摘要

Manipulation has long been and continues to be practiced worldwide to treat musculoskeletal pain and dysfunction. The potential role of manual medicine in physiatric practice is discussed with emphasis on practical considerations for the physiatrist. Patient selection, communication issues, physician and patient treatment goals, time management, and integration of focused structural examination and manipulative treatment into a busy contemporary physiatric practice, as well as billing and coding considerations are reviewed. Hypotheses regarding the etiology of somatic dysfunction and the mechanisms of efficacy of manipulative treatment, and return to work issues are elucidated. The most common manipulative approaches are described and practice variations are discussed. The physiatric practitioner who contemplates the integration of manual medicine into their practice is provided a practical foundation from which to proceed with emphasis on contemporary practice issues.