For centuries people have practiced the techniques and experienced the physical benefits of manual therapies. Manual therapies include any therapy in which the practitioner works with his or her hands to improve a person's muscular or skeletal functions. Through manual therapy people have experienced relief from back pain, headaches, and stress and anxiety, among other ailments. While an increasing number of Americans are familiar with the basics of massage therapy, there are numerous variations. These include osteopathic manipulation, reflexology, lymphatic massage, Asian massage, and rolfing. The following is a brief overview of these therapies.

Asian massage (Tui na and shiatsu). Both tui na and shiatsu are believed to help heal the whole body in addition to localized areas. Tui na is a deep tissue massage and manipulation often used to treat arthritis and rheumatic pains, promote circulation, and restore weak or damaged nerves. Shiatsu uses gentle finger and hand pressure on acupuncture points and, similar to acupuncture, is used to treat gastrointestinal disturbances, muscle and nerve ailments, bone and joint ailments, respiratory ailments, female reproductive system ailments, and other conditions, such as addiction, headaches, and sinusitis.

Lymphatic massage. Practitioners of this type of manual therapy use a very light, pulsing touch along the body's lymph vessels. Their touch works to stimulate lymphatic circulation and thereby help the body eliminate toxins. This kind of massage is often used to treat sprains, bruises, muscular spasms due to chronic tension or overuse, and swelling after surgery.

Massage therapy. Most therapists rely on a variety of techniques, ranging from gentle stroking and kneading of muscles to targeted therapy concentrating on specific muscles. It's the most widely used muscular therapy and has been clinically proven to relieve muscle tension and reduce stress. Certified therapists complete an intensive training program, take national board examinations, and are licensed or registered in many states.

Osteopathic manipulation. This type of therapy uses a wide range of manipulative techniques to treat musculoskeletal conditions such as back pain, neck pain, joint pain, and headaches. It is also used for other conditions, such as sinus pain and digestive difficulties, as a complement to other treatments. Osteopathy holds that the structural integrity of the whole body is the key to good health. This integrity is easily compromised by things like muscle tension due to anxiety or misaligned bones due to sports injuries. Doctors of Osteopathy (D.O.s) receive conventional medical training as well as training in osteopathic therapies.

Reflexology. In this form of manual therapy, all parts of the body are believed to have a direct connection to a precise area on the foot, hand, or ear. Specialized massage of these areas is used to return normal function to the associated parts of the body. Many massage therapists have some training in reflexology.

Rolfing. This relatively new technique primarily relies on deep massage of the muscles and connective tissues to help the body achieve "structural balance." Practitioners of rolfing believe that structural balance in the body is critical for good health; a balanced body is able to conserve energy, release tension, move more easily, and function better neurologically. Many practitioners complete hundreds of hours of graduate-level training at the Rolf Institute in Boulder, Colorado to receive their certification.

Chronic: refers to an illness or disease that develops slowly and is persistent (often lifelong)

Lymph vessels: The lymphatic vessels work to remove waste products, bacteria, and foreign substances from bodily tissues. The lymphatic vessel system is activated in part by skeletal muscle contractions and plays an important role in intestinal and immune system function.

Rheumatic: relating to rheumatism, which is a condition characterized by inflammation or pain in the muscles, joints, or fibrous tissue

Toxins: bacteria, poisons, fats, coal dust, dyes, and dead cells and cells parts, or other material that can lead to disease if they are not removed from the body

The following sources are available to help you learn more and locate a practitioner near you:

Asian massage: Contact the American Oriental Bodywork Therapy Association at 609-782-1616.

Lymphatic massage: Contact NAVALT at 419-729-3258.

Massage therapy: Contact American Massage Therapy Association at 847-864-0123 or visit their Web site at www.amtamassage.org.

Osteopathic manipulation: Contact American Academy of Osteopathy at 317-879-1881 or visit their Web site at www.aao.medguide.net. OR: Contact the American Osteopathic Association at 800-621-1773 or visit their Web site at www.aoa-net.org.

Reflexology: Contact the American Reflexology Certification Board at 303-933-6921.

Rolfing: Contact the Rolf Institute of Structural Integration at 800-530-8875 or visit their Web site at www.rolf.org.

Other resources:

Bodywork: What Type of Massage to Get—And How to Make the Most of It by Thomas Claire (Quill 1996)

The Bodywork and Massage Sourcebook by Andrew S. Levine and Valerine Levine (Lowell House 1999)

Is Your Body Trying to Tell You Something? Why It is Wise to Listen to Your Body and How Massage and Body Work Can Help by Carmen Renee Berry (Pagemill Press 1997)