Spinal manipulation is a hands-on therapy involving applying a thrust to the spine. This is done to help correct spinal nerve interference. Most chiropractors use spinal manipulation, but osteopathic physicians and some physical therapists perform it. Researchers believe that spinal manipulations cause a variety of neurophysiological responses. These include reducing the excitability of A motor neurons and modulating a neuroendocrine response that causes pain relief.
What is Manipulation?
Spinal manipulation (spinal adjustment) is a hands-on treatment for pain in the back or neck. Practitioners use their hands or a device to apply a controlled force to a joint of the spine, usually the lower back (lumbar) joints. The force used can vary from gentle to firm, and the speed of the movement can be varied, too. Other joints of the body may also be treated. Chiropractors, for example, Brad Kern, often perform this therapy. Manipulation techniques have many names, depending on the profession using them: chiropractic uses “spinal adjustment,” osteopathic physicians use “high-velocity low amplitude thrust manipulation,” and physical therapists use “spinal mobilization.” The goal is to reduce pain by relieving pressure on the joints in the spine and improving nerve function. Manipulation may cause temporary side effects, such as soreness or stiffness, but serious problems are rare when a trained health professional performs it.
How is Manipulation Done?
During spinal manipulation, practitioners use their hands or a device to apply a controlled thrust to a spine joint. It is thought that this repositions the small bones of the vertebrae to reduce pressure on the discs and relieve pain by interrupting the painful “pain-spasm” cycle. In a study of low back pain, doctors found that patients who received spinal manipulation experienced modest improvements in their pain and how they functioned. That suggests that the treatment helps people get better at day-to-day activities, such as walking faster or turning in bed. It needs to be clarified precisely how spinal manipulation works. One theory is that it repositions small bones in the spine called vertebral facets and restores some of the material in the disk between the vertebrae. Another possibility is that it affects the central nervous system and reduces “central sensitization,” which happens when nociceptors in the spine’s nerves become over-sensitive to subthreshold mechanical or chemical stimulation.
What are the Benefits of Manipulation?
In a large study, patients with low back pain reported significant improvements in pain and function following spinal manipulation and exercise. The authors suggest this improved function because spinal manipulation can improve joint mobility and muscle activity and reduce nerve compression. Physiotherapists, chiropractors, and physicians use spinal manipulation as part of a holistic approach to patient health and wellbeing. The exact mechanism of action is not fully understood, but it is thought to be related to the modification circuit of pain descending pathways. The mechanical stimulation of manipulation is thought to elicit the descending modulation of spinal stretch dubai reflexes, inhibiting muscular hyperactivity and thus disrupting the pain-spasm cycle. It is also believed to influence the A motor neuron excitability. In addition, research has shown that spinal manipulation can effectively treat neck pain. Moreover, it can be used as an adjunct to exercise and physician consultation to improve neck pain outcomes.
What are the Risks of Manipulation?
Spinal manipulation is safe when performed by someone trained to deliver the care, such as a chiropractor or physical therapist. A recent study found that spinal manipulation is moderately effective in easing chronic low back pain that lasts four weeks or more. It’s also slightly to moderately effective in easing acute low back pain. Aside from the occasional side effects, such as stiffness and local discomfort, spinal manipulation is a relatively benign treatment. It’s important to note that the number of adverse events reported is small, and case reports are weak evidence. Nevertheless, it has often been associated with severe complications in the upper spine. These complications are believed to be due to manipulations beyond the normal physiological range and may result in vertebrobasilar dissections, leading to strokes and paralysis.