Ever considered “getting your back cracked,” as spinal manipulation is informally known? Maybe the only reason you haven’t gone ahead is the uncertainty; you don’t know what it really is, or what it can do for you either. Well, this guide will provide all the answers you’ve been looking for.
What is Spinal Manipulation?
Spinal manipulation (AKA manual therapy or spinal manipulative therapy) is a treatment technique that involves the application of a sudden controlled force to spinal joints. It’s often characterized by audible popping sounds — the result of gas movements within the joint cavity — although this isn’t really necessary for the treatment to be effective. Manual therapy aims to alleviate pain caused by inflammation and pressure along the spinal column, all while restoring nerve function.
A Brief History
Manipulative therapy has been in existence for over a couple of millennia, as attested by Chinese scripts dating back to 2700 BCE. Hippocrates, the father of modern medicine, employed manipulative techniques to a great effect. Other ancient cultures from various parts of the world have also described these treatments in their writings.
However, it’s only in the late 1800s that modern forms of manual therapy emerged. This was after it faded in and out of favor with physicians a number of times over the course of the 19th century. During this period, it was generally perceived that manipulative treatments only succeeded due to sheer luck.
Not everyone shared this opinion, though — a few practitioners still acknowledged the link between illness and musculoskeletal abnormalities. This minority group would, over time, develop the theories upon which chiropractic and osteopathic practices are based. As these theories found acceptance in the mainstream, so did manipulative therapy. It’s now been adopted practically everywhere across the globe, employed by osteopaths, physiotherapists, chiropractors, and even general physicians in some cases.
Manipulative Therapy in Chiropractic Care
As we’ve just seen, chiropractic care is based on the rationale that disease or discomfort can be caused by abnormalities occurring along the spinal column (subluxations). Manipulation is one of the numerous techniques that chiropractors can employ towards remedying these anomalies. What makes it different from most other treatments is the amount of force used; manipulation employs high-velocity, low-amplitude (HVLA) thrust.
As technical as it sounds, HVLA manipulation is actually very simple in practice. The term implies that movement occurs at high speed or velocity and concentrated over a small area (amplitude). To initiate this particular movement, a chiropractor applies a sudden jerking force on the target joint to restore its normal range of motion.
This technique has spawned several different variations as it’s evolved over time. Even so, the application of HVLA thrust is still the distinguishing feature of manipulative therapy. And while most manipulations are performed by hand, there are special tools that a chiropractor could use if necessary.
Does Spinal Manipulation Work?
Although manipulative therapy has been practiced since time immemorial, the specific mechanisms through which it works are yet to be understood. Nevertheless, research over the years has shown that it can bring positive outcomes for quite a few conditions. Here are a few illustrations:
– Neck pain: People with mechanical neck pain can benefit appreciably from HVLA thrust manipulation of their cervical and upper thoracic vertebrae. That’s according to a report appearing in the Journal of Orthopedic & Sports Physical Therapy, Jan 2012 issue. Later the same year, a separate study suggested that manipulation might be more effective than pharmaceutical painkillers in both the short- and long-run.
– Low back pain: A 2017 publication from the American College of Physicians indicated that spinal manipulative therapy is a viable treatment option for acute and chronic low back pain. Earlier in 2015, a study of 100+ subjects showed that manipulation offers a greater degree of relief than conventional care. This was further affirmed 3 years in a survey of 750 US military service members; it was found that those who received chiropractic manipulation fared significantly better than those who didn’t.
– Headaches: According to the US Agency for Healthcare Research and Quality, spinal manipulation can bring slight-to-moderate improvements in symptoms compared to standard treatments for headaches. Other sources have suggested that it can be as effective as medication in preventing migraines.
Sciatica: A clinical trial reviewing treatments for sciatica suggested that while manipulation isn’t typically used for the condition, it can help relieve leg pain caused by irritation of the sciatic nerve.
Other conditions that might benefit from manipulative therapy include sinus disorders, chronic obstructive pulmonary disease, and menstrual pain.
And Just How Safe Is It?
Well, individuals with osteoporosis, high susceptibility to stroke, an unstable spine, and spinal cancer are advised to steer clear of any form of manipulative treatment. As are those who experience unusual sensations (limpness, numbness, and tingling) on their limbs. These exceptions aside, spinal manipulation is relatively safe as long as it’s performed by qualified, licensed practitioners such as doctors of chiropractic.
DC’s are experts not only in manipulation but also in administering other treatments with which it combines favorably. Be sure to get in touch with your local chiropractor and see if you’re a suitable candidate for spinal manipulation.