The Benefits of Hands-On Physical Therapy

Massage techniques complement strengthening exercises

Manual physical therapy (PT) refers to a cluster of hands-on therapeutic techniques used by a therapist to treat a wide variety of symptoms and conditions.

This style of treatment, which is often performed alongside other rehab techniques like exercise or pain-relieving modalities, can be helpful in addressing numerous different concerns, including pain, stiffness, or range of motion limitations.

This article will describe hands-on physical therapy, techniques, when and where it is used, costs, and alternatives.

Mobilization of the spine by a physical therapist

KatarzynaBialasiewicz / Getty images

What Makes Manual Therapy “Hands-On”?

Whether it is passively moving your joints, massaging a body region, or stretching a muscle, this type of therapy allows your physical therapist to harness their knowledge of anatomy and pathology while using their own hands to treat your specific condition.

Manual therapy can be utilized for various purposes, including increasing the flexibility of a muscle, relaxing a muscle group, improving the range of motion at a joint, or decreasing your pain.

Oftentimes, this treatment category is particularly valuable during the more acute phases of rehab, when your movement may be more limited in a region and pain levels are traditionally higher.

As symptoms begin to subside and movement improves, manual therapy may still be utilized later on in combination with more active therapy techniques, like strengthening, balance training, or plyometric exercise.

Ultimately, passive hands-on treatments are a beneficial part of your care, but they are seldom performed in isolation without a complementary active component. 

Therapeutic Techniques

As you might expect, manual therapy is considered a “hands-on” treatment because each technique within this category involves the therapist physically touching you.

Among the wide variety of different hands-on techniques included in this rehab category are:

  • Soft tissue massage: Stroking or gliding motions performed over a muscular or connective tissue area that help to improve tissue relaxation, mobility, or pain in the region
  • Joint manipulation: A quick, thrust-style technique that takes a joint beyond its normal range of motion in order to improve mobility and (in some cases) help with pain
  • Joint mobilization: Slower, repetitive oscillations within a joint’s range of motion limits that promote mobility and increase the range of motion in a joint
  • Friction massage: A more irritating form of massage that is meant to temporarily increase inflammation and break up scar tissue in an effort to promote healing and reduce pain
  • Passive stretching: Extending or lengthening a muscle or group of muscles to improve range of motion and increase flexibility in an area

Each of the techniques listed above can be beneficial when used in the correct circumstances. Many are often employed in tandem with one another.

After a thorough evaluation, your physical therapist can provide you with more information about which hands-on techniques may be useful to you. 

When to Try Hands-On Physical Therapy

Manual therapy can be a valuable addition to PT for a variety of concerns. For example, following a surgery or procedure, joint mobilizations and passive stretching often play an important role in recovering your range of motion in the affected area.

Certain types of manipulations and mobilizations may also be used following a more acute injury, like a back or neck strain. In addition, soft tissue massage can be beneficial for managing chronic pain complaints and improving participation in the more active components of therapy.

Many different specific diagnoses have been found to benefit from manual physical therapy. For instance, several studies have shown improved pain and function in patients with knee osteoarthritis after being treated with soft tissue massage.

People with shoulder pain also responded favorably to joint mobilizations and manipulations to their mid-back. The same is true for individuals with neck pain whose therapy treatment included mobilizations and manipulations to their upper (cervical) spine.

Finally, passive stretching, massage, and mobilizations can help manage the symptoms associated with plantar fasciitis.

Because of the wide range of conditions that may benefit from hands-on physical therapy, it is important to speak to your physical therapist about your individual symptoms.

Manual Therapy Costs

Estimating the cost of manual therapy can be difficult. While most therapists can provide you with an upfront price guide for physical therapy if you pay out of pocket, the large majority of patients elect to use their insurance to cover their therapy costs.

In most cases, manual physical therapy is covered as a part of your insurance’s physical therapy benefits when it is deemed to be skilled and medically necessary by both the therapist and the insurance. That said, under most insurance plans, you are still responsible for any co-pay, co-insurance, or deductible costs that apply.

It is also important to work with your physical therapist to ensure coverage, as some hands-on techniques (like massage) can be coded in several different ways, some of which may be denied by your insurer.

For an accurate estimate of costs, it is a good idea to speak to your insurance carrier before you receive care. They can point you in the direction of a provider whose manual services are in network and can give you a rough idea of what you can expect to pay.

Where to Go

Every physical therapist receives education and training on performing manual physical therapy techniques during their schooling. However, if you are looking for a physical therapist who specializes in some of the hands-on skills discussed above, you may want to locate one who is a member of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT).

Physical therapists in this organization have undergone a two-year fellowship program after their normal education has been completed and have developed advanced skills in manual therapy. You can use their website to locate an AAOMPT provider in your area.

At-Home Alternatives

There are no direct substitutes for the skilled manual therapy you receive from a physical therapist. However, in some cases, the cost of physical therapy makes receiving care unattainable, and at-home alternatives must be considered.

Many different devices are available for purchase that attempt to replicate some of the hands-on techniques performed by a therapist. For example, foam rollers can be used to improve flexibility and range of motion in a muscle when combined with stretching exercises.

Other pieces of equipment, like massage guns or massage balls, are also widely available, though their benefits are still being studied. Be sure to speak to your physician before starting to use any at-home device to ensure it is appropriate for your specific situation.

In addition, you may want to speak to your physical therapist about any financial difficulties you are having. Many clinics have self-pay discounts or sliding scales based on your income, which can make receiving physical therapy more affordable.


Manual therapy includes several hands-on treatment techniques used by a physical therapist to treat various conditions. These techniques may be used together or separately, especially in the acute phase of rehabilitation. Later, they may be used in addition to exercises. While all physical therapists are trained in manual therapy, some specialize in it.

A Word From Verywell

Physical therapy is an effective treatment option for a wide range of pain-causing conditions, and manual therapy can play an important role in your rehabilitation. Whether your pain is the result of surgery, an injury, or a chronic condition, it is important to remember that living in pain doesn’t have to be normal.

If you are dealing with a musculoskeletal issue that is impacting your ability to function, be sure to speak to your doctor about whether physical therapy and manual therapy are right for you. Getting connected with a physical therapist who is skilled in hands-on treatments is often the first step on your road to recovery. 

Frequently Asked Questions

How does manual therapy differ from physical therapy?

Manual therapy refers to a cluster of hands-on treatments that may be included in a physical therapy session. Depending on your individual condition, passive manual therapy interventions are typically utilized alongside other more active treatments (like exercise) while you are in rehab. 

What are the benefits of manual physical therapy?

Manual physical therapy can provide you with several benefits, including pain relief, increased joint mobility, better range of motion, and improved muscular flexibility. 

Is manual therapy the same as massage? 

Soft tissue massage is one of several “hands-on” techniques included in the cluster of manual therapy interventions. Unlike at-home massagers, the manual techniques provided by a physical therapist utilize their specific training in anatomy and pathology to care for your body’s unique needs.

Manual therapy includes several hands-on treatment techniques used by a physical therapist to treat various conditions. These techniques may be used together or separately, especially in the acute phase of rehabilitation. Later, they may be used in addition to exercises. While all physical therapists are trained in manual therapy, some specialize in it.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Tim Petrie, DPT, OCS
Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.