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Benefits of Spinal Manipulation

Spinal manipulation is a technique that involves putting a quick stretch through the spine, that may or may not cause a cracking sound. It was once believed that these spinal manipulations put the spine “back into place,” resulting in pain improvement. This theory of the “subluxed vertebrae” has been since found to be complete bogus; however, the spinal manipulations are an excellent way to achieve pain relief.

The mechanism of why spinal manipulations is effective is based on “neurophysiological” mechanisms. What this means in English is spinal manipulations serve as a reboot, or “Control/Alt/Delete” for the nervous system. These benefits are as follows:

  • Stretching tight tissues to increase flexibility
  • Decreasing pain
  • Stimulating receptors responsible for influencing muscle tone, thus increasing flexibility
  • Stimulating receptors responsible for controlling muscles, thus increasing the strength and coordination of the muscles that attach to your spine

Spinal manipulations do not change position of the vertebrae. If such a small amount of force could cause a change in vertebral position, NFL players would be paralyzed every time they are tackled.

To determine who benefits most from receiving spinal manipulation, it has been shown that those with low back pain that has been present for less than 16 days and do not have leg pain past the knee. While these two factors show those who benefit the most, other patients have been shown to benefit from receiving a spinal manipulation.


  • Bialosky, Joel E. et al. “Spinal Manipulative Therapy–Specific Changes In Pain Sensitivity In Individuals With Low Back Pain (NCT01168999)”. The Journal Of Pain, vol 15, no. 2, 2014, pp. 136-148. Elsevier BV, https://doi.org/10.1016/j.jpain.2013.10.005.
  • Flynn T, Fritz J, Whitman J, et al. A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation. Spine. 2002;27(24):2835-2843.
  • Fritz, Julie M. PT, PhD, ATC, Cleland, Joshua A. PT, PhD, OCS, FAAOMPT, and Childs, John D. PT, PhD, MBA, OCS, FAAOMPT, “Subgrouping Patients With Low Back Pain: Evolution of a Classification Approach to Physical Therapy,” Journal of Orthop Sports Physical Therapy 37, no. 6 (June 2007): 290-302.
  • Koppenhaver, Shane L. et al. “Association Between Changes In Abdominal And Lumbar Multifidus Muscle Thickness And Clinical Improvement After Spinal Manipulation”. Journal Of Orthopaedic & Sports Physical Therapy, vol 41, no. 6, 2011, pp. 389-399. Journal Of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2011.3632.

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