Therapeutic Interventions and Manual Techniques

Recently, the phrase "active is better than passive" has been published in articles, memes, and thrown around in chat boards as if it's some undeniable truth. But I am not sure how this myth got started. There is absolutely no support in the research for this statement.  So, let's start by stating the facts. Based on the available research, active interventions are NOT better than passive interventions. 

Research Confirmed: Messaging, expectations, and treatment preference may have an inconsistent effect on the perception of pain induced by a manual therapy technique (e.g. how painful an acupuncture needle feels), but no significant effect on post-treatment outcome measures (e.g. pain during motion or functional outcome measure scores). Further, stress and catastrophizing are unlikely to have a significant effect on outcomes; however, it may be advised that joint manipulations are not performed when stress/catastrophizing is high. Stress is likely to be highest during session 1 and decrease with subsequent sessions, and matching a patient's assessment findings to the best treatment option significantly improves outcomes, regardless of expectations.

Myths About Sacroiliac Joint (SIJ) Motion, Palpation, Assessment, and Treatment

Research Summary Statement: The randomized controlled trials (RCTs) available that compare pain neuroscience education (PNE) to other interventions imply that PNE is unlikely to be more effective than biomedical education, and is unlikely to result in additional benefit when added to supervised manual therapy, exercise, and/or the combination of other effective interventions. Further, the addition of manual therapy and exercise to PNE reliably results in significant improvement in patient outcomes, implying that PNE alone cannot be considered an optimal treatment approach. The addition of PNE to a home exercise program may enhance patient outcomes (perhaps due to enhanced effort and compliance during exercise). Last, PNE does reliably improve Tampa Scale of Kinesiophobia (TSK) scores; however, the validity of this finding and/or correlation with other recovery outcome measures is questionable. 

An evidence-based article defining cavitation sound, the mechanism of sound creation, how it relates to joint manipulation, and whether a cavitation sound is correlated with patient outcomes following manipulation.

You Can Palpate the Psoas