8 Methods of Manual Therapy for Back Pain

Do you suffer from back pain and soreness? If you do, you’re not alone as about 80 percent of all Americans struggle with this condition at some point in their lives. Fortunately, many people have found relief from back pain by using manual therapy. Simply put, these are specific forms of physical therapy done with the hands instead of using a machine or device. Here are eight types of manual treatments physical therapists use for relieving lower back pain, along with some considerations and warnings. 

1. Massage/Myofascial Release 

This is a physical therapy that therapists use for treating what’s known as myofascial pain syndrome, which is a chronic pain condition due to tightness and sensitivity of the myofascial tissues. Usually, the pain begins from certain trigger points within the myofascial tissues.

These treatments, which are typically done during massage therapy sessions, involve a therapist gently massaging the myofascial to detect tight, rigid spots. The treatment starts with the therapist stretching and massaging these areas, using light pressure. Next, the therapist helps the supportive sheath and tissue to release tightness. The entire process is repeated several times until all the tension is released. 

2. Instrument Assisted Soft Tissue Mobilization 

The manual therapy treatment known as instrument-assisted soft tissue mobilization, which is also called the Graston technique, can also be effective for treating back pain. It involves a therapist using a Graston device to manipulate a patient’s soft tissue that breaks down scar tissue. This therapy also improves the patient’s range of motion.

3. Joint Mobilization for Alignment and Mobility Assistance 

Often, people who’ve been diagnosed with a muscle spasm are told to massage the area, apply ice, and rest. But relief is only temporary since the pain usually returns. A better way to address the problem is by using joint mobilization, which entails a restricted joint being loosened up, besides increasing joint range of motion. What’s more, joint mobilization also increases the distance of movement or amplitude. Joint mobilizations are generally pain-free, provided they’re not done too aggressively.

4. Cupping 

The ancient technique known as cupping involves cups that a therapist applies to a patient’s back for producing suction. This creates a vacuum effect, targeting deep tissue located within the patient’s back. The treatment not only dulls pain but also breaks up scar tissue and improves blood flow and inflammation, which helps in decreasing pain. 

5. Dry Trigger Point Needling 

The technique known as dry trigger point needling is another effective treatment for muscle spasms and muscular tension. This treatment, which is considered invasive, entails a therapist inserting a dry needle or empty syringe that doesn’t contain any medication into a patient’s skin. By stimulating blood flow to triggering points, this therapy eases muscle contraction that helps in blocking pain signals. Although it’s still not approved in Pennsylvania, it’s expected to be legalized soon. 

6. Stretching Exercises

Stretches are highly effective for treating back and neck pain. These exercises include those, such as simple hamstring stretching that doesn’t require a lot of time. In addition to helping their patients do stretches during therapy sessions, physical therapists will show their patients how to do simple stretches that can be done at home. It’s best to do them at the same time of day so that it becomes a part of your daily routine. Furthermore, stretching exercises can be especially effective for treating muscle knots.

7. Muscle Energy Techniques

Also known as METs, muscle energy techniques are a type of manual therapy using muscle contractions for relaxing and normalizing joint motion as well as for lengthening shortened muscles. This manual therapy involves using a patient’s own muscle energy. Isometric contractions are used for relaxing muscles. Rather than being a passive treatment, such as static stretching in which all the work is done by the therapist, it’s an active technique. In other words, the patient also participates.

8. Strain-Counterstrain

The therapy known as strain-counter strain is a type of hands-on therapy designed to ease connective tissue and muscle tightness. It uses specific treatment positions that are held from 90 seconds to as long as three minutes. During this time, a therapist uses mild stretching to induce asymptomatic strain. Then, muscles are reset to a normal tension level so that healing can occur. As this therapy is exceptionally gentle, it’s used for extremely acute or delicate back issues that can’t be treated with other procedures.

Other Considerations and Warnings 

  • A physical therapist first conducts a full assessment of the nerve and blood supply to the affected area and performs a bone and muscle valuation. This is for determining whether or not there could be an increased risk for complications.
  • All manual treatments are in conjunction with exercises for posture and stability in giving the patient the best possible chance for success.
  • Poor posture, such as slouching, can lead to lower backache, besides neck pain.  To reduce back pain and strain, you need an ideal postural alignment.


You don’t have to continue to live with lower back and neck pain. Call Cawley Physical Therapy and Rehab at 570-208-2787 or email us at cawleyptfrank@gmail.com

Cawley PT specializes in Manual Based Therapy!!  In pain??  Want to get your problem checked out for FREE??  Call today for one of our Free Discovery Sessions!