Why Feeling Better Doesn’t Always Mean Something Was Fixed

Lately, I’ve been seeing more explanations online that sound scientific. They use anatomy pictures, medical-sounding words, and terms like fascia. But from what I’ve learned so far, many of these explanations rely more on assumptions than solid evidence.

Not long ago, I came across a post on social media that stuck with me.
In the video, the practitioner explained that tension around the heart pulls on tissues connected to the neck, making the neck stiff. The idea was that by shaking or pulling the neck, this “heart tension” could be released, and the neck would feel better. The video showed anatomical drawings, talked about fascial connections, and finished with a neck manipulation, a loud click followed by instant relief.

I can see why this kind of content lands well. The story is simple, it looks anatomical, and people often do feel better straight after.
But speaking only from my own training and experience as a remedial massage therapist, I think this explanation deserves a closer look.

Being Connected Doesn’t Always Mean One Thing Is Causing Another

From what I understand, one of the biggest problems here is assuming that because two structures are connected, one must be causing the other.

It’s true that the heart sits inside the chest, and it’s also true that some tissues in the neck are connected to structures in the thorax. That part isn’t wrong.
But being connected doesn’t automatically mean that tension or force is being pulled from one area into another in a meaningful way.

Fascia doesn’t work like a rope where pulling one end directly tugs on the other. It’s more like a layered sheet that spreads force out and allows movement between layers.
So the idea that tension around the heart is physically pulling on the neck, or that pulling the neck releases tension around the heart, seems, to me, like a very simplified way of describing a much more complex system.

Based on what I’ve been taught, this is a case of confusing things being linked with one thing causing another.

A Story That Makes Sense Isn’t the Same as Proof

Another issue, as I see it, is assuming that if an explanation sounds reasonable, the treatment must work.

In healthcare, plenty of ideas have made sense in theory but didn’t hold up when they were properly tested. In this case, the explanation often stops at “releasing tension,” without answering practical questions that matter in real life:

Does the improvement last?
Does it happen for most people, or just some?
Does it still work when other factors are taken into account?

As far as I know, explaining how something might work isn’t the same as showing that it actually works in a consistent and reliable way.
When the main argument becomes “you’ll understand once you try it,” that shifts away from evidence and toward belief.

Feeling Better Straight Away Doesn’t Mean the Problem Is Fixed

The cracking sound and short-term relief after neck manipulation can feel very convincing. I don’t doubt that people genuinely feel better in the moment.

However, my understanding is that the cracking noise usually comes from changes inside the joint fluid, not from bones being put back in place or deeper issues being corrected.
Short-term relief can also be explained by changes in how the nervous system processes pain, or simply by expectation.

Feeling good right after a treatment is real, but it doesn’t necessarily mean the underlying problem has been solved. In clinical work, immediate relief doesn’t always translate to long-term improvement.

Neck Stiffness Is Usually More Than One Thing

In my own clinical experience, neck stiffness is rarely caused by just one factor.
Sleep position, stress levels, breathing habits, upper back movement, shoulder control, work posture, and training load often all play a role.

Reducing all of that to one hidden cause, like “tension around the heart”, might make for a clean story, but it doesn’t match how these issues usually show up in real people. From what I’ve seen, complex problems don’t have single, simple answers.

If an Idea Can Never Be Wrong, It Can’t Really Be Tested

Another concern is that this kind of explanation is very hard to challenge.

If someone improves, the idea is said to be correct.
If they don’t, the explanation changes, maybe the area was “more restricted” or needed “stronger work.”

When an idea can explain every outcome, it becomes impossible to properly test. And if it can’t be tested, it’s hard to treat it as a solid clinical explanation.

Why I Still Care About This as a Manual Therapist

I want to be clear about where I’m coming from.

I’m a remedial massage therapist. I don’t claim to know more than physios, osteos, or chiros, and I’m still learning. What I’m sharing here is based on my education so far, my clinical experience, and how I understand evidence-based healthcare to work.

Manual therapy belongs in healthcare because it aims to be consistent, repeatable, and open to questioning, not because it sounds impressive or feels dramatic.

Good treatments should be explainable in plain language, able to be tested, and open to being challenged.

Where I Personally Draw the Line

I want to run a successful business and make good money, I’m upfront about that.
But I also want to stay within what I understand and can honestly stand behind.

That means not overselling effects, being clear about uncertainty, and avoiding explanations that sound clever but can’t really be backed up.
In my view, that’s how manual therapy keeps its credibility, and how patients stay protected.

And that’s a line I’m comfortable sticking to.