What is massage, traction and manipulation?
Various forms of massage, traction, and manipulation have been used as a part of medical practice.
Although there is no knowledge of the complete physiology of massage, traction, or manipulation, it is generally accepted that these treatment approaches are beneficial in musculoskeletal conditions.
Each modality represents an approach to treatment. Each of these treatment approaches carries some potential risks and may be contraindicated in certain conditions. Hence, it is important to consult with a medical professional first.
The procedures are performed by trained professionals, including a physiotherapist, chiropractor, orthopedic surgeon, sports medicine specialist, or physical medicine and rehabilitation specialist.
From an osteopathic perspective, these techniques are not always intended to be a standalone treatment. A combination of treatment approaches and a “team approach” may be required to achieve complete recovery of the patient.
What is a massage?
A massage is a therapeutic manipulation of the soft tissue of the body with the goal of achieving normalization of those tissues. There are various forms of massage techniques with origin west and east. Massages are performed by trained professionals, and the duration can vary from 15 to 120 minutes.
Some benefits of a massage are as follows:
- Mobilization of tissue fluids
- Reduction or modification of edema (fluid trapped in the body tissues)
- Increase in blood flow
- Decrease in chronic muscle pain, soreness, and stiffness
- Facilitation of relaxation and mood improvement
- Prevention or elimination of adhesions
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Traction refers to the practice of slowly and gently pulling on a fractured or dislocated body part. It is usually performed by a medical professional such as a physiotherapist, using ropes, pulleys, and weights. These tools help apply force to the tissues surrounding the damaged area.
Manual traction involves the practitioner using their hands on the patient’s body and providing a tractive force of the patient’s body weight.
Auto-traction is controlled by the patient pulling on bars or handles without the direct involvement of a practitioner. Gravitational traction with a tilt table and underwater variations may be used sometimes.
Benefits of traction
- Stabilizing and realigning bone fractures
- Helping reduce the pain of a fracture before the surgery
- Treating bone deformities, such as deformities of the spine
- Correcting stiffness and constriction
- Relieving chronic pain in the neck and back
Types of traction
- Skeletal traction: This involves placing a pin, wire, or screw in the fractured bone, after which weights are attached to it, so the bone can be pulled back into the correct position. This may be done using general, spinal, or local anesthesia to avoid pain during the procedure.
- Skin traction: Less invasive than skeletal traction, it involves applying splints, bandages, or adhesive tapes to the skin directly below the fracture, after which weights are attached to it. The affected body part is then pulled into the right position using a pulley system attached to the hospital bed.
- Cervical and lumbar traction: During cervical traction, a metal brace is placed around the neck or back. The brace is then attached to a body harness or weights, which help correct the affected area. The procedure may be performed under general anesthesia.
What is manipulation?
Manipulation is the use of the hands by a professional on the patient by using specific techniques and maneuvers to achieve painless movement and the right posture of the musculoskeletal system.
The most common types of manipulation involve passive mechanical forces applied to specific vertebral segments, regions, or other joints to restore a complete range of motion.
Benefits of manipulation
- Treatment of musculoskeletal problems, especially those of the rib cage, upper and lower extremities, back, pelvis, and neck
- Treatment of the loss of motion or function
- Decrease in localized tenderness or pain during motion
Types of manipulation
- Direct thrust (high velocity/low amplitude): The practitioner rotates, bends sides, and either flexes or extends the adjacent vertebral segments, locking the facet so that further motion is limited to the segment in question.
- The articulatory technique (low velocity/high amplitude): This involves the passive movement of a vertebral joint within a reduced range of motion.
- Indirect positional techniques: This involves thrust, articulation, and muscle energy techniques to lengthen shortened, passive tissues.
Medscape Medical Reference
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