Manipulation is one of the skills used by physiotherapists in the treatment of musculo skeletal conditions. It is often referred to as a ‘high velocity thrust’ technique and may produce an audible ‘click’ as the joint releases. It can be defined clinically as techniques used to force a joint beyond its presumed physiologic barrier and up to its anatomical limit (Haldeman & Hooper 1999). Physiotherapists have been developing manual therapy techniques for over 100 years and have produced significant research into the effect of these techniques. Research evidence examining the efficacy of manipulation has demonstrated it to only provide short term benefit for pain and stiffness (see Clinical Evedence Vol 4 BMJ review guide). There is no reliable evidence to suggest manipulations can make ‘adjustments’ to your spinal ‘alignment’ or ‘positional faults’ (Dalsth 1976). There is furthermore no evidence that manipulation aids the return of prolapsed disc material which in lay terms is called ‘slipped disc’ (Mathews & Yates 1969 and Bourdillon and Day 1987).Physiotherapy helps in reducing the pain, increasing the ROM in cervical and lumbar spine.

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