Spinal manipulation is a common form of treatment used by physiotherapists in the management of neck pain, headaches, upper back pain and low back pain. Manipulation of a joint occurs when a high velocity, short amplitude thrust is directed to the joint and a ‘crack’ or ‘pop’ may occur. This is known as joint cavitation and can result in reducing pain, muscle spasm and restoring normal movement within the joint. It is important to realise the joint does not ‘slip in’ or ‘out’.
Not all joints require manipulation and not all conditions respond well to manipulation. Hence, manipulative techniques are used only in the appropriate patients at the right time.
Research has shown that spinal manipulative therapy (SMT) is an effective form of treatment in the management of acute low back pain and in headache patients.
There are specific risks associated with SMT, although risk can be minimised with a thorough interview and history. If your therapist decides a manipulative technique would be beneficial they will inform you and ask for your consent after discussing the risks and benefits.
Physica therapists have received additional training in SMT. Feel free to discuss the option of manipulative techniques with your treating practitioner.