Therapeutic touch is a powerful tool. All manual therapy has a component of therapeutic touch but all therapeutic touch is not manual therapy. A provider simply placing their hands on a patient during the evaluation can help foster therapeutic alliance, which is necessary for developing a positive rapport and trust. As this narrative review discusses, therapeutic touch can reduce pain, heart rate, systolic blood pressure, fear avoidance, and cortisol while promoting relaxation and a sense of safety.
Manual therapy stimulates much debate, with some clinicians believing it is vital for health and wellness and others believing it is a waste of time, potentially creating dependence. Both extremes are in contrast with current evidence. Much of manual therapy's success stems from the power of therapeutic touch and the resulting therapeutic alliance. Therapeutic alliance and physical touch contribute to the development of a collaborative relationship between patient and clinician. When a patient trusts their provider, they are more likely to reveal fears and doubts that can impede movement and progress. Adherence to treatment and self-efficacy both improve when a therapeutic alliance is established.
Therapeutic touch also impacts expectations and prediction. Many manual therapy effects can be attributed to belief effects. If a patient believes a treatment will help, they are more likely to experience positive outcomes. Manual therapy techniques are non-specific (e.g., the spinal segment you choose doesn’t matter) but the effects a patient experiences are real. Patients with chronic pain demonstrate prediction errors with movement and positioning. Therapeutic touch can help develop biofeedback loops to improve misinterpreted bodily sensations and predictions, helping reduce the pain experience.
All this to say, physical touch is a great tool in rehabilitation. The specific technique clinicians use for manual therapy is not as important as the intent behind the treatment and the relationship built between the provider and the patient.