In the article the authors stand up for the value of therapeutic touch. The article argues the importance of hands-on treatment and forms a critical (very plausible) counter-sound for the dominant hands-off approach in physiotherapy, in which physical touch has evolved to an action that is ‘not-done’. This counter-sound is a relief for daily physiotherapy practice in the unbalanced hands-on/ hands-off debate and is a confirmation of the intuitive feelings of many physiotherapists about the value of physical touch in patients suffering from pain. As author of this expert opinion I want to urge every colleague to read this article, because the postulated message touches upon the individuality of everyday physiotherapy directly. In addition, reading this article is very useful because it provides physiotherapy with a powerful theoretical-biological framework about the multiple supposed effects of therapeutic touch.
Almost every physiotherapist will agree that a diagnostic exploration of physical aspects is an important core value of physiotherapy. In patients with suffering from pain, this exploration is characterised by making physical contact, accompanied by an exploration of the painful spot. This contact contributes to the trust relationship between the physiotherapist and the patient in a general sense. Generally, with this the chance of therapeutic success also increase, especially when the expectations of the patient about diagnostics are met. When the patient expects the opposite, NOT touching the painful spot can easily result in a feeling that ‘it is between the ears’, and with that disappointment and less confidence in the physiotherapist, or even disillusionment and anger.
From a therapeutic perspective the targeted use of physical touch is also of tremendous value. Touching and movement (exercise) are the two non-verbal main ingredients of physiotherapy. Tactile and tactful touching does something to people. First, it confirms the feeling that you are there as a (fellow) human being and that you have a body that needs serious investigation. The painful body requests attention. Second, it gives the feeling that the other one (the physiotherapist) is there for you, makes sincere contact and tries to feel along with you. This reliefs the feeling of suffering. Third, it modifies the body image, modulates the painful sensation, and creates physical confidence.
Touching is a crucial foundation of the physiotherapeutic relation (it strengthens the relationship) but it also potentially is a powerful therapeutic effect that can be pursued with varying focus. The physiotherapist lets ‘their hands speak’ through touching. Therapeutic touching consists of two components: a biophysical component and a (multiple) perceptual component. In patients suffering from pain, the physiotherapist can direct therapeutically on cognitive, affective and biological aspects of pain perception just by touching.
