<p>Manual medicine is the medical discipline that deals comprehensively with the diagnosis, therapy, and prevention of reversible functional disorders of the musculoskeletal system and other associated organ systems. Using the latest literature and considering various scientific guidelines, the evidence-based effectiveness of manual medicine procedures is presented. The article highlights neuroanatomical and neurophysiological fundamental elements of the mechanisms of manual medicine diagnostics and therapy. Case studies illustrate the clinical approach. Contraindications and an outlook on the requirements and possibilities of scientific pain analysis, as postulated in the preamble of the DGOOC guideline on “specific low back pain”, are presented in detail.</p>