According to Hayden et al. (2021), a comprehensive review of 249 international studies on chronic low back pain discovered that exercise and manual therapy are the two most effective treatments. What a coincidence – that is exactly what we offer in our office! But what exactly is manual therapy? Let us delve deeper by first learning what manual therapy is and how it works as a treatment for lower back pain.


What is Manual Therapy? 

Manual therapy is a type of physical therapy in which hands are used to apply pressure to muscle tissue and manipulate joints in an attempt to alleviate back pain caused by muscle tension, joint dysfunction, and muscle spasm. Spinal manipulation may be used in manual therapy to treat joints and muscles and improve flexibility. Here are the two manual therapy techniques: 

  • Pressure is applied to soft tissues or muscles. The pressure relaxes tense muscles, improves blood circulation, and relieves muscle pain.
  • Mobilization of joints and muscles involves the use of slow to fast movements and gentle to forceful pressure to manipulate joints and bones into the correct area. This aids in the loosening of tight muscles around joints, as well as the reduction of muscle and joint pain and the improvement of alignment and flexibility.


Types of Manual Therapy 

Here are some types of manual therapy used to treat low back pain.


  • Joint Mobilization – This type of manual therapy increases joint range of motion and loosens restricted joints.
  • Soft Tissue Mobilization – Rhythmic stretching and deep pressure are applied to the muscles around the spine.
  • Muscle Energy Techniques – An active procedure that involves mobilizing restricted muscles and lengthening shortened muscles.
  • Strain-Counterstrain – This helps to correct abnormal reflexes of the neuromuscular system that cause postural problems that result in back pain. This aids in determining the most comfortable position and keeps the patient in that position for 1 minute and 30 seconds. Following that, gentle stretching will be performed to move the body out of its comfortable position, allowing the muscles to return to their normal level of tension. 


How Does It Work? 

Many studies and experiences have shown that physical therapist-assisted manual therapy and exercises work best for chronic lower back pain. In fact, non-pharmacological and non-invasive treatment for lower back pain is recommended by low back pain clinical guidelines. These include advice on staying active as well as exercise therapy such as manual therapy. This is due to the fact that manual therapy is beneficial in the treatment of muscles and joints that lack a range of motion and mobility in certain musculoskeletal conditions. 


Manual therapy helps to restore mobility to stiff joints and reduce muscle tension, allowing the patient to return to more natural movement without pain. As a result, it will provide back pain relief to patients suffering from chronic back pain caused by joint problems, as well as acute back pain caused by soft tissue injuries. The following are the objectives of manual therapy for lower back pain:

  • Improve low back function to allow for as much independence in daily activities as possible.
  • Improve the flexibility and range of motion of the spine.
  • Prevent the recurrence of back pain.
  • Reduces the severity of lower back pain symptoms.


Manual therapy combined with exercises can help with the treatment of low back pain. The patient can perform their exercise more precisely thanks to the immediate pain relief that manual therapy can produce. When combined with manual therapy, exercise treatment is more effective than electrotherapy or education alone. 


If you have chronic lower back pain or pain in any other part of your body, come to Ashworth Chiropractic Physical Therapy and Acupuncture right away for the best treatment and relief you’ve ever had. Make an appointment right away by calling (515) 225-4002 or visiting our clinic at 5504 Ashworth Rd., West Des Moines, IA 50266.