What Does A Chiropractic Adjustment Do? And Does Chiropractic Work?
Let’s cut to the chase you’re here because you want to know what a chiropractic adjustment does and is it effective. So let me (an evidence based chiropractor) answer those questions first and foremost.
What does the chiropractic adjustment do?
Chiropractic Adjustments, also known as spinal manipulation, are a form of joint mobilization. Joint mobilizations take the joint(s) through a range of motion in a passive manner. The goal of this type of maneuver is to reduce pain, relax the surrounding musculature, and overall improve the mobility of the joint and surrounding area.
There are different types of mobilizations from slow to fast. Chiropractic adjustments are the fastest type of mobilization. A high velocity but low amplitude thrust is used to take the joint through its motion. Sometimes spinal manipulation will have an associated cracking sound, other times it doesn’t. I will get more into that later in this post.
Well let’s clarify this a bit more. Chiropractic is a profession not a specific treatment type. When people ask this question they often actually mean “does the chiropractic adjustment work?” And the answer to that is well it depends on what you mean by work.
If the question is: does the chiropractic adjustment work to reduce pain and improve the outcome of rehabilitation for musculoskeletal conditions (such as back pain and neck pain)? Then the answer is yes it does.
Spinal manipulation and mobilization are effective procedures for reducing pain and improving outcomes for low back pain and neck pain. (Bronfort G 2004)
Other studies support similar findings:
“Manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe. Multimodal programs may be a promising option.” (Coulter I 2018)
“SMT produces similar effects to recommended therapies for chronic low back pain, whereas SMT seems to be better than non-recommended interventions for improvement in function in the short term.” (Rubinstein S M 2019)
However if the question is do chiropractic adjustments realign the spine, remove interference from the nervous system, improve the immune system, or cure systemic disease? Then the answer is no, it does not. While these are claims that some will make there is no good quality evidence to support them.
Let’s discuss this in a bit more detail.
How does a chiropractic adjustment work?
As I discussed above the chiropractic adjustment is a type of mobilization. An outside force is used to move the joints through a range of motion. What this does is it causes an analgesic effect, reduces the muscle tightness in the area, and overall helps to improve the mobility of the area.
When the outside force is put through the joint it causes the two surfaces of the joint to gap apart. The cracking sound that is so commonly associated with the chiropractic adjustment is caused by this gapping.
Our joints are essentially closed environments filled with fluids and gasses. When a gap is quickly created between two joint surfaces a gaseous bubble is able to form in the middle of this gapped area. The formation of this bubble is what causes the cracking sound. This process is known as tribonucleation.
The tribonucleation, and therefore the cracking sound, is not all that important. The important part is actually the movement of the joint through its motion from an outside force. This is what causes the muscles in the area to relax and the analgesic effects to happen.
How the chiropractic adjustment doesn’t work?
Out dated theories proposed that the vertebrae would go out of alignment and this would put pressure on nerves which could interfere with the nerve firing properly. These outdated theories proposed that manipulation put the bones back into alignment thereby reducing this interference.
These theories have become outdated as we have gained a better understanding of how the body works.
The amount of forced required for a vertebrae to actually move in and out of alignment, as in a dislocation, is immense. These true dislocations can happen with severe trauma (bad car accident with likely fractures) but are by no means everyday occurrences. Furthermore the force of spinal manipulation is nowhere close to the force required to either reduce or dislocate the vertebrae. From this we can conclude that manipulation is not putting bones that are out of alignment back into alignment.
When should you get a chiropractic adjustment and how often?
You should consider going to get a chiropractic adjustment when you have neck pain, back pain, or headaches. In general these are the three things that the chiropractic adjustment is most effective for. In fact the American College of Physicians recommends spinal manipulation as a first line treatment for back pain. (Qaseem, et al. 2017)
How often you should get a chiropractic adjustment is more dependent on the specifics of your condition. With that said for most patients dealing with neck pain, back pain, and headaches spinal manipulation should be just one part of the treatment approach. For most issues combining spinal manipulation with exercises and education is a more effective treatment approach then just spinal manipulation on its own.
At Tauberg Chiropractic & Rehabilitation We Use The Chiropractic Adjustments As A Part Of An All Encompassing Treatment Plan
When you come to my clinic my goal is to get you out of pain and back to enjoying your favorite activities as quickly as possible. While I will often use the adjustment to help me do this I also incorporate personalized exercises and education to make sure we can achieve our goals.
Spinal manipulation is great but self empowerment is even better. I want you to leave my office feeling like you know what you need to do in order to make a full and quick recovery. The exercises that I show you are meant to help you take control over your condition. Often times the exercises can be used to help minimize the pain in addition to rehabilitate the injured area.
If you’re in pain and want to work together give me a call at 412-517-8124 or follow me for more pain relief tips on TikTok @ThePittsburghChiro or IG @ThePittsburghChiropractor
Bronfort G, Haas M, Evans RL, Bouter LM. “Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.” Spine Journal, 2004: 335-56.
Coulter I, Crawford C, Hurwitz E, Vernon H, Khorsan R, Booth MS, Herman P. “Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis.” The Spine Journal, 2018.
Qaseem, A, T Wilt, R McLean, and M A Forciea. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.” Annals of Internal Medicine, 2017.
Rubinstein S M, de Zoete A, van Middelkoop M, Assendelft W J J, de Boer M R, van Tulder M W et al. “Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials.” BMJ, 2019: 364.