What is manipulation in medicine?
Manipulation in medicine is defined as manual treatment of musculoskeletal anatomy, including bones, joints, muscles, cartilage, and fascia. Treatment is external, i.e. without body penetration, as opposed to surgical or biochemical remedies. Over 90% of manipulation in America is spinal, performed by chiropractors.
The definition above ignores two factors: 1) the essential effect of manipulation and 2) the process that connects the procedure to the effect. With few exceptions, the usual goal of manipulation is to relax the localized stress response that causes pain and/or anatomical disorders, e.g. poor lymph drainage. The same goal applies to osteopathic manipulation, chiropractic adjustment, muscular manipulation (e.g. trigger point or myofascial release), and the scar tissue remedies found in sports massage, physiotherapy, etc. Manipulation either 1) forces anatomy into a more comfortable position or state, or 2) tricks the body to release tension, e.g. proprioceptive stimulation, which supports secondary relaxation.* Regardless, without the relaxation response, benefit is not achieved; stress response, pain, and/or dysfunction remain. (* Muscle tension release does not equal relaxation, which is secondary.)
With scar tissue remedies, treatment is usually painful, which means that comfort and relaxation are usually delayed, sometimes by hours or days. In contrast, when the goal is simple relaxation of muscle tension, relaxation is achieved either quickly or not at all. Treatment becomes more dependable as more comfort details are addressed. This is where we uncover the subtle but critical process that leads to relaxation.
For example, a chiropractic adjustment places the spine in a more comfortable position that affords a certain amount of local and systemic relaxation. But how does the procedure translate to relaxation? In every medical remedy, the body actively uses the conditions offered to perform a self-regulation function. The same holds true for manipulation. The body uses the chiropractic adjustment to become comfortable, in the same way that it uses a drink of water when thirsty, a bed when tired, or scratching of an itch. Each scenario represents an active process in which the body reaches out internally to appreciate and use the procedure, which supports comfort. The active process, involving judgment, is revealed if the procedure is not supportive enough; the body will not accept it and respond agreeably. For example, if the treatment is too aggressive, the practitioner is scary, or some other negative condition exists, the body will literally recoil (stress response) and refuse to relax, telling us that the conditions are not supportive enough. Hence, if it were a passive cause and effect relationship—between manipulation and relaxation—then relaxation would be guaranteed and every chiropractic treatment would be equally effective. But this is not the case because pain sufferers have different needs for comfort, safety, boundaries, etc. In other words, relaxation is never guaranteed—not until all the client's needs are met.
If the chiropractor adds other comforting procedures, perhaps massage by a gentle therapist, hot packs, and quiet office atmosphere, the adjustment becomes easier to execute, more relaxing, and lasts longer. The body relaxes a bit more with each upgrade. If the practitioner follows this logic, eventually he/she will arrive at the Arneson Method. The latter meets the client's emotional needs so completely that, owing to profound relaxation, the body can perform its own adjustments internally (auto-adjustment), without external force. This occurs normally, day to day, when the spinal muscles are not constrained by severe stress response. The same self-regulation process is simply accelerated, on the table, during an Arneson Method treatment. (However, the Arneson Method is not appropriate for purely stress-related tension or spinal deformity, therefore it does not replace chiropractic. Every method is a piece of the puzzle.)
According to the Arneson Method’s behavior model, the body’s local use of physical comfort, including spinal manipulation, is a behavior response—local, internal, involuntary behavior that yields a change in emotional state. Even a small area of the body has its own, local emotional response, indicated by enjoyment and relaxation. In other words, during body therapy, that small area of spasm and pain can be related to as if it were a miniature person with needs and responses. When a practitioner shifts his/her awareness to accommodate this detailed description of behavior, a new world of benefits is revealed.