Spinal manipulation: your questions answered

Spinal manipulation, also known as thrust techniques, may form part of hands-on care. However, it is not needed in every session or suitable for everyone.

What does it involve?

A brief, controlled thrust is applied to a joint after assessing whether the technique is appropriate. It may be used to help relieve certain symptoms and improve movement.

Its usefulness depends on the problem and the context: it is not a universal solution and does not replace exercise or any other care you may need.

Does it put a vertebra “back in place”?

That is not an accurate description of what happens. Manipulation does not involve returning a vertebra that has slipped out of place to its original position.

Does there have to be a cracking sound?

No. A cracking sound alone does not show that the treatment has worked. What matters is assessing how you feel afterwards and whether there is any change in your movement or the symptoms that brought you to the practice.

Are there any risks?

Temporary soreness, stiffness or an increase in pain may occur. Serious complications have also been reported, although they are uncommon. With neck manipulation, particular consideration must be given to risks involving the blood vessels.

Before using these techniques, it is necessary to review your medical history, assess any contraindications and explain the potential benefits, risks and alternatives.

Can I choose other techniques?

Yes. If you do not want to receive manipulation, you can say so. At my practice, we can consider slower joint mobilisation, soft tissue work and other options suited to you.

The choice of technique should take both the assessment and your preferences into account.

NCCIH — Spinal Manipulation: What You Need To Know