Chiropractic manipulation is becoming an increasingly common treatment for neuromusculoskeletal complaints, with physiotherapists and osteopaths also beginning to practice it for back pain. But how does chiropractic manipulation help relieve pain?
Manipulation is not the only treatment method that chiropractors use; however, it is something which they are renowned as the foremost providers of. Performed in the correct manor and situation, manipulation is one of the most effective treatments for neuromusculoskeletal pain and dysfunction, and is particularly effective for back and neck pain.
Firstly I feel the need to state that manipulation, despite the sound of the word, is not a painful treatment. When performed by an experienced and professional chiropractor it is a very specific and gentle technique which can be used on almost any joint in the body, from the feet right up to the jaw.
A manipulation, sometimes call an adjustment, is defined as a high-velocity, low-amplitude, thrust, or HVLA thrust for short. To perform this, a joint must be taken near to the point at which it will move no further. This position places the joint under a very minor stretch and is called “end-range”. Physical assessment helps determine in which direction and to what extent a joint must be stretched, and it is this specificity that is one of the keys to successful manipulation.
Upon reaching end-range, a small thrust is delivered, usually from the hand of the clinician although some clinicians use “adjusting tools”. The depth and force of this thrust varies hugely depending on factors such as patient age and size, the nature of problem and area of the body involved. The training and experience of your clinician is invaluable at this point. As an example, chiropractors practice this every day for 4 years before being let loose on a patient.
The HVLA thrust, or manipulation, takes the joint beyond its normal range of movement. This has a number of physiological and mechanical effects.
Most obviously, moving a joint beyond its normal limit increases the overall mobility of that joint. This is important in the spine where stiff joints impact on the function of muscles and flexibility of the limbs. Crucially, the aim of manipulation is not to create a supple spine (this type of spine is more prone to injury), but to restore an even distribution of mobility of each segment in the spine. The topic of spinal biomechanics is definitely one for another article!