Manual Therapy in Amman | Joint Mobilisation

What is manual therapy?

It is a group of hands-on techniques the physiotherapist chooses after an examination. They include joint mobilisation, with gentle, repeated and controlled movements of a joint, and mobilisation with movement from the Mulligan Concept, where the physiotherapist holds a gentle glide on the joint while you do the movement that was painful or limited — this should not hurt. They also include soft-tissue techniques and release of muscle knots. It differs from a massage: a massage mainly aims to relax the muscles and help recovery, while manual therapy targets a specific joint, muscle or movement found in the assessment, and we always follow it with exercises that keep the improvement.

Who may it help?

Neck pain and stiffness, and a stiff upper back
Low back pain, as part of an exercise-based plan
A stiff, painful shoulder, alongside stretching and movement exercises
Knee pain and stiffness, including knee osteoarthritis, together with therapeutic exercise, not instead of it
A stiff ankle after a sprain, together with balance and strengthening exercises

What does the evidence say?

NICE guidance on low back pain advises using manual therapy only as part of a treatment package that includes exercise, and its osteoarthritis guidance says there is not enough evidence to support using it alone. The American Physical Therapy Association’s neck pain guideline also combines it with exercise. Its effect is often short-term: it may ease pain and stiffness for a while so that moving and exercising become easier, while exercise and regular activity remain the core of the plan. So we do not rely on it alone.

What happens in a session and what will I feel?

We start with an assessment: we ask about your health, medicines and injuries, and examine movement, strength and nerves
Before treating the neck we ask specific questions about dizziness, headache and vision, to look for signs of a problem with the arteries in the neck
We explain the technique and ask for your consent, and you can ask us to stop or adjust at any moment
The techniques are gentle and controlled; you may feel pressure or a mild stretch, and they should not be very painful
You may sometimes hear a click: it comes from a small gas bubble forming in the joint fluid, not from a bone going back into place
Mild soreness or stiffness for a day or two is common and settles on its own, and we continue with exercise

When we do not use it, or wait

A suspected fracture, or a recent serious injury such as an accident or fall — we refer you to a doctor first
Severe osteoporosis — we use only very gentle techniques or choose other options
Inflammation or infection in the joint or the area, or a fever
Signs that may point to a problem with the arteries in the neck, such as dizziness with trouble speaking or swallowing or changes in vision — we do not treat the neck and refer you straight away
Signs of a pressed nerve that are getting worse, such as increasing weakness or numbness in an arm or leg — we refer you to a doctor
Some cancers, especially if they have spread to the bones — we refer you to your doctor and work with them

When do you need urgent medical care?

A sudden, severe headache or neck pain unlike any before; or weakness or numbness in the face, an arm or a leg, a drooping face or eyelid, trouble speaking or swallowing, double vision or loss of vision; or dizziness with loss of balance, sudden falls or fainting — before or after a session: this is an emergency, call an ambulance
Neck, jaw, shoulder, arm or upper back pain with chest pain or pressure, shortness of breath, sweating or feeling sick — this is an emergency, call an ambulance
Numbness around the buttocks or genitals, a new problem controlling your bladder or bowel, or weakness in the legs — this is an emergency
Increasing weakness or numbness in an arm or leg, or new difficulty using your hands or walking — see a doctor the same day
Severe pain after a fall or accident, especially if you have osteoporosis, as it may be a fracture
Pain with fever, unexplained weight loss or a history of cancer, or severe constant night pain

In these cases go to the nearest emergency department or a doctor straight away (ambulance: 911 in Jordan, 122 in Iraq and the Kurdistan Region) — instead of booking physiotherapy.

FAQ

Does manual therapy hurt?

It should not be very painful. You may feel pressure, a stretch or mild discomfort, and we adjust or stop whenever you ask. Mild soreness for a day or two after a session is common and settles on its own.

Do I need to hear a crack for it to work?

No. The techniques we use are gentle and controlled, and they may or may not make a sound. The sound comes from a gas bubble forming in the joint fluid, not from a bone going back into place, and research suggests the benefit may not depend on hearing it. We do not recommend cracking your own neck or back.

Is manual therapy the same as massage or chiropractic?

No. Massage mainly focuses on relaxing the muscles and recovery. Chiropractic is a separate profession with its own training, known for quick spinal adjustments. Manual therapy at Revibe is part of physiotherapy: we choose it after an assessment, use gentle techniques and always combine it with exercise.

How many sessions will I need?

It depends on your condition and its stage; after the first assessment we explain the plan and the expected number of sessions.

More common questions: Physiotherapy techniques questions — 20 questions