When the painkiller Vioxx was pulled from pharmacy shelves, Sally Archer joined a large group of patients seeking something else to relieve persistent, life-limiting pain.

Her doctor diagnosed arthritis as the cause of the pain. Her question was, what next?

Dina Drits was in a car accident about a year ago, her vehicle rear-ended by a drunken driver.

She was left with soft-tissue damage in her lower back and her pelvis out of alignment.

The pain built over time until she couldn't lean forward at all, she said. "It hurt to brush my teeth and I couldn't walk for more than 15 minutes at a time. I couldn't do any of my regular sports — and I was a ballroom dancer."

She went to several doctors and had magnetic resonance imaging, which showed no clear solution. She tried chiropractics and physical therapy. From the therapist she learned exercises to strengthen her abdomen, which strengthens the back. She could walk farther in a couple of months, but she still couldn't shake the lower back pain.

That's changing. The two women find themselves among a growing number of patients discovering a type of physical therapy that has evolved over the past 20 years, gaining popularity across the country.

Called integrated manual therapy, also referred to as integrative manual therapy, it's a subspecialty of physical therapy based on holistic, osteopathic principles. It uses the body's own corrective mechanisms to release tension and restrictions that cause pain, according to Jane Glaser-Gormally, who has a master's degree and more than a decade's experience in physical therapy. She's practiced the form of physical therapy for the past five years.

The hands are the tools of choice, the whole body the target.

"The body is an integration of systems," she said. "We help the body take its own corrective action."

"What I tell my patients is integrative manual therapy means you're incorporating a systems type of approach to treatment," said Christine Powell, a physical therapist in Logan whose practice is based on integrated techniques. "It's not a single problem that causes a person's pain or dysfunction. It's a number of the systems in the body interacting."

Those systems include musculoskeletal, visceral, connective tissue and many more, even a body's energy.

Powell said when a shoulder stops moving and hurts, for example, it could be that adjacent tissue is not moving, either. The point of therapy is finding what's interconnected, what needs to be done first and then working backward to resolve the problem.