Definition: What is Manual Therapy really?
Many people think manual therapy means being passively “clicked back into place”. That’s a misunderstanding!
MT is a highly qualified treatment carried out by specially trained physiotherapists (260 hours of additional training). After a thorough examination, your therapist will discuss with you which combination of the three pillars of treatment makes sense for you:
Active training – individually selected exercises for long-term success
Manual techniques – gentle, targeted hands-on techniques when your joints or muscles need them
Education – helping you understand your body and your pain
The decision is made together by therapist and patient: the therapist’s expertise shows what is possible, while your wishes and goals help determine what is actually done. This is how your individual treatment plan is created.
Difference: Why Manual Therapy is not a Wellness Massage
“I thought I was going to get a massage” – we hear that sentence a lot. Time to clear things up: manual therapy and massage are fundamentally different, and that’s a good thing.
A classic massage may feel pleasant, but there is hardly any proven long-term effect on pain. Especially for back pain – the most common problem in physiotherapy – research is clear: movement helps best, not passive kneading. That’s why we regularly go out onto the training floor with our patients.
Aspect | Manual therapy | Classic massage |
Approach | Combination of active and passive | Completely passive |
Long-term effect | Scientifically proven only in combination with active therapy | Little evidence, usually only short-term effect |
For back pain | High effectiveness | Only short-term relief |
Your role | Actively involved | Passively receiving |
The crucial difference: MT empowers you to become active yourself. You understand your complaints better and learn what you can do on your own.
Symptoms: What problems can Manual Therapy help with?
Manual therapy is suitable for almost all problems of the musculoskeletal system.
The most common reasons patients come to us include:
Back pain – from acute “lumbago” to long-standing pain
Disc herniations – as long as there are no severe neurological deficits
Radiating pain
Joint problems, such as:
Frozen shoulder
Hip, knee, ankle and foot pain or stiffness
Tennis elbow
Headaches – when the cause comes, for example, from the neck
Jaw joint problems (TMD)
Restricted movement after sports injuries or surgery (for example after anterior cruciate ligament rupture or ankle sprain)
Less well known: MT can also help with stress-related muscle tension and is often underestimated in post-operative rehabilitation.
Process: What actually happens during treatment?
Your first session starts with a thorough examination and medical history. Ideally, you fill out a short questionnaire before the appointment so your therapist can prepare in the best possible way.
The first session is often used entirely for getting to know each other, taking your history and understanding your complaints. During this, your therapist examines for example:
How mobile are your joints?
Which movements are painful?
What does your posture look like?
Actual treatment usually starts in the second session, once all important information is available and an appropriate therapy plan has been created.
The treatment can combine different techniques – your therapist will choose the right mix together with you.
Passive techniques:
Mobilisation – slow movements of your joint within a tolerable range
Traction – gentle pulling to modulate pain
Soft-tissue techniques – targeted treatment of the muscles for short-term pain relief
Neural mobilisation – nerve-gliding movements to reduce pain and feelings of tension
Active exercises (just as important!):
Stabilisation exercises for your joints
Mobilisation exercises to improve mobility
Strengthening exercises for muscle building
An individual home-exercise programme
The diagram in the original document (page 3) shows this path visually: after the initial appointment (history and functional assessment), treatment can consist of passive techniques, active therapy, education or different combinations of these – plus a home programme.
Education
Developing an understanding of your own complaints
Strengthening your sense of self-efficacy
Communication is important throughout the treatment. Tell your therapist how things feel. The treatment is continuously adjusted based on your feedback.
What’s special at Somana: we continuously test whether the chosen technique is working. If there is no improvement, we adapt the treatment. You are constantly giving us feedback – after all, you know your body best. Together we find the optimal treatment path for you.
After Treatment - Is sport allowed or is rest better?
After your first appointment, you might feel a little tired – that’s normal. Your body is reacting to the new stimuli.
What you can expect:
Slight tiredness or muscle soreness
Sometimes a short-term increase in symptoms for 1–2 days
This shows: things are starting to change!
Moderate exercise directly after your session is usually allowed and even recommended. Gentle movement or a walk helps to reinforce the treatment effect. You should avoid very intense workouts immediately after treatment.
Particularly important: your home exercises. Those few minutes a day are your best investment in a pain-reduced future. At Somana, you also have the option to train with us between your sessions – under optimal conditions. The best thing is to discuss this with our team.
Duration: How long does therapy take?
The key facts at a glance:
One session: 20–30 minutes of focused treatment
For acute pain: often 2x per week
For chronic complaints: usually 1x per week
Typical course of treatment: 6–10 sessions
After the first treatment cycle, your doctor will discuss with you whether continuing makes sense. Sometimes a few sessions are enough; sometimes several cycles are needed – this is very individual.
Science: Does MT actually work?
Short answer: Yes – especially in combination with exercises.
Current studies show clear improvements in:
Back and neck pain
Various joint problems
Movement restrictions
MT influences your pain system and nervous system. Muscles relax, joints move more freely, and your brain learns: “This movement is not dangerous.”
To be completely honest: MT does not heal destroyed joints and it doesn’t turn a 60-year-old into a 20-year-old. But it can improve your function and help you live a more active life again.
Training: Why exercises are just as important as treatment
Imagine your car has a flat tyre. Manual therapy pumps the tyre back up – but if you don’t fix the hole, it will soon be flat again. The exercises are the repair kit.
A practical example: after treating your painful shoulder, you should strengthen your rotator cuff. These small muscles stabilise the joint and help prevent the problem from coming back.
Pain: Does Manual Therapy hurt?
Most patients are surprised at how gentle MT is. The techniques should not cause strong pain and are always tailored to the patient’s tolerance.
What is normal:
Increased pain in the affected area
A mild flare-up for 1–2 days after treatment
Possible “cracking” sounds during treatment (completely harmless!)
Important: you set the limit. Tell us immediately if something is too painful.
“Blockages”: The myth of the “dislocated” vertebra
“Something is out of place” – the reality is less dramatic. In a so-called “blockage”, nothing is actually dislocated. Your muscles are tense, the nervous system is irritated and the joint is not moving freely.
Modern MT does not “put something back in place”, but gently releases this tension. The joint naturally returns to its normal movement – without any brutal “pushing back”.
By the way: it does not have to crack for the therapy to work!
Costs: How much does MT cost and who pays?
Statutory health insurance:
With prescription: €10 prescription fee + 10% of the treatment costs
For 6 treatments: total of around €25–35
With exemption from co-payments: free of charge
Private insurance:
Usually fully reimbursed
Depending on your plan, there may be limits
Self-pay (without prescription):
€30–60 per treatment
Advantage: faster appointments, more flexibility
Tip: specifically ask your doctor about “manual therapy” – many are happy to prescribe it if it is indicated.
At Somana: Evidence-based therapy
At Somana you receive manual therapy at the highest level. Our therapists are trained in the Maitland Concept – the most scientifically grounded approach in MT.
What does that mean for you?
Continuous adjustment of treatment to your progress
Your feedback guides our therapy
We explain exactly what we are doing and why
You become an expert on your own body
With us, you won’t get outdated concepts or unproven methods. Instead, you’ll receive treatment that is based on current research and has been shown to be effective.
Ready for the first step? Book an appointment – by phone or online. We’ll take the time for you and your complaints.
