Integrated manual therapies: IASP taskforce viewpoint.

Manual therapy refers to a range of hands-on interventions used by various clinical professionals, such as osteopaths, osteopathic physicians, chiropractors, massage therapists, physiotherapists, and physical therapists, to treat patients experiencing pain. To present existing evidence of mechanisms and clinical effectiveness of manual therapy in pain. This Clinical Update focuses on the 2023 International Association for the Study of Pain Global Year for Integrative Pain Care. Current models of manual therapy and examples of integrative manual therapy are discussed. The evolution of concepts in recent years are presented and current gaps in knowledge to guide future research highlighted. Mechanisms of manual therapy are discussed, including specific and contextual effects. Findings from research on animal and humans in manual therapy are presented including on inflammatory markers, fibrosis, and behaviours. There is low to moderate levels of evidence that the effect sizes for manual therapy range from small to large for pain and function in tension headache, cervicogenic headache, fibromyalgia, low back pain, neck pain, knee pain, and hip pain. Manual therapies appear to be effective for a variety of conditions with minimal safety concerns. There are opportunities for manual therapies to integrate new evidence in its educational, clinical, and research models. Manual therapies are also well-suited to fostering a person-centred approach to care, requiring the clinician to relinquish some of their power to the person consulting. Integrated manual therapies have recently demonstrated a fascinating evolution illustrating their adaptability and capacity to address contemporary societal challenges.

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Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

Déclaration de conflit d'intérêts

J.D.R. has received grants from the Osteopathic Foundation, the University College of Osteopathy, the General Osteopathic Council, and the Institute of Osteopathy; and honororia payments from Kookie Learning, Nordic Osteopathic Alliance, Metropolia University, Centre International d'Ostéopathie, and Osteopathy Europe; and has a leadership role in the Strengthening Osteopathic Leadership and Research programme (UTS Sydney, Australia). D.N. received grants from Research Innovation Fund (UK) and the Chiropractic Research Council. M.F.B. receives fudning from Temple University and NICCH/NINDS. J.B. has no conlict of interests to report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.