Manual (Latin manus = the hand) medicine is the method of treatment that is carried out on the patient only with the hands. “Manual Medicine” and “Chirotherapy” (Greek cheir = the hand) largely mean the same thing. It is painless and, as is known from the therapy of headache and back pain, considerably less risky than treatment with pain-relieving drugs.
Manual medicine is concerned with disturbances of the mobility of joints, which in turn are moved and held by muscles.
In manual medicine a differentiation must be made between two different types. On the one hand there is the physiotherapeutic technique of manual therapy, which after diagnosis increases the mobility of the joints through repeated mobilisation. This treatment technique is known as “mobilisation”. There is no further reflex effect on the control system. Physiotherapists may carry out manual therapy on the joints only on the express and detailed prescription of a doctor.
Manual medicine carried out by doctors has other effects. It requires a holistic diagnosis of all health disorders, and this is placed in relation to the biomechanical disturbances of the patient’s musculoskeletal system. In certain cases X-rays are required before manual medicine can be applied.
After the biomechanical disturbances have been felt by the doctor’s hand, the patient is positioned so that the affected joint is briefly opened by a single short impulse with the hand. The procedure is called chirotherapeutic manipulation.
This medical manipulation is burdened by some bizarre prejudices among the general population, and also among doctors who are not specialists in manual medicine. The opening of the joint is mostly accompanied by a cracking sound, which greatly impresses some patients because they have completely wrong associations with a possible “putting back” of joints or “bone setting”. But that is precisely what does not happen. If a joint were to be put back, it must first have had to be put out. However, vertebrae put out of the vertebral column mostly result in paraplegia or death. Chirotherapeutic manipulation merely releases reflectory muscle tensions that hinder the joint mechanics. As a result of the restoration of mobility, the physical perception is changed positively, and in cases of painful tension the pain is relieved. The cracking is a harmless, accompanying physical phenomenon (vacuum cracking), which has nothing to do with the actual therapeutic act.
The force used by the doctor in manipulation is very slight and does not exceed the everyday stresses placed on a person’s joints (e.g. accelerating when driving, effects of forces when carrying loads, during sport, etc.). To clarify a further preconception: it is also impossible to make joints unstable, i.e. to “wear them out”, by correctly performed repeated medical manipulations. The manipulation itself must be absolutely painless – otherwise the doctor has a poor treatment technique.
In Germany physiotherapists are not allowed to carry out chirotherapeutic manipulation, because during their training they have not learned to make a holistic medical diagnosis, do not interpret X-rays and cannot recognise possible contraindications and treatment-typical danger