Overview

Spinal manipulation is a treatment that uses pressure on a joint of the spine to improve pain and function. It is also called spinal adjustment.

The manipulation can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong and from slow to rapid. Sometimes other joints of the body are also worked on to help treat the spine.

If you have tight muscles or muscles that spasm, your health care provider may first use heat, ultrasound, or electrical current. This helps relax your muscles before you receive spinal manipulation.

This treatment is safe when done by a trained health professional. Some people feel tired or sore after spinal manipulation. But serious problems are very rare.

Spinal manipulation can work as well as other treatments for back pain, whether the pain is new or has lasted a long time. But pain relief from this treatment may only last for a short time.

Like most back pain treatments, spinal manipulation works for some people but not for others.

Why might you choose this treatment for back pain?

You might consider spinal manipulation if:

• Your back pain hasn't improved after a few weeks of other treatments, such as heat or ice, pain medicine, or physical therapy.
• You want a treatment that involves hands-on contact.
• You want to avoid medicines and their possible side effects.
• You've had spinal manipulation before, and it helped.

How does spinal manipulation feel?

Spinal manipulation normally doesn't hurt. If you're already in pain because of your back, it may hurt to move. But manipulation is aimed at making you feel better.

The most familiar type of spinal manipulation is the hands-on approach: You lie on a table while the health professional uses their hands or a device to apply pressure to an area of your spine. Some people call this "cracking" your back because of the popping sound that is sometimes made. But nothing is actually "cracking." The sound happens when the tissues of the spinal joint are stretched.

Some health professionals use a drop table for manipulations. Parts of the table drop slightly when the health professional presses down on your back. The table is noisy, but this method is actually very gentle.

Some health professionals use a handheld device called an activator to do spinal manipulations. This is also very gentle.

Who can do spinal manipulation?

Health care providers who are commonly trained to do spinal manipulation include: