HEALTH / Common Remedies: Manipulation and massage

FROM ancient times, charismatic popular healers have laid their hands on a sick person's body while more orthodox practitioners have preferred to keep body contact to a minimum. For hundreds of years in Britain, surgeons - who set broken bones and dealt with wounds and abscesses - were regarded as socially inferior to physicians, who made their diagnosis at a distance. Surgeons and physicians have long since made up their differences, but body contact with patients is still seen by many doctors as being on the fringe of mainstream scientific medicine.

The main exception is the manipulation used by orthopaedic surgeons to restore damaged bones and joints to a normal position. This is a continuation of a long tradition: in the past, before anaesthetics and X-rays, skilled bonesetters became famous for their ability to use their hands to discover how to reposition broken bones so that they would heal without deformity. This repositioning is just as important today, though X-rays have made it easier, and rapid healing depends on accurate positioning of the bone fragments. Manipulation of a dislocated joint is another skilled procedure; it is not just a matter of putting the bones back into place, but of doing so without causing any further damage to ligaments.

It is manipulation of the spine that is the really controversial issue. The 33 bones of the spinal column are joined together by tough cartilage discs, and they also have small facet joints which allow the spine to bend, twist and rotate. In the 19th century, the founders of osteopathy and chiropractic developed whole theories of medicine based on the belief that many diseases of the digestion, heart and lungs were due to subtle small faults in the alignment of the spinal bones. These misalignments were thought to interfere with the nerves and blood vessels, and so disturb the general health. Both systems were based on the belief that spine manipulation could restore normal health.

Nowadays, osteopaths and chiropractors make less wide-ranging claims. But they still assert that the health of many people can be improved by putting their spines back into the correct healthy position. Mainstream doctors agree that many people with backache benefit from having spines massaged and manipulated, freeing joints and encouraging an optimum posture. Research has shown that people with back pain recover more quickly following manipulation than when simply told to rest in bed and take pain-relieving tablets. Osteopathy and chiropractic are regaining status and becoming more popular as victims of backache discover the benefits of therapeutic manipulation.

Massage, like manipulation, may be orthodox or alternative. Orthodox is prescribed by doctors and carried out by physiotherapists, while a whole range of massage therapies in the private sector are claimed to enhance health. Massage is said to increase the blood to the muscles, to loosen up tense muscles and ligaments, and to help stiff joints move. Just why massage makes most people feel better is not at all clear. Touch seems to have calming, relaxing, life-enhancing properties. Doctors who remain aloof from physical contact with patients are denying them one of the oldest ingredients of the healing process.