Chiropractic Adjustment
A chiropractic adjustment, commonly called spinal manipulation, is a key treatment technique widely used by chiropractors. This manual therapy involves a chiropractor performing a high-velocity, low-amplitude thrust to a joint, typically in the spine, near the end of its range of motion. Often referred to as “cracking” joints, this procedure aims to improve joint function and alleviate pain.
An adjustment, a form of joint mobilization, is a type of manual therapy used to increase a joint’s range of motion. Joint mobilizations are categorized by intensity, ranging from grade 1 to grade 5. Non-thrust mobilizations employ low-velocity, passive movement techniques of varying intensities within the patient’s range of motion. As the grade of mobilization increases, the closer it approaches the joint’s passive end range. An adjustment, or grade 5 mobilization, involves a high-velocity, low-amplitude thrust that goes beyond the patient’s passive range of motion.
How does the adjustment work?
Chiropractic manipulation works through both biomechanical and neurophysiological mechanisms. The biomechanical theory posits that manipulation targets dysfunctional or “stuck” joints, aiming to reduce internal mechanical stress. This adjustment increases the range of motion in joints that were previously restricted. Meanwhile, the neurophysiological approach suggests that adjustments impact nerve cells within muscle tissues, the motor control system, and the pain processing system in the spine. This means that spinal adjustments cause changes in sensory neurons of the joint and surrounding tissues, helping to alleviate pain.
How Does Spinal Manipulation Work?
Various theories exist on how spinal manipulation works, but none have been definitively proven due to the complexity of designing and administering such studies. A 2005 review by Potter, McCarthy, and Oldham explored proposed theories, including joint gapping, improving range of motion, reducing muscle hypertonicity, and altering pain perception. It is possible that spinal manipulation works through a combination of these mechanisms, though more research is needed.
It’s important to note that spinal manipulation does not “push a vertebra into place” or “correct a misalignment.” Often, what feels like a “misalignment” is actually a tight or restricted joint. In some cases, segments may move excessively, causing the sensation that something is out of place. However, physically, there isn’t a true misalignment. Your spine is robust and does not misalign from everyday activities.
