Physical Medicine

Overview of Naturopathic Medicine and Manipulative Therapy
“Naturopathic physical medicine” (NPM), including “naturopathic manipulative treatment” (NMT), has historically been an integral part of the practice of naturopathic medicine and has been included in naturopathic medical education and licensure since the existence of the first naturopathic college (1902). Naturopathic physicians use appropriate diagnostic and imaging methods with physical medicine modalities and procedures as part of an integrated approach to the diagnosis and treatment of the full spectrum of health disorders and the optimization of structure and function in healthy individuals, including but not limited to the musculoskeletal/postural, nervous, circulatory, respiratory, metabolic, psychosocial, and bio-energetic systems. NPM and NMT are applied based on naturopathic principles of practice based on the individual needs of each patient.

Naturopathic Physical Medicine (NPM)
Naturopathic physical medicine is the therapeutic use by naturopathic physicians of the physical agents of air, water, heat, cold, sound, light and the physical modalities/procedures including but not limited to hydrotherapy, electrotherapy, magnetic therapy, diathermy, ultrasound, ultraviolet, infrared and low level laser light, therapeutic exercise, naturopathic manipulative treatment and the use of needling and injection therapies including dry needling, regenerative injection therapy (prolotherapy), mesotherapy, neural therapy and myofascial trigger point therapy.

Naturopathic Manipulative Treatment (NMT)
Naturopathic manipulative treatment (NMT) is treatment by naturopathic physicians using manual and other mechanical means of all body tissues and structures, including but not limited to bones, fascia, muscles, tendons, ligaments, entheses, joint capsules, bursae, tendon sheaths, scar tissue, and visceral organs. These may be located anywhere in the human body, including, but not limited to the spine, cranium, oracoabdominal cavity and/or extremities.

These manual and mechanical techniques involve the use of oscillation, thrust, pressure and sustained tension including but not limited to: high and low velocity techniques, high and low amplitude techniques, traction, mobilization through physiologic and extra-physiologic ranges of motion including passive intrinsic mobility of all body joints, and repositioning of displaced body tissues and organs.

Naturopathic Medical Education with Regards to Manipulation
Naturopathic medical education includes naturopathic physical medicine and naturopathic manipulative treatment both in courses devoted specifically to NPM and NMT and integrated with other courses and clinical experience. This training prepares NDs to safely and competently perform NPM and NMT, to recognize the limits of their skills, understand the risks, precautions, contraindications and limitations of the modality, and to refer patients to specialists when appropriate.

Position of the American Association of Naturopathic Physicians:

  • Naturopathic physicians use the diverse methods and therapies described as naturopathic physical medicine in a safe, healthful and clinically integrated manner consistent with naturopathic principles and philosophy.
  • Naturopathic manipulative treatment, as a traditional, integral and essential part of naturopathic medical practice, is a distinct and unique manipulative technique.
  • Naturopathic medical educational programs educate and train naturopathic physicians to safely and effectively perform naturopathic physical medicine and naturopathic manipulative treatment.
  • Naturopathic medical education programs educate and train naturopathic physicians to safely and effectively utilize physiotherapeutic medical devices, modalities, procedures, and injection therapies.
  • Naturopathic medical education programs educate and train naturopathic physicians to safely and effectively prescribe movement integration, functional training and therapeutic exercise programs.
  • Naturopathic physical medicine continues to evolve and integrate new therapeutic methods consistent with naturopathic principles and philosophy.


Submitted by N. Buratovich NMD; M. Cronin ND; A. Perry ND;
K. Frangos ND; E. Edwards ND; K. Wilson ND; and S. Bailey ND.
Adopted by the House of Delegates August 2006
Amended by HOD PPRC July 2011


American Association of Naturopathic Physicians. Paper Docs/Manipulative Therapy.pdf

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