To be able to use the hands in an exclusively upright position was a decisive step in human evolution and this ability was the first thing used to relieve pain and various other physical conditions affecting mankind. The development of these skills over the centuries, ultimately refined in the hands of physicians, has evolved into what we now call manual medicine.

Nobody will ever dispense with “high tech medicine” when it is necessary but nevertheless there is a worldwide acceptance that the manual approach for helping patients remains highly effective. The techniques and methods of manual medicine are diverse and innumerable; therefore, it was necessary to delineate the scientific background in anatomy and physiology on which they were based, to gather proof of their effectiveness in reported clinical studies and to identify the positioning of manual medicine in complex clinical therapeutic regimens.

The techniques and methods of manual medicine are diverse and innumerable

With this in mind, the European Scientific Society of Manual Medicine (ESSOMM) was founded in 2006 in order to unite all interested European experts and authors under one scientific roof. Today 14 national scientific societies, amounting to more than 12,000 physicians, form ESSOMM. In 10 3-day annual meetings, held in Rome between 2010 and 2021, the ESSOMM formulated a consensus concerning a curriculum and the principles of manual medicine based on translational research, clinical studies and the clinical experience from the various national specialist representatives. Many authors from all the member countries have substantially contributed to the important issues that were to be debated and agreed upon. It was a demanding and lengthy process to satisfactorily resolve all of the questions that this undertaking posed but finally this was achieved and we are now very proud of being able to offer the present paper.

The paper is divided in two parts:

Part I: the ESSOMM curriculum

This contains what the consensus conference considered to be the required and scientifically based content for educational proceedings to achieve the so-called additional competence in manual medicine as a postgraduate qualification for specialist physicians. A shortened version of these contents was adopted by the Union Européenne des Médecins Spécialistes (UEMS) council in 2015 as: the European Training Requirements for Manual Medicine (to be found on UEMS Homepage, Documents 2015).

Part II: principles of manual medicine

This contains important articles that reflect the content of respected publications and also the personal opinions of internationally renowned authors in the vanguard of this field presented as a general discussion of the current eclectic concepts, theories and findings.

No medical discipline can pretend to have all the answers to everything and so we consider this part of the paper as a kind of “work in progress” representing the continuous evolution of scientific knowledge and understanding in this particular specialty.

In representation of all the faithfully industrious friends and colleagues from all over Europe who have diligently contributed to this collaborative consensus with the hope of its wide distribution and interest.

Yours Hermann Locher