Immediate effects
Mobilising a stiff joint or releasing tight tissue often produces an immediate increase in range of movement and a drop in pain, which is one of the most satisfying things about hands-on treatment. For an acute problem such as a locked neck or a sudden back spasm, one or two sessions can resolve it.
Why the effect fades at first
Tissue and joints tend to return to their previous state, particularly if the cause, such as posture, load or weakness, is still there. Early gains are partly maintained and partly lost between sessions, and the balance shifts towards maintained with each visit.
The typical course
For a recent problem, two to four sessions. For a problem that has been there for months, four to eight, with sessions spaced further apart as you improve. Rehabilitation after injury or surgery runs longer. You should see a clear direction of travel by the third session; if not, the approach should change.
What makes it last
Exercise. Manual therapy creates the opportunity by restoring movement and reducing pain; exercise builds the strength and control that keep it. This is why manual therapy is delivered by physiotherapists and osteopaths alongside a programme rather than as a standalone treatment.
At Omnia
Manual therapy at our Chiswick clinic is built into a plan with exercise and, where useful, acupuncture or red light therapy. We review at session three and adjust rather than continue by habit.