Table of ContentsView AllTable of ContentsUsesBenefitsRisksWhat to ExpectFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Uses
Benefits
Risks
What to Expect
Frequently Asked Questions
Spinal manipulation therapy involves using the hands or another device to apply force to manipulate the joints in the spine. This form of therapy aims to improve mobility to relieve ailments such aslower back pain.Chiropractorsare most known for performing spinal manipulation, however, other types of licensed healthcare practitioners can perform it as well.
This article provides an overview of spinal manipulation, its uses, benefits, risks, and what to expect if you receive this therapy.
ljubaphoto / Getty Images
Licensed practitioners primarily use spinal manipulation to relieveback painor improve body function and mobility. This therapy involves using the hands or another device to apply force and manipulate the joints in the spine.
There are many types of licensed professionals who perform spinal manipulation, including:
Many licensed practitioners will also prescribe or recommend other at-home self-care practices in addition to spinal manipulation.
CAM TherapySpinal manipulation therapy is a form of complementary and alternative medicine (CAM) therapy. It’s the most widely used CAM therapy for children and adults in the United States.
CAM Therapy
Spinal manipulation therapy is a form of complementary and alternative medicine (CAM) therapy. It’s the most widely used CAM therapy for children and adults in the United States.
The most reported benefit of spinal manipulation therapy is reduced chronic back pain. However, a 2019 meta-analysis of 47 randomized controlled trials found other benefits, including improved body function and short-term pain relief.
Like many other CAM therapies, there are fewer clinical studies on spinal manipulation benefits than more traditional therapies, such as medication and surgery. Yet many people who use spinal manipulation report that they find additional benefits, though not yet proven.
The most reported side effects include temporary soreness at the manipulation site and exhaustion.
One 2017 study identified 283 reviews from spinal therapy patients and found that some rare adverse reactions can include:
There may be additional risks associated with spinal manipulation of the uppercervical spine. However, that area is usually not addressed when receiving treatment for lower back pain.
The study also concluded that it’s not currently possible to provide guidelines regarding the safety of spinal manipulation. Although severe or life-threatening events can occur after spinal manipulation, the study reported that it is rare, occurring in about 1 in 20,000 to 1 in 250,000 manipulations.
Preexisting health conditions may increase the risk associated with spinal manipulation and should be thoroughly discussed with your provider prior to treatment. High-quality research studies regarding the risks and benefits of spinal manipulation are needed.
There are over 100 versions of spinal adjustment techniques in the world.However, most practitioners will incorporate just a few or several of them into their practice.
Two common approaches include spinal manipulation and spinal mobilization.
Spinal Manipulation: High-Velocity Low-Amplitude Thrust (HVLA)
Spinal Mobilization: Low-Force Chiropractic Techniques
Depending on a patient’s comfort level, age, size, or preference, a therapist may decide that a spinal mobilization is best. Patients who are uncomfortable with twisting or forceful thrusting may also prefer this therapy.
Many licensed professionals who use spinal manipulation also use additional therapies to complement the treatment plan, including:
Discuss treatment options with your practitioner before starting therapy to determine a plan that is right for you.
ContraindicationsSpinal manipulation is not for everyone. Physical therapists will evaluate any contraindications (reasons why this treatment should not be used because it may cause harm), including:Any risk of significant bone weakeningNeurological issues, likecord compressionorpinched nervesVascular or bleeding conditionsPositioning can’t be achieved because of pain or resistance
Contraindications
Spinal manipulation is not for everyone. Physical therapists will evaluate any contraindications (reasons why this treatment should not be used because it may cause harm), including:Any risk of significant bone weakeningNeurological issues, likecord compressionorpinched nervesVascular or bleeding conditionsPositioning can’t be achieved because of pain or resistance
Spinal manipulation is not for everyone. Physical therapists will evaluate any contraindications (reasons why this treatment should not be used because it may cause harm), including:
Summary
A Word From Verywell
Back pain and other chronic musculoskeletal problems can be frustrating and even debilitating at times. Talk with your healthcare provider to see if alternative therapy methods, such as spinal manipulation, can complement your current health management plan. Sometimes the use of multiple approaches to pain management can be more effective than using a single treatment.
The appointment usually lasts about 30 minutes. However, the spinal manipulation itself will take less time. The initial intake visit can take up to an hour or longer because you will need to discuss your health history and objectives for care.
It’s not recommended and may be unsafe to try to align your own back without the assistance of a licensed and trained healthcare professional. It’s often impossible to know what areas specifically need attention without diagnostic information, such as anX-ray. It’s also possible to hurt yourself while attempting self-alignment.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Center for Complementary and Integrative Health.Spinal manipulation: what you need to know.National Institute for Complementary and Integrative Health.Four things to know about spinal manipulation for low back pain.Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW.Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials.BMJ. 2019;364:l689. doi:10.1136/bmj.l689Côté P, Hartvigsen J, Axén I, et al.The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.Chiropr Man Therap. 2021;29(1):8. doi:10.1186/s12998-021-00362-9. Erratum in:Chiropr Man Therap. 2021;29(1):11. doi:10.1186/s12998-021-00368-3Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M.The risk associated with spinal manipulation: an overview of reviews.Syst Rev. 2017;6(1):64. doi:10.1186/s13643-017-0458-ySpine Health.Understanding spinal manipulation.Physiopedia.Spinal manipulation.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Center for Complementary and Integrative Health.Spinal manipulation: what you need to know.National Institute for Complementary and Integrative Health.Four things to know about spinal manipulation for low back pain.Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW.Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials.BMJ. 2019;364:l689. doi:10.1136/bmj.l689Côté P, Hartvigsen J, Axén I, et al.The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.Chiropr Man Therap. 2021;29(1):8. doi:10.1186/s12998-021-00362-9. Erratum in:Chiropr Man Therap. 2021;29(1):11. doi:10.1186/s12998-021-00368-3Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M.The risk associated with spinal manipulation: an overview of reviews.Syst Rev. 2017;6(1):64. doi:10.1186/s13643-017-0458-ySpine Health.Understanding spinal manipulation.Physiopedia.Spinal manipulation.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Center for Complementary and Integrative Health.Spinal manipulation: what you need to know.National Institute for Complementary and Integrative Health.Four things to know about spinal manipulation for low back pain.Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW.Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials.BMJ. 2019;364:l689. doi:10.1136/bmj.l689Côté P, Hartvigsen J, Axén I, et al.The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.Chiropr Man Therap. 2021;29(1):8. doi:10.1186/s12998-021-00362-9. Erratum in:Chiropr Man Therap. 2021;29(1):11. doi:10.1186/s12998-021-00368-3Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M.The risk associated with spinal manipulation: an overview of reviews.Syst Rev. 2017;6(1):64. doi:10.1186/s13643-017-0458-ySpine Health.Understanding spinal manipulation.Physiopedia.Spinal manipulation.
National Center for Complementary and Integrative Health.Spinal manipulation: what you need to know.
National Institute for Complementary and Integrative Health.Four things to know about spinal manipulation for low back pain.
Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW.Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials.BMJ. 2019;364:l689. doi:10.1136/bmj.l689
Côté P, Hartvigsen J, Axén I, et al.The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.Chiropr Man Therap. 2021;29(1):8. doi:10.1186/s12998-021-00362-9. Erratum in:Chiropr Man Therap. 2021;29(1):11. doi:10.1186/s12998-021-00368-3
Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M.The risk associated with spinal manipulation: an overview of reviews.Syst Rev. 2017;6(1):64. doi:10.1186/s13643-017-0458-y
Spine Health.Understanding spinal manipulation.
Physiopedia.Spinal manipulation.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
