How can pointers be used in PHP functions to manipulate and return variable values effectively?

Pointers in PHP functions can be used to manipulate variable values directly instead of passing them by value. This can be useful when you want a function to modify the original variable rather than just a copy of it. To use pointers in PHP functions, you can pass variables by reference using the `&` symbol in the function definition. This allows the function to directly modify the variable passed to it.

function increment(&$num) {
    $num++;
}

$value = 5;
increment($value);
echo $value; // Output: 6