What does the science say?

Heather selects the most effective therapeutic strategies by attending training sessions, meeting with practitioners, listening to patients, and applying scientific principles. This section provides a detailed analysis of peer-reviewed research supporting the manual therapies described on our site. Below, we summarize the current scientific understanding of each technique’s effectiveness, helping you make informed decisions about your care. Of course, this does not encompass the vast array of anecdotal evidence from practitioners and patients worldwide. 

Key Findings:

• A 2020 randomized trial compared the Feldenkrais Method to core stability exercises in 60 patients with chronic low back pain. Those in the Feldenkrais group saw greater improvements in quality of life (+33%), interoceptive awareness (+48%), and disability reduction (−47%) compared to the control group11216.
• Pain scores decreased significantly in both groups, but the Feldenkrais approach uniquely enhanced body awareness, which correlated with long-term functional gains1216.
• Research suggests its focus on mindful movement retrains the nervous system, making it particularly effective for chronic pain management12.

Strength of Evidence:

• High for chronic low back pain and movement re-education.

Key Findings:

• A 2003 case-control study of 69 hospitalized patients found that those with pneumonia were 3.9x more likely to have tender Chapman reflex points for the lungs9. Sensitivity (69%) and specificity (64%) suggest diagnostic potential, though microscopic tissue analysis has not confirmed structural changes213.
• Limited therapeutic studies exist, but clinical reports propose lymphatic stimulation at reflex points may support immune function and organ health213.

Strength of Evidence:

• Moderate for diagnostic correlation; Low for therapeutic benefits (more research needed).

Key Findings:

• A 2011 RCT on baseball players with shoulder tightness showed MET increased horizontal adduction range by 15° and internal rotation by 12° immediately after treatment3.
• The collaborative nature of MET (patient-therapist effort matching) makes it safe and effective for joint mobility issues, with effects lasting beyond the session3.

Strength of Evidence:

• High for acute improvements in joint range of motion.

Key Findings:

• A 2021 review of 12 systematic reviews found manual therapies can influence both sympathetic (stress) and parasympathetic (rest) nervous systems, though results vary by technique4.
• Resonance breathing (6 breaths/minute) significantly improved heart rate variability (HRV) in young adults, indicating better ANS balance10. Regular aerobic exercise also enhances parasympathetic activity11.
• Hands-on ANS therapies lack robust evidence, but theoretical models suggest gentle touch may activate calming C-tactile nerve fibers4.

Strength of Evidence:

• Moderate for lifestyle interventions (breathing/exercise); Low for manual techniques alone.

Key Findings:

• A 2021 meta-analysis of 10 studies found myofascial release reduced chronic low back pain by 37% compared to controls5. Functional improvements were modest but consistent17.
• For chronic neck pain, a 2024 review noted pain reduction in 7/10 trials, though effects on mobility were inconsistent1417.

Strength of Evidence:

• Moderate for pain relief; Low for long-term functional changes.

Key Findings:

• A 2025 RCT found no changes in heart rate variability (HRV) during osteopathic listening tests, questioning its direct impact on autonomic function6.
• Philosophical theories propose it enhances inter-corporeal awareness, but no controlled studies confirm therapeutic benefits15.

Strength of Evidence:

• Very Low; primarily theoretical at this time.

Key Findings:

• A 2024 meta-analysis of 15 RCTs concluded craniosacral therapy provided no clinically meaningful improvements for musculoskeletal or non-musculoskeletal conditions78.
• An earlier 2016 study reported pain reductions in chronic neck pain (−21 mm on a pain scale), but these findings were not replicated in larger reviews8.

Strength of Evidence:

• Low; mixed results with recent high-quality reviews showing minimal support.

This analysis reflects the latest research as of 2024. Always consult your healthcare provider to determine which therapies align with your specific needs. 

The Research:

1. https://pubmed.ncbi.nlm.nih.gov/32723088/ 

2. https://pubmed.ncbi.nlm.nih.gov/27215948/ 

3. https://journals.sagepub.com/doi/full/10.1177/0269215520947069 

4. https://pubmed.ncbi.nlm.nih.gov/14620082/ 

5. https://www.advancedtherapyinstitute.net/bodyworkblog/chapmans-neurolymphatic-reflexology-coming-back-after-being-illegal-for-a-century-law-reverses-criminalization-of-holistic-health-practices 

6. https://osteogoodhealth.com/chapmans-reflexes-neuro-lymphatic-reflexes/ 

7. https://www.jospt.org/doi/10.2519/jospt.2011.3292 

8. https://pmc.ncbi.nlm.nih.gov/articles/PMC8638932/ 

9. https://pmc.ncbi.nlm.nih.gov/articles/PMC8924557/ 

10. https://pmc.ncbi.nlm.nih.gov/articles/PMC11250637/ 

11. https://pubmed.ncbi.nlm.nih.gov/33984499/ 

12. https://www.csp.org.uk/journal/article/physiotherapy-journal-june-2024/effectiveness-myofascial-release-adults-chronic 

13. https://pubmed.ncbi.nlm.nih.gov/38290198/ 

14. https://pubmed.ncbi.nlm.nih.gov/40019866/ 

15. https://s7ef6b6b08b3b4330.jimcontent.com/download/version/1636361900/module/11432751872/name/The%20emergence%20of%20feeling%20in%20osteopathic%20manual%20listening%20VF.pdf

16. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1452465/full 

17. https://pubmed.ncbi.nlm.nih.gov/38540643/