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.

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

Spinal manipulation is safe when done by a trained health professional. Afterward, some people feel tired or sore. But serious problems are very rare.

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.

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 hand-held 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:

• Chiropractors.
• Osteopathic doctors.
• Physiotherapists.
• Medical doctors, such as physiatrists.