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Pain Manag. 2015;5(6):455-64. doi: 10.2217/pmt.15.39. Epub 2015 Sep 24.

What effect can manual therapy have on a patient's pain experience?

Author information

Department of Physical Therapy, PO Box 100154, University of Florida, Gainesville, FL 32610, USA.
Center for Pain Research & Behavioral Health, PO Box 100165, University of Florida, Gainesville, FL 32610, USA.
Pain Research & Investigation Center of Excellence, 2004 Mowry Road, University of Florida, Gainesville, FL 32610, USA.
Department of Physical Therapy, University of Valencia, Av. de Blasco Ibáñez, 13, 46010 València, Spain.
Brooks Rehabilitation-College of Public Health & Health Professions Research Collaboration, PO Box 100154, University of Florida, Gainesville, FL, 32610, USA.


Manual therapy (MT) is a passive, skilled movement applied by clinicians that directly or indirectly targets a variety of anatomical structures or systems, which is utilized with the intent to create beneficial changes in some aspect of the patient pain experience. Collectively, the process of MT is grounded on clinical reasoning to enhance patient management for musculoskeletal pain by influencing factors from a multidimensional perspective that have potential to positively impact clinical outcomes. The influence of biomechanical, neurophysiological, psychological and nonspecific patient factors as treatment mediators and/or moderators provides additional information related to the process and potential mechanisms by which MT may be effective. As healthcare delivery advances toward personalized approaches there is a crucial need to advance our understanding of the underlying mechanisms associated with MT effectiveness.


biomechanical; clinical reasoning; effectiveness; expectation; neurophysiological; placebo; preference; psychological; treatment mediation; treatment moderation

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Financial & competing interests disclosure This work was supported by funding from the National Institutes of Health National Center for Complementary and Integrative Health (R01AT006334 – MD Bishop, J Bialosky; F32 AT007729 – CW Gay) and National Center for Medical Rehabilitation Research (K12HD055929 – JM Beneciuk). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

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