What is manual therapy and how does it work?

July 12, 2024

Updated December 18th, 2025

Are you living with musculoskeletal pain?

Musculoskeletal pain is pain in your muscles, joints, bones, tendons and/or ligaments.

If you have pain like this, you’re not alone. According to the NHS, more than 20 million people in the UK have a musculoskeletal condition, like back pain or arthritis.

Chronic musculoskeletal pain can be debilitating. It can make everyday activities more difficult and impact your quality of life.

If you’re suffering with pain due to an injury or long-term condition, you might have been considering manual therapy.

And you might have questions, like:

  • What is manual therapy?
  • Is manual therapy right for me?
  • How does manual therapy work to reduce pain?
  • What techniques and tools are used in manual therapy?
  • What’s the difference between physiotherapy and manual therapy?

In this article, we’ll provide answers to these questions and more.

What is manual therapy?

Manual therapy is a form of physical therapy that uses hands-on techniques to assess and treat your soft tissues and joints. It can include massage and a range of other treatment options, depending on your condition and level of pain.

The end goal is to relieve your pain and leave you feeling better and more mobile.

Manual therapy might be recommended as part of a wider treatment plan. It’s often coupled with exercise therapy to help you get back to the active lifestyle you enjoy.

Who can benefit from manual therapy?

Manual therapy can benefit many people, with a range of different needs.

It could be right for you if you’re one of the following:

Athletes

If you’re an athlete, or you participate in athletic activities, manual therapy can help you recover from injuries sustained during sports or training. It can help to reduce your risk of injuries, or address specific injuries that are hindering your performance.

People with pain or stiffness

People of all ages can experience pain and stiffness. Whether you’re 9 or 90, manual therapy can help restore your mobility and improve your quality of life.

People suffering from stress

If you’re looking for ways to manage your stress levels, manual therapy can help soothe your muscles and relieve the tension.

People recovering from injury

Manual therapy can help if you’re recovering from injury — especially soft tissue injuries, like sprains, strains and muscle tears. Combining manual therapy with physical therapy can often be an effective treatment.

People with chronic conditions

If you have a chronic condition, like back pain or arthritis, regular manual therapy sessions can ease your pain. It can also help to manage your symptoms and prevent further complications.

People recovering from surgery

Manual therapy can help if you’re going through post surgery rehabilitation. It can speed up the healing process and improve your range of movement, so you can get back to exercising and the activities you enjoy.

How does manual therapy work?

Manual therapy works by:

  • Targeting pain and discomfort
  • Relieving tension and stiffness
  • Improving the range of movement in your joints
  • Reducing inflammation and swelling
  • Increasing tissue extensibility
  • Improving your circulation
  • Increasing your flexibility
  • Opening a window of opportunity to enhance your strength and movement.

What’s the role of a manual therapist?

Manual therapists assess and treat joint and soft tissue disorders using hands-on techniques and manual therapy tools.

During your sessions, your therapist will apply firm, but safe, pressure to massage, stretch, and mobilise the areas where you’re experiencing pain.

What is manual therapy used to treat?

Manual therapy can help to relieve pain in your muscles or joints, whether that’s due to an injury or long-term condition.

Some of the common conditions that can be treated with manual therapy include:

What techniques are used in manual therapy?

Manual therapists use a range of techniques, including:

Joint mobilisation

Gentle movement of the joints to improve range of motion and reduce pain.

Soft tissue mobilisation

Techniques such as deep tissue massage to target muscles, tendons and ligaments.

Myofascial release

Targets the fascia (connective tissue) by applying gentle pressure to release tension.

Trigger point therapy

Targets specific areas of muscle tension, or “knots” to relieve tension and pain.

Stretching

Manual stretching techniques, like PNF (Proprioceptive Neuromuscular Facilitation) stretching, to improve your range of motion.

Soft tissue and deep tissue massage

Regular massage to soothe and mobilise muscles, with the capacity to work into much deeper layers where needed.

What tools are used in manual therapy?

Manual therapists offer a range of tool-based therapies, including:

Myofascial cupping

Suction cups are used to stimulate the treated area. This helps to reduce tension and increase blood flow.

Hot stone massage

Hot stones are applied to targeted areas of the tissue, helping to release tension and promote relaxation. As the muscles loosen up, your manual therapist can work deeper within the tissues to achieve the best results.

Rock blades

Rock blades are used for instrumental soft tissue mobilisation (IASTM).

They help to:

  • Relieve pain
  • Stimulate your nervous system
  • Improve muscle function
  • Improve your performance.

Rock Blades are effective because they provide deeper penetration of adhesions and scar tissue. They can also be used to treat injuries, and pain in the joints, lower back and neck.

What’s the difference between physiotherapy and manual therapy?

Physiotherapy and manual therapy often work hand in hand, but they each play a different role in how you recover.

Physiotherapy focuses on understanding what’s going on in your body, identifying the root of the problem, explaining it clearly, and creating a tailored plan to help your recovery. This usually includes a mix of hands-on treatment and exercise-based rehabilitation to help you move better, feel stronger and prevent the issue returning.

Manual therapy is a hands-on treatment that focuses on easing tension, improving movement and reducing pain. It works by treating joints, muscles and soft tissues through skilled mobilisation and soft-tissue work. It’s ideal when you need targeted relief, help to restore movement, or support alongside your rehabilitation.

Physiotherapists may use elements of manual therapy within their treatment, while manual therapists specialise in these hands-on techniques as their primary approach.

Which option is right for you will depend on your symptoms, your goals and how quickly your body responds. Many people benefit from using both physiotherapy and manual therapy at different stages of their recovery.

Book manual therapy at Hatt Clinic

If you’re dealing with chronic pain, a sports injury, stress-related pain or post-surgery recovery, we can help. Our team of expert manual therapists is dedicated to helping you get back to a pain-free, active lifestyle.

Manual therapy is available at all three of our clinics, in Devizes, Frome and Marlborough.

From your initial session, your therapist will work with you to develop a personalised treatment plan which will target the root of your pain.

To book your first session online, visit our online booking page and select initial massage and manual therapy from the menu.

Alternatively, you can email us at: enquiries@hattclinic.co.uk

Or call the clinic:

Devizes: 01380 730473

Frome: 01672 516580

Marlborough: 01373 452604

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