Choice Point Technique

Why does manual therapy work?

It’s a question most of us have been asked — by patients, by students, sometimes by ourselves mid-treatment.

A 2025 living review in PLOS ONE (Keter et al.) pulled together 62 systematic, narrative, and scoping reviews to map the current evidence.

Manual therapy doesn’t act on one system. It produces measurable responses across the following:

- Neurological
- Neurovascular
- Neurotransmitter,
- Neuroimmune
- Neuromuscular
- Neuroendocrine
- Biomechanical

The strongest, most consistent signals are central, not local: increased pressure pain thresholds at sites distant from treatment and enhanced descending pain modulation.

The biomechanical “joint-out-of-place” model? It's not supported by the evidence. The treatments purporting to do this may help, but for the reasons above, not because the joint has been popped back in.

What this means in practice: our hands are interacting with the central nervous system at least as much as the tissue beneath them and the language we use with patients should reflect that.

The full one-page clinical summary is below 👇

📖 Source: Keter et al. (2025), PLOS ONE. doi:10.1371/journal.pone.0319586

🌟 Can Lumbar Herniated Discs Heal Themselves? The Science Says Yes! 🌟

Did you know that lumbar herniated discs can sometimes heal without surgery? A groundbreaking systematic review by Chiu et al. (2015) found that spontaneous regression of herniated discs is not only possible but surprisingly common in certain cases.

🔬 The Science Behind It:
Your body is an incredible healer! Researchers discovered that mechanisms like inflammation and resorption can naturally reduce disc herniations over time, especially in cases of:
✅ Sequestrated or extruded discs – these types showed the highest likelihood of regression.
✅ Smaller, localized herniations – the body can reabsorb the displaced material.

👩‍⚕️ What This Means for You:
If you’re dealing with back pain from a herniated disc, there’s hope for recovery without invasive procedures.

💡 Your Takeaway:
Always explore your options! There’s a path forward that doesn’t always involve surgery.

💬 Curious about how our treatments can support your body’s natural healing? Drop a comment or send a message—I’m here to help you take the first step!

📖 Reference: Chiu CC, et al. (2015). The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil.