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  7. Benefits of Spinal Manipulation

Benefits of Spinal Manipulation

What are Spinal Manipulations? 
Spinal manipulations include positioning of a patient and then performing a single, rapid movement to an area of the spine including cervical (neck), thoracic (upper back) and lumbar (lower back). These rapid movements are also known as “high-velocity thrusts.” A manipulation is different from a mobilization where mobilization is a lower velocity repetitive oscillation or sustained hold. Spinal manipulation has been shown to be an effective tool physical therapists use to reduce patient pain and improve function. 

What symptoms can manipulations be effective for? 
Spinal manipulations can be effective for many conditions including, but not limited to:

  • Low back pain
  • Thoracic (mid-back) pain
  • Neck pain
  • Headaches that stem from the neck
  • Joint stiffness and decreased mobility

How do Spinal Manipulations help reduce symptoms? 
The mechanism of spinal manipulations remains unclear. It is suspected, however, that spinal manipulations reduce symptoms by causing what is referred to as a “neurophysiological response.” This neurophysiological response affects the nervous system in such a way that results in decreased pain signals to the brain and improved muscle activation.

What is the noise that occurs with spinal manipulation and must it happen in order to be effective? 
Spinal manipulations often result in an audible “pop.” This is caused from the release of gas in the manipulated joint(s) or surrounding joints that occurs when a high-velocity thrust is performed. 

This “pop” is NOT due to joints being “re-aligned.” The human spine is incredibly strong and resilient; contrary to popular belief, it does not go out of alignment. 

Are spinal manipulations necessary for me to get better?
Spinal manipulations are one of many tools physical therapists use to decrease patient pain and improve function. Although beneficial, spinal manipulations are not necessary in order to get better. If spinal manipulations do not sound appealing, your physical therapist will discuss one of our several treatment options. 

Coronado, R. A., Gay, C. W., Bialosky, J. E., Carnaby, G. D., Bishop, M. D., & George, S. Z. (2012). Changes in pain sensitivity following spinal manipulation: a systematic review and meta-analysis. Journal of Electromyography and Kinesiology, 22(5), 752-767.

Kuczynski, J. J., Schwieterman, B., Columber, K., Knupp, D., Shaub, L., & Cook, C. E. (2012). Effectiveness of physical therapist administered spinal manipulation for the treatment of low back pain: a systematic review of the literature. International Journal of Sports Physical Therapy, 7(6), 647.

Ruddock, J. K., Sallis, H., Ness, A., & Perry, R. E. (2016). Spinal manipulation vs. sham manipulation for nonspecific low back pain: a systematic review and meta-analysis. Journal of Chiropractic Medicine, 15(3), 165-183.

Masaracchio, M., Kirker, K., States, R., Hanney, W. J., Liu, X., & Kolber, M. (2019). Thoracic spine manipulation for the management of mechanical neck pain: a systematic review and meta-analysis. PloS one, 14(2), e0211877.

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