Is a 'hands-on' approach still relevant in the contemporary management of spinal pain?

Certainly there has been a focus on the use of manual therapy within physiotherapy in recent years, with evidence based literature questioning its role within modern physiotherapy. Indeed, the expansion of this is reflected in the historical changes that have occurred within our profession. Grieves "Modern Manual Therapy" has now changed it's title to be more accommodating to the current biopsychosocial perspectives, so eloquently titled Modern Musculoskeletal Physiotherapy. Equally, the illustrious journal "Manual Therapy" has in 2017 had a name change to Musculoskeletal Science & Practice. The debate rages on between the art versus the science, and the future of our profession rests in the balance. No one considers regression to the days where evidence was lacking, however there is enough conjecture to suggest we do not throw out the baby with the bath water. Meanwhile, professions that remain embedded in the schema of "hands-on" therapy continue to thrive, physiotherapy is questioning the role actually providing therapeutic input has to play. The following blog hopefully captures and summarizes some of the current context, evidence and opinion surrounding this very important domain.