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Spinal Manipulation

Spinal manipulation is typically performed by chiropractic physicians and osteopathic physicians specifically trained in these technique. It is a passive form of treatment where something is done to the patient versus active exercise. The hands on component of the treatment are very important in both diagnosis and management of certain spinal conditions. There are two main types of treatment provided: soft tissue or muscle energy techniques, and, high velocity/low amplitude techniques. The soft tissue techniques focus on manual examinations and hands on treatment for specific affected areas.

Many physicians are incorporating the traction machine therapy into their protocols. The high velocity techniques are commonly referred to “pop and crunch”. The facet joints of the spine are forcibly mobilized through a restricted range of motion causing an audible pop of the joint much like “cracking your knuckles”. The theory is that the facet joint is mobilized and any abnormal swelling or fluid collection in the joint is released decreasing excessive pressure and alleviating pain. Areas of the spine that are typically treated show up as “trigger points” or localized areas of pain, swelling, and a palpable lump. These problems can occur in the neck, thoracic, lumbar or sacroiliac spine areas.

There is a general feeling amongst physicians that too much manipulation therapy can cause hyper mobile joints. No studies have proven this claim. My thought is that passive manipulation therapy must be combined with an active exercise program. As normal range of motion is re-established, then strengthening the surrounding muscles will help to keep the alignment and proximity of the spine in a normal position and lessen the recurrence of similar problems.

I do have some concerns about the use of manipulation treatment to manage certain systemic conditions such as diabetes, heart disease, and other medical conditions. This simply has not been proven to work. Like any non-surgical treatment for spine problems, manipulation has its place, it advantages, and its role in the comprehensive management of certain spinal disorders and can help many people.

Spinal Manipulation can treat the following conditions:

Sprains and Strains
Herniated Intervertebral Disc