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What is a Spinal Manipulation?

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What is a Spinal Manipulation?

Physiotherapy is sometimes not the first profession thought of when it comes to spinal manipulations. The truth is, physiotherapists have been performing manipulations for as long as the profession has been around. Physiotherapists perform many different treatments and spinal manipulations are just part of their toolbox.

A spinal manipulation is short way to say ‘spinal joint manipulation;’ it is actually the joint that is being treated. A joint manipulation is when a therapist moves a joint at a specific speed and amplitude, technically known as a “high velocity low amplitude thrust.” When this type of movement is performed and the joint is aligned properly, a ‘cavitation’ can occur. Cavitation is a word to describe the rapid release of gas molecules inside a liquid. It occurs due to a change in pressure in the joint; the joint is kind of being burped! Along with a cavitation usually comes a popping or cracking sound. This can be done to any synovial joint in the body (not just the spinal joints). Next time a joint cracks in your body, remember that a cavitation just occured.

Perhaps the most profound effect a joint manipulation has on the body is called a “neurophysiological effect.”¹ Manipulations have shown to release a variety of natural chemicals in our body that can have profound impacts on our nervous system and can effectively reduce pain and muscle tension. These effects tend to be short-lived; however, in combination with other treatments it may be possible to keep them around.

Many (but not all) physiotherapists perform spinal manipulations. Most physiotherapy Colleges (regulating bodies) require therapists to have additional education, including theoretical and practical examinations, before spinal manipulations can be performed on patients.

There are many patients who find spinal manipulations very helpful. As with any treatment, how effective it is depends on many variables. There are risks associated with spinal manipulations; risks and benefits should be discussed with your physiotherapist prior to treatment.

1. Pickar, J. G. (2002). Neurophysiological effects of spinal manipulation. The spine journal, 2(5), 357-371.

Please note

This article is not intended to be a literature review.  While some literature may be cited in some cases, this article should not be used as scientific-evidence of a treatment or service.  Please contact your physiotherapist or other appropriate health care provider to better understand the scientific literature supporting or refuting the use of a particular treatment.

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