Achieve optimal health and well-being
The Body Leads.
The Practitioner Follows.
Functional Indirect Manipulation — a gentle, evidence-based approach to pain relief, offered as part of holistic naturopathic primary care.
The Body Leads.
There is a moment in a Functional Indirect Manipulation session when something shifts.
The practitioner’s hands are resting gently on the area of restriction — a stiff low back, a locked rib, a neck that hasn’t turned freely in months. But instead of pushing into the tightness, the hands have moved in the opposite direction, guiding the tissues toward ease.
And then, quietly, the body lets go.
Muscles that have been clenching for weeks or months simply release. The joint moves. The pain softens. No force was applied. No medication was needed. The body did the work — it just needed someone to listen.
A Different Kind of Manual Therapy
Most hands-on treatments for pain work by pushing directly into the area that’s restricted — engaging the barrier head-on. Functional Indirect Manipulation does the opposite.
Developed by Ed Stiles, this technique positions tissues in the direction of greatest ease, creating the conditions for the body to release tension and restore function on its own. The practitioner follows the body’s lead, finding the precise position where muscles can relax, joints can move, and the nervous system can calm.
There are no high-velocity thrusts. No sudden adjustments. No forcing through barriers. The body leads, and the practitioner follows.
This is not a passive technique — it requires deep skill, precise palpation, and years of training to practice effectively. But for the person on the table, the experience is remarkably gentle.
Conditions Treated
Functional Indirect Manipulation is particularly effective for:
- Acute and chronic low back pain
- Neck pain and whiplash-related conditions
- Rib dysfunction and costochondritis
- TMJ disorders
- Ankle sprains and lingering joint injuries
- Thoracic outlet syndrome
- Hypermobility syndromes, including hypermobile EDS
- Older adults with osteoporosis or anyone for whom high-velocity spinal adjustments aren’t appropriate
Because the technique is so gentle, it is one of the few manual therapy approaches safe for nearly everyone — including elderly patients, those with fragile tissues, and people who have had poor experiences with more forceful treatments.
Schedule NowThe Medication Question
Pain medication has its place. In acute situations, it can be essential. But as a long-term strategy for managing chronic pain, medication has significant limitations.
Anti-inflammatories, muscle relaxants, and opioids interrupt pain signals — but they don’t change what’s happening in the tissues. The restriction remains. The joint dysfunction remains. The cycle of inflammation continues beneath the surface. Meanwhile, the medications themselves carry risks: gastrointestinal damage from long-term NSAID use, dependency and tolerance with opioids, cognitive effects, and the slow accumulation of side effects that can become their own health problem.
Research consistently shows that patients who receive effective manual therapy are significantly less likely to rely on opioids and other pain medications long-term.
Functional Indirect Manipulation works at the source. When restricted tissues release, the pain doesn’t just quiet down — it resolves. Circulation improves. The nervous system calms. Mobility returns. These are not temporary effects masked by chemistry. They are the body’s own healing response, given room to work.
What Happens When the Body Lets Go
Immediate Pain Relief
When tissues move into a position of ease, muscles relax, nerve irritation diminishes, and pain decreases — often within the session itself.
Reduced Medication Dependence
Effective manual therapy is associated with significantly lower long-term use of opioids and other pain medications. Addressing the source means less need to manage symptoms.
Better Circulation
Relaxed tissues allow blood to flow more freely, reducing swelling and supporting the body’s natural healing process.
Restored Mobility
Joint stiffness eases and range of motion returns — without the jarring force of high-velocity adjustments.
A Calmer Nervous System
The technique reduces stress hormones and can help desensitize a nervous system stuck in overdrive, lowering the brain’s perception of pain.
Safety
Because the technique works with ease rather than through resistance, it is one of the safest manual therapy approaches available — appropriate for elderly patients, those with osteoporosis, and anyone for whom forceful manipulation is contraindicated.
Dr. Joshua Rubinstein, ND
Dr. Joshua Rubinstein is a naturopathic primary care physician at Heart of Wellness in Olympia, WA. He earned his Doctor of Naturopathic Medicine degree from Bastyr University in 2004 and has spent over 21 years in clinical practice and medical education.
Dr. Rubinstein trained in Functional Indirect Manipulation under the lineage of Ed Stiles, the technique’s founder, studying with Patricia Kortekass and Joe Keeney. He has also spent two decades teaching naturopathic medical students at Bastyr University and served as Associate Dean of Clinical Education at the University of Western States.
His approach to this work is simple and consistent:
“During indirect manipulation sessions I really try to listen to the patient’s body and let it guide the course of the treatment. It is this collaboration between myself and the patient that I really appreciate about indirect manipulation.”
Dr. Rubinstein specializes in:
- Chronic pain and fibromyalgia
- Autoimmune conditions
- Primary care naturopathic medicine
- Functional indirect manipulation of the spine and extremities
- Nutrition and lifestyle counseling
More Than a Technique
At Heart of Wellness, Functional Indirect Manipulation is not offered as a standalone treatment. It is part of holistic naturopathic primary care.
Dr. Rubinstein takes time in every visit to understand the full picture — how diet, movement patterns, stress, and sleep are influencing the current condition. Pain and physical dysfunction are always treated in the context of overall health and wellbeing. When someone is struggling with chronic pain, the manual therapy work is one dimension of a comprehensive approach that also includes nutrition guidance, lifestyle counseling, and the kind of thorough, unhurried attention that is increasingly rare in modern healthcare.
Heart of Wellness is built around longer appointments, a collaborative care team, and the belief that healing happens when the whole person is cared for — not just the symptom.
