Man Ther. Author manuscript; available in PMC 2010 Oct 1.
Published in final edited form as:
Man Ther. 2009 Oct; 14(5): 531–538.
Published online 2008 Nov 21. doi: 10.1016/j.math.2008.09.001
PMCID: PMC2775050
NIHMSID: NIHMS140696
Joel E Bialosky, PT, MS
Abstract
Prior studies suggest manual therapy (MT) as effective in the treatment of musculoskeletal pain; however, the mechanisms through which MT exerts its effects are not established. In this paper we present a comprehensive model to direct future studies in MT. This model provides visualization of potential individual mechanisms of MT that the current literature suggests as pertinent and provides a framework for the consideration of the potential interaction between these individual mechanisms. Specifically, this model suggests that a mechanical force from MT initiates a cascade of neurophysiological responses from the peripheral and central nervous system which are then responsible for the clinical outcomes. This model provides clear direction so that future studies may provide appropriate methodology to account for multiple potential pertinent mechanisms.