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"What Does the Evidence Say About the Effectiveness of Hands-On Therapy in the Subacute Phase of Injury?"




The evidence for the effectiveness of hands-on therapy during the subacute phase of injury, including lower back pain, is more consistent and positive compared to the acute phase. The subacute phase typically refers to the period following the initial onset of symptoms but before the condition becomes chronic. Here are some key points based on available evidence:


  • Manual Therapy and Exercise: Combining hands-on therapy, such as manual therapy techniques (e.g., spinal mobilisation or manipulation), with exercise interventions has shown promise during the subacute phase of lower back pain. Studies suggest that this combination can lead to improvements in pain, function, and disability.

  • Physical Therapy: Physical therapy, which often includes hands-on techniques, becomes more prominent in the subacute phase. Physical therapists may use a combination of manual therapy, therapeutic exercises, and other modalities to address specific impairments and help patients regain function and reduce pain.

  • Massage Therapy: Similar to the acute phase, massage therapy may continue to be beneficial during the subacute phase. It can help alleviate muscle tension, improve circulation, and contribute to overall relaxation.

  • Acupuncture: Acupuncture may still be considered during the subacute phase for individuals with lower back pain. Research suggests that acupuncture could provide pain relief and improve function during this stage.

  • Individualised Approach: The subacute phase often requires a more individualised approach to treatment. Healthcare professionals may tailor hands-on therapy techniques based on the specific needs and characteristics of the patient, taking into account factors such as biomechanics, muscle imbalances, and psychosocial aspects.


While the evidence supporting hands-on therapy during the subacute phase is generally positive, it's essential to recognise that individual responses to treatment can vary. Moreover, the integration of hands-on therapy into a comprehensive rehabilitation plan that includes exercises and education appears to be key for long-term success. Patients should work closely with their healthcare providers to determine the most appropriate and effective combination of interventions based on their unique condition and goals.

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