What are bodywork and manual therapy?

Bodywork and manual therapy are general terms that refer to body manipulation therapies used for relaxation and pain relief. Massage and chiropractic are well-known forms of manual therapy.

The idea behind bodywork is that people learn—or are forced by injury or stress into—unnatural ways of moving or holding their bodies. This unnatural movement or posture changes the natural alignment of bones, which in turn causes discomfort and may contribute to health problems.

The aim of bodywork is to realign and reposition the body to allow natural, graceful movement. Bodywork, along with identifying possible contributing causes of unnatural movement and posture, is thought to reduce stress and ease pain.

Some of the most common forms of bodywork are:

• The Alexander technique, which focuses on proper alignment of the head, neck, and trunk. It emphasizes improving health by increasing awareness of proper posture.
• The Feldenkrais method, a gentle form of bodywork that increases flexibility and coordination. Feldenkrais exercises are intended to help increase a person’s awareness of body movement and develop new patterns of movement.
• The Trager approach, which people use to help relearn natural movements and exercises so their bodies can function better. Practitioners teach gentle, rhythmic motions to improve flexibility and promote relaxation (called psychophysical integration) and dancelike exercises to increase awareness of body movement (called Mentastics).
• Deep tissue massage, which attempts to treat chronic tension in deep muscles of the body. Deep tissue massage is thought to relieve pain and increase flexibility.
• Rolfing, a form of deep tissue massage that practitioners use to realign the tissues that cover and connect all muscles and body organs (fascia). Bringing the body back into proper alignment is thought to reduce pain, improve flexibility and energy, and reduce muscle tension.
• Dance/movement therapy, which has many of the same characteristics as the bodyworks above with the addition of creative and expressive art elements.

What is bodywork used for?

People may use bodywork to promote relaxation, relieve stress, and reduce pain associated with certain disorders of the muscles and joints, such as arthritis and fibromyalgia.

Is bodywork safe?

Bodywork can be a safe form of therapy when a qualified and experienced practitioner performs it. Its effectiveness is not scientifically proven. Talk with your doctor before you start any bodywork program, so you can choose the most appropriate form of bodywork for your specific condition.

Many states license practitioners who provide bodywork therapies. Your doctor or local hospital may be able to help you find a qualified bodywork practitioner.

Always tell your doctor if you are using an alternative therapy or if you are thinking about combining an alternative therapy with your conventional medical treatment. It may not be safe to forgo your conventional medical treatment and rely only on an alternative therapy.

Call 911 or other emergency services immediately if you have been injured and you have:

• A severe neck injury, such as an injury caused by a:
  • Serious car accident.
  • Fall from a height of 15 ft (4.6 m) or more.
  • Major sports-related injury.
  • Very forceful blow to the head or neck.
  • High-energy strike on top of the head.
  • Penetrating injury, such as a stab or gunshot wound.

• Signs of a spinal cord injury, such as:
  • Weakness or inability to move the arms or legs.
  • Continuous numbness of one or both arms or legs.
  • Loss of bowel or bladder control.

• Neck pain that occurs with chest pain and other symptoms of a heart attack. These include:
  • Chest pain that is crushing or squeezing or feels like a heavy weight on the chest.
  • Chest pain that occurs with:
    • Sweating, shortness of breath, nausea, or vomiting.
    • Pain that spreads from the chest to the back, neck, or jaw, or one or both shoulders or arms.
    • Dizziness or lightheadedness.
    • A fast or irregular pulse.

Call your doctor immediately if you have:

• A stiff neck and/or severe headache, fever, vomiting, confusion, and/or difficulty staying awake or alert.
• Neck pain and severe arm pain.
• Neck pain and suddenly developing numbness, tingling, or weakness in one or both of your arms.
• Severe neck pain following an injury.
• Severe neck pain with no known cause.
• A new weakness in your arms and legs.
• A new loss of bladder or bowel control.

Call your doctor today if you have:

• Severe restriction of neck movements.
• Neck pain or stiffness after starting a new medicine.
• Constant numbness or tingling in one arm or hand.
• Constant weakness in one arm.
• Moderate pain following an injury.
• Arm weakness, numbness, or tingling that has become worse since you were evaluated by your doctor.
• Ongoing (chronic) pain that is getting worse.

Watchful Waiting

Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. Most neck pain does not require medical care. In general, pain relief and neck movement should improve after a couple of days of home treatment that includes:

• Limiting activities that increase neck pain.
• Taking nonprescription pain relievers and using ice to reduce pain.
• Doing gentle exercises to keep the neck flexible.

If you have severe neck pain that has not gone away after 1 or 2 days and you are not able to do your normal daily activities, call your doctor.

For many patients, that benefit lasted for a year, the team reported in the Archives of Internal Medicine.

“Our study shows that you don’t need to stick needles into people to get the same effect,” said Dr. Daniel Cherkin of Group Health Center for Health Studies in Seattle, who led the study.

“Historically, some types of acupuncture have used non-penetrating needles. Such treatments may involve physiological effects that make a clinical difference,” Karen Sherman of Group Health, who worked on the study, said in a statement.

The team, wanted to study the effects of different types of acupuncture in a large, carefully controlled study of 638 patients with chronic low back pain.

They divided patients into several groups. One got seven weeks of standardized acupuncture treatment known to be effective in back pain. Another group got an individually prescribed acupuncture treatment.

A third group was treated using a toothpick in a needle guide tube that did not pierce the skin as regular acupuncture does, but targeting the correct acupuncture “points”.

A fourth group just got standard medical treatment, which included medication and physical therapy.

After eight weeks, 60 percent of the patients who got any type of acupuncture reported significant improvement in their ability to function compared with those who got standard medical care alone.

But there was no significant difference in the pain relief people got from the acupuncture using needles or from toothpicks.

The researchers said there is some evidence that even needles were used 2,000 years ago in acupuncture treatment, and some imaging studies have shown that “superficial and deep needling of an acupuncture point elicited similar blood oxygen level-dependent responses,” the team wrote.

Another study even found that lightly touching the skin can induce some emotional and hormonal reactions, which could explain the benefit, they wrote.

Or, it may simply be the experience of visiting an acupuncturist for treatments that helps.

Regardless of how it worked, they said acupuncture appears to be a relatively safe and painless way of easing an aching back, especially when traditional medicine alone fails.

(Reporting by Julie Steenhuysen; Editing by Maggie Fox and Cynthia Osterman)