibromyalgia, sciatica, migraine, and frozen shoulder. It is also used to manage aspects of anxiety and panic attacks, Parkinson’s disease, and cerebral palsy.

Chiropractic treatment often involves the realignment of the spinal column to ease any irritation to the spinal nerves that may be causing pain or malfunction. It brings effective pain relief in cases of headaches, neck pain, lower back strain, and sciatica.

Massage therapy manipulates muscles to increase the circulation of blood and lymph. Additional benefits include increased muscle relaxation, the release of endorphins and serotonin, and improved sleep. Massage therapy may be practiced to promote muscle recovery in athletes; to prevent the formation of scar tissue in persons recovering from surgery, trauma, or burns; and to ease depression.

Physical therapy works to improve a person’s mobility to promote independence and enhance the quality of life. Each treatment plan is tailored to the patient’s present condition and the underlying cause of the impairment. Physical therapy is commonly prescribed following joint replacement and limb amputation.

Reflexology is based on a connection between sites on the hands and feet and the corresponding internal organs. Thus, it is often sought as a noninvasive, nonpharmacological treatment for hormonal imbalances, infertility, sleep disorders, and adverse stress effects.

Like other manipulative body techniques Shiatsu promotes: relaxation, increased flexibility, and enhanced stamina. It also affects the digestive and endocrine systems, may be used to treat constipation, insomnia, and metabolic disorders.

Scientific Evidence

Double-blind studies are difficult to apply to manipulative and body-based therapies because the subjects know what therapy they are receiving. The effectiveness of such therapies may be demonstrated, however, by measuring specific parameters before and after treatment and determining the statistical significance of any difference in a population of subjects. Such parameters include quantitative range of motion and grip strength; blood levels of serotonin, dopamine, epinephrine, and cortisol; and qualitative scales of pain, depression, and disability. Effectiveness may also be compared among therapies and compared with self-care or pharmacological treatment alone.

Choosing a Practitioner

Qualified practitioners are typically required to hold a current state license; the names of licensed practitioners are available from each state’s licensing board. Many practitioners are members of professional associations; membership information by geographical area may be available to potential clients.

Safety Issues

Trained, licensed professionals often hold certificates in first aid and cardiopulmonary resuscitation to address unexpected reactions to therapy. Because each person’s body is different, the reaction to therapy may vary. Injuries may be exacerbated, bruising and swelling may occur, and pain may persist after treatment from nerve inflammation and muscle ache.


American Chiropractic Association. http://www.acatoday.org. The largest professional association for chiropractic doctors.

American Massage Therapy Association. http://www.amtamassage.org. A professional association for massage therapists.

Association of Reflexologists. http://www.aor.org.uk. A nonprofit organization for professional practitioners of reflexology.

Baker, Julian. The Bowen Technique. Champaign, Ill.: Human Kinetics, 2002. A paperback textbook with photographs illustrating proper hand placement.

Gach, Michael Reed, and Beth Ann Henning. Acupressure for Emotional Healing: A Self-Care Guide for Trauma, Stress, and Common Emotional Imbalances. New York: Bantam Books, 2004. A clearly written guide to practicing self-care with acupressure.