Thursday Thoughts: Non-Specific Effects | Modern Manual Therapy Blog

Thursday Thoughts: Non-Specific Effects

apparently this guy is Non-Specific Action Figure - he approves this post

What happens when you read literature that says your favorite manual treatment or exercise has non-specific effects? Do you get upset? Do you roll with it and keep on doing the same? Maybe you question what you have been doing all along.

I'll tell you what has non-specific effects

  • joint mobilization/manipulation
  • soft tissue work
  • corrective exercise
  • repeated motions
It certainly does not mean that just because any of these have been tested "the right way to do them" versus sham, and hopefully with a control, that you should not be using them as treatments. What it does mean is that the intention of making a change, and giving the nervous system novel input will restore a homeostasis to the area applied.

This means if
  • you wiggle a joint
  • scrape some skin
  • needle it 
  • use some PNF to get the area moving
that if there are muscles that are faciltated, they will have tone reduction. Muscles that are inhibited, will have increase in tone. Yes, it's convenient.

One more thing, regular readers will know my passion for pain science education, and how it is promoted in all my evaluations and treatments along with my courses. However, we see sham pain science education working daily in clinics all over the world. Patients get explanations that certain exercises are going to reduce discs, strengthen their core, reposition their pelvis, or any other type of biomechanical explanation. They buy it, placebo occurs, and they get better. When delivered by an interactive, charismatic, compassionate practioner, sham pain science also works to reduce fear avoidance. Has this ever been studied? Not that I am aware of, but I believe since it happens clinically, it would also happen under controlled conditions. 

Are you a better clinician for moving away from pathoanatomy and using modern explanations of treatment, movement, and pain? You know my thoughts. What about yours? Chime in below on on the facebook page.

Keeping it Eclectic...


  1. Hello!
    I love your posts, and appreciate you taking the time to educate and clarify many confusing aspects of our practice! Would you be able to explain to me your method of pain education mentioned in this post? Thank you for any and all help!

  2. Thanks Nick, this text is currently at the top of my most recommended list for Pain Science.

  3. Nick,

    I am about 3/4 the way through the text book and I must say like Dr. changer in my clinical practice patterns as well as my education to my patients. Cannot recommend TNE enough to fellow clinicians!


  4. Dr. E,
    Couldn't agree with you more. As a newer therapist with hands that have not had countless hours of training I still tend to have some pretty good results despite me not being 100% sure that I am actually feeling/doing exactly what my manual technique was set out to do. I have found that ensuring a person that they are not as "broken" as they think they are when they come to PT and enstilling confidence in them that they can get better. The brain is a powerful thing when it comes to healing and if the brain is not in the right mindset, healing will not occur as well. Does the TNA book discuss similar things as discussed in Explain Pain bby Lorrimer Mosely? I have read that one but am also intersted to see if there are stark differences between the two books.

  5. The TNA book is more comprehensive and it's also for clinicians, wheras Explain Pain is much shorter and written for the general public or for clinicians to use during their clinical interactions. You will not regret TNA, it's THE textbook for Pain Science Education

  6. Bill, I can only needle when I treat the patients in Houston. Honestly, since it's so new to my practice, I am not as proficient as I could be, and IASTM has much less contraindications. I also do not use it around the face, thoracic spine and other areas off limits for Level 1 KinetaCore.

  7. Thanks for the info, shot to the top of my To Read list...

  8. As a thank you, please use my affiliate link for amazon so I get a little credit for the purchase if you haven't gotten it already Thanks again!