There are many types of manipulation therapy. They include:

• Chiropractic medicine. Concentrates on musculoskeletal and neuromuscular disorders and their effect on the rest of the body. Chiropractic medicine is based on the belief that misaligned vertebrae can affect the spine’s range of motion and the nerves radiating from the spine. As a result, the organs served by these nerves may function improperly or become diseased. Spinal realignment may restore range of motion and improve nerve and organ function.
  
  
• Osteopathic medicine. A holistic form of medicine that emphasizes repairing structural imbalances and preventive care. Osteopathic physicians try to maintain correct relationships between bones, muscles and connective tissues. Practitioners sometimes use osteopathic manipulative treatment (OMT), in which they use their hands to apply force in an effort to treat structural abnormalities. Unlike chiropractic medicine, however, osteopathy also embraces medication and surgery. Patients who see an osteopathic physician often use this practitioner as their primary care physician for a broad range of conditions and concerns.
  
  
• Massage therapy. Incorporates techniques involving manipulation of the soft tissues of the body through pressure and movement. This is sometimes used in combination with medications to treat pain. Practitioners may massage the entire body or a specific body part (e.g., the back, feet or hands). Massage helps patients relax and distracts attention away from pain. The many forms of massage therapy include Swedish massage (applies strokes, kneading and friction to muscles and active and passive movements of joints), shiatsu (an Oriental method based on the idea that energy flows through the body in meridians and that blockage of these channels causes disorders), trigger point therapy (concentrates on tender or irriated areas of muscle) and deep tissue massage (uses slow strokes and greater finger pressure to release tension from deeper muscles).
  
  
• Acupuncture. Procedure adapted from Chinese medicine in which specific body parts are pierced with fine needles to relieve pain.
  
  
• Acupressure. Application of pressure to specific points of the body to control pain. It is similar to acupuncture but does not involve needles.
  
  
• Alexander technique. Aims to identify improper movements and correct them. The patient is educated and guided in ways to improve posture and movement to use muscles efficiently.
  
  
• Ayurveda. Traditional holistic healthcare system of India, emphasizing the mind-body connection and incorporating techniques such as touch, sound, aroma and nutritional therapy.
  
  
• Bowen technique. Gentle massage of muscles and tendons over acupuncture and reflex points. By gently touching and moving certain parts of the body, the body is re-energized and able to heal itself.
  
  
• Craniosacral therapy. Uses gentle hand and finger touch, movement and pressure of the skull plates. The craniosacral system is composed of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord. Craniosacral therapy claims to remove abnormalities or blockages that prevent the cerebrospinal fluid from moving properly. Several studies have not demonstrated any benefit from this type of therapy.
  
  
• Feldenkrais method. Technique that educates patients about improving movement and enhancing overall body function. Through this method, patients may improve range of motion and flexibility, and discover the innate capacity for efficient movement. The improvements in movement may enhance the patient’s functioning in other aspects of daily living.
  
  
• Jin Shin Tara. An acupressure-like treatment that originated in Japan, has been used to address trauma pain and, according to the U.S. National Institutes of Health, is being studied for possible use in stroke rehabilitation.
  
  
• Manipulation under anesthesia. Uses a combination of manipulations, passive stretches and maneuvers to break up fibrous adhesions and scar tissue around the spine and surrounding tissue. It can be performed under general anesthesia, with a mild sedative or after anesthetic solutions are injected into tissues of the spine.
  
  
• Myofascial release. Attempts to end pain and restore joints’ range of motion through gently stretching that may resolve restrictions on fascia, a type of connective tissue that covers organs, muscles and other soft internal structures.
  
  
• Naprapathy. System that tries to ease pain by manually manipulating connective tissue that may be irritating nerves.
  
  
• Naturopathic medicine. A holistic form of medicine that emphasizes prevention and incorporates techniques including acupuncture, manipulation therapy, nutrition, herbs and counseling.
  
  
• Reflexology. Technique based on the principle that there are reflexes in the feet and hands that correspond to every body part. By stimulating and applying pressure to the hands or feet, circulation is increased and specific bodily and muscular function is believed to be improved.
  
  
• Rolfing. Involves deep tissue massage. Also called structural integration, Rolfing is not a cure for a particular disease or physical ailment, but a systematic approach that tries to restore balance to the entire body.
  
  
• Trager bodywork. Gentle rocking and shaking of the patient’s trunk and limbs in a rhythmic fashion. It is aimed at promoting relaxation and increasing mobility and mental clarity. It is used by athletes for performance enhancement or patients with musculoskeletal and back problems.
  
  
• Tuina. Application of pressure with the fingers and thumbs and manipulation of acupressure points in the body. This has been used in China for 2,000 years. It is based on the principle that massage and manipulation techniques can help the body heal itself. Tuina (also called tui na) is similar to acupressure, but includes both pressure and movement at pressure points, whereas acupressure is static.
  
  
• Traction. A procedure in which a mechanical device is used to correct fractures or dislocated bones, overcome muscle spasms or relieve pressure. Traction can be used to treat problems in the spine, arms, legs or neck. It is sometimes used as part of a chiropractic treatment.
  
  
• Zero balancing. Incorporates massage and gentle positioning of the body in an effort to balance the body’s structures with internal energy.