Pressure Point Therapies Health And Social Care Essay

Manual Therapy

According to American Academy of Orthopedic Manual Physical Therapy (AAOMPT), manual therapy is defined as a "clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion; reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function."

Despite its several advantages and healing properties, manual therapy is not for everyone. Aside from osteopathic manipulative techniques, it is absolutely contraindicated when patients have disorders that can be aggravated by manipulation, such as infected or rheumatic joints, neoplasm, and vascular ailments. Patients with Down syndrome have a high incidence of cervical spine anomalies and should avoid manual treatment. Severe osteoporosis would also preclude application of forceful approaches.

Some examples of manual therapy techniques are acupressure, spinal manipulation, spinal mobilization, massage therapy, medical acupuncture, muscle energy technique, joint manipulation, muscle energy technique, osteopathic manipulative medicine, polarity therapy, traction, shiatsu, etc.

Manual therapies may relieve symptoms sooner (especially for acute low back pain) but are not believed to alter the natural history of an episode of low back pain (especially chronic back pain) The clinical evidence for the use of manual therapies for low back pain most often cited is in a practice guideline published by the Agency for Healthcare Research and Quality (AHRQ) in 1994. [1] In the guideline, low back pain was defined as "activity intolerance due to back-related symptoms. Using osteopathic manipulation for treating acute low back pain is accepted in the medical community. There are about 42,000 licensed osteopathic physicians in this country making up about 5% of the total physician population. [3] Not all osteopathic physicians practice manipulative treatment, although some allopathic physicians do.

The manual therapy for back pain used by physical therapists includes applying passive movements to the joints to restore necessary joint function. It also usually includes stretching and exercise programs and is often offered in a home program. Individualized treatment exercises are developed, and posture training is taught. A common exercise is the lumbar roll, and sitting postures are recommended that do not place undue strain on the back. Patients are also taught how to avoid movements that cause or exacerbate symptoms.

About 55,000 chiropractors are licensed in this country making them the largest group of practitioners of manual therapy Chiropractic care relies primarily on spinal manipulation. The chiropractic philosophy is based on the belief that disturbances in biomechanics affect the nervous system, which then affects all other body systems. These disturbances are referred to as subluxations. Chiropractors seek to improve neurotransmission by conducting "short-lever, high-velocity spinal adjustments applied to specific contact points on the spinous process.

Massage therapy usually refers to classic muscle massage that practitioners claim relaxes the mind and musculature, with a possible mechanism of action being endorphin release. While many people use massage for treating low back pain, hard evidence to support its efficacy has been lacking. One recent review could find only 4 controlled trials of massage for low back pain published in the past 20 years. [9] A recent trial, however, randomized 262 patients to receive acupuncture, therapeutic massage, or self-care education for chronic low back pain. [10] At 10 weeks, after 10 treatments, massage was superior to self-care and acupuncture on a symptom scale. After 1 year, massage was not better than self-care but was better than acupuncture. The authors conclude that massage may be effective for chronic back pain.

Massage therapy

A component of Western health care since the days when Hippocrates was in practice, massage therapy currently exists in dozens of permutations. All are forms of soft-tissue manipulation that blend mechanical proficiency and artistic sensibility. While therapists generally use their hands to apply pressure, cause movement, or hold the body, they may also employ elbows, feet, forearms, or instruments such as handheld rollers. The procedures must be technically correct, and they must be applied at a pressure suitable for the particular patient undergoing treatment.

Overall, massage techniques are believed to confer a number of helpful effects on a variety of body systems. For example, massage is said to promote the circulation of blood and movement of lymph as well as the removal of cellular waste products from muscles. It's also credited with the ability to speed recovery from musculoskeletal injuries, soothe pain, reduce edema, diminish anxiety, and offset, to some degree, the consequences of inactivity in bedridden patients.

Studies indicate that massage can indeed be worthwhile, and it is sometimes used along with conventional medical techniques. When seven cancer patients took part in a 30-minute massage session on each of 2 consecutive days, they reported significant reductions in pain and anxiety.[3] Participants also felt significantly more relaxed after therapy. Positive effects have been documented in infants and children, too. For example, preterm new-borns receiving massage therapy gained 47% more weight and left the hospital 6 days sooner than those who didn't.[4]

Massage has also been used in the treatment of children with a variety of illnesses. Among other benefits, the practice appears to reduce anxiety in youngsters with asthma, bulimia, juvenile rheumatoid arthritis, and posttraumatic stress disorder. In children with autism, a month of massage therapy lessened sensitivity to touch and distraction by sounds. Children receiving treatment were also more attentive in class.

Osteopathic manipulation

Although osteopathic medicine is now a mainstream practice, it took many decades for osteopathic physicians to gain the same recognition afforded to their allopathic counterparts. These days, except for the specialized training osteopathic physicians can provide every kind of medical service. In fact, a wry complaint of some who practice or participate in traditional osteopathic manipulation is that too many osteopathic physicians have become almost indistinguishable from allopathic physicians in their delivery of health care.

A fundamental difference between traditional osteopathic medicine and allopathic medicine is the paradigm illustrating the relationship between pathophysiology and the role of treatment. Osteopathic medical principles emphasize a reciprocity between body structure and function. Behavior can affect both. Discord among the structure, function and behavior can lead to disease, disability and impairment. It is the osteopathic physician's job to diagnose the underlying problem and administer a treatment program meant to remove any impediment to the body's natural ability to heal. All of the conventional tools of modern medicine can be used for these purposes, as can sensitive manual diagnostic procedures devised to procure accurate interpretations of signs and symptoms.

An assortment of manual techniques helps traditional practitioners gauge health status and assist healing (see "Going through the motions"). Aside from using scientific modes of diagnosis, the osteopathic physician seeking a diagnosis will assess the patient's posture and gait, overall mobility, straightness of the spine, and physical symmetry. Skin examination and delicate palpation permit detection of potential signs of illness such as articular restrictions, fluid retention, muscular changes, myofascial contractures, neurotrophic changes, temperature variations, and tenderness.

Depending on the practitioner's findings, manipulative approaches may be used alone or in combination with drug therapy and other standard medical treatments or with various alternative approaches. Manual therapies are not used in place of clearly indicated allopathic strategies. For example, appendectomy remains the treatment of choice for appendicitis. However, manipulative treatments might be part of the therapeutic plan deployed postoperatively to improve healing. Unquestionably, they would be used in patients with carpal tunnel syndrome or chronic pain.

One aspect of manipulative treatment is familiar to all physicians. Postural drainage, a technique commonly used to dislodge mucus plugs, is a form of osteopathic manipulation. Strategies designed to mechanically propel body fluids are important in traditional osteopathic medicine because it is believed that enhanced blood circulation is necessary to the healing process.

Pressure point therapies

Several systems rest on the belief that the application of finger pressure to selected areas will relieve pain and treat assorted illnesses. One type is reflexology or zone therapy, in which particular areas on the feet or hands are believed to be connected to specific parts of the body (see Figure 1, page 82). Precise touch is thought to generate a beneficial effect on an ailing part of the anatomy by arousing a series of reflex points.

Acupressure methods--shiatsu, jin shin do, jin shin jyutsu--share much the same philosophy as acupuncture. Pressure is placed on sites along meridians--Oriental medicine describes these as channels that conduct vital energy or qi (pronounced "chee") throughout the body. The duration and intensity of the pressure are based on the system of acupressure being used, the disorder requiring treatment, and whether the practitioner's goal is to stimulate or quiet specific meridian points.

Shiatsu is intended to confer general relaxation and balance. The practitioner travels the length of each meridian, applying thumb pressure to successive points along the way. In this way, the healer prods acupressure points while transferring some personal qi from thumb to patient. These objectives can also be accomplished when pressure is applied with a foot instead of a hand in a process known as barefoot shiatsu.

Jin shin jyutsu and jin shin do, more specific therapies, are used much like acupuncture to treat particular disorders. Pressure points are chosen along meridians that feed the ailing organ.

If a patient has been receiving manual therapy of any type and symptoms have not improved after 3 to 4 treatments, advise discontinuation of the therapy and reevaluate the patient. If underlying disease is still not found, the time may have come to assess the patient's psychological needs.

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Chronic pain management alternatives show promise. (2011). The Journal of Musculoskeletal Medicine, 28(7), 248. Retrieved from

Jette, N., McChesney, J., Metcalfe, A., Patten, S. B., & Williams, J. (2010). Use of complementary and alternative medicine by those with a chronic disease and the general population - results of a national population based survey. BMC Complementary and Alternative Medicine, 10, 58. Retrieved from

Bower, P. J., Rubik, B., Starr, C., & Weiss, S. J. (1997, December 15). Manual therapy: hands-on healing. Patient Care, 31(20), 69+. Retrieved from