Naprapathic Manual Treatment

Defining Naprapathy

Naprapathy is defined as a system of specific examination, diagnostics, manual treatment and rehabilitation of pain and dysfunction in the neuromusculoskeletal system. The therapy is aimed at restoring function through treatment of the connective tissue, muscle- and neural tissues within or surrounding the spine and other joints. Naprapathic treatment consists of combinations of manual techniques for instance spinal manipulation and mobilization, neural mobilization and Naprapathic soft tissue techniques. The manual techniques are often combined with advice regarding physical activity and ergonomics as well as medical rehabilitation training in order to decrease pain and disability and increase work ability and quality of life. A Dr. of Naprapathy is specialized in the diagnosis of structural and functional neuromusculoskeletal disorders, treatment and rehabilitation of patients with problems of such origin as well as to differentiate pain of other origin.

The History of Naprapathy

Naprapathy is well established in the Scandinavian countries, especially in Sweden where the first Naprapathic College outside the United States was founded in 1970. Naprapathy was originally initiated in 1907 in the United States by Dr. Oakley Smith, who rejected the “subluxation-theory” used as an explanation for pain and disability in manual therapies at that time. Naprapathy, which literally means “to correct the cause,” is a health profession characterized by viewing the neuromusculoskeletal system as a whole.

Naprapathic Philosophy

The concept of connective tissue and its effects on joints, nerves and muscles consists of interaction between the different structures within the neuromusculoskeletal system. This interaction is important for optimal function. Shortened soft- and connective tissue within the neuromusculoskeletal system, especially around the spine and other joints, are believed to be one of the primary causes of pain and disability. This was initially based on Smiths early research findings of what he named a “ligatite” which is described as a scar tissue in the ligaments adjacent to the vertebral column. That pathology in the connective tissue was, according to Smith, likely to be the main reason for restricted motion of a vertebral unit or a peripheral joint.

To be able to diagnose, understand, treat and rehabilitate a patient with pain, it is of great importance to consider not only the structures and functions involved in causing the patients symptoms. The environment, physical as well as psychological and psychosocial, in which the patient work and live could also be affecting and interfering with work ability and quality of life of that patient. It is from this perspective that

Naprapathy looks at pain and disability from the neuromusculoskeletal system. Therefore Naprapaths treat each patient from his or her individual capability in the purpose of restoring balance and function to the neuromusculoskeletal system in order to obtain an optimal healing process. The effect of Naprapathic manual treatment has recently been evaluated in a large RCT, showing that Naprapathy is an effective treatment for non-specific back and neck pain (Skillgate et al Clinical J of Pain, 2007, 23, 431-9).

Naprapathy as a Health Care Profession

Since 1970 Naprapathy has grown and developed and today it constitutes one of the leading professions within the field of manual medicine in Sweden as well as Norway and Finland. In addition to the colleges in Sweden and the United States there is a new college in the city of Kotka in Finland. The education consists of a four year full time program plus one year service within the health- and medical care system. Naprapathy is practiced in Sweden, United States, Finland, Norway and in some other European countries.

Since 1994 the Naprapathic profession is a part of the Swedish health and medical care system, by the license from the National Board of Health and Welfare, for treating patient with pain and disability from the neuromusculoskeletal system. Over one third of the Swedish population has received Naprapathic treatment. Each year over 1.5 million Naprapathic treatments are performed in Sweden (nine million citizens). Most of the patients that receive Naprapathic treatment do so for low back pain, neck and shoulder pain, headaches, sciatica or other radicular symptoms as well as athletic injuries.

As presented at the 6th Interdisciplinary World Congress on Low Back & Pelvic Pain, Barcelona, by licenced naprapaths Claes Ekström and Annika Hilborn of Naprapathögskolan – Scandinavian College of Naprapathic Manual Medicine, licenced naprapath, PhD Eva Skillgate of Naprapathögskolan – Scandinavian College of Naprapathic Manual Medicine and the Institute of Environmental Medicine, Karolinska Institutet and licenced naprapath Petteri Koski of Kymenlaakso University of Applied Science, dep. of Naprapathy.


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