The Mechanism and Safety of Chiropractic Manipulation

How does a chiropractic adjustment work?

Chiropractic adjustments, or manipulation, is a process that decreases pain and stiffness in a specific joint through using the chiropractor’s hands, an adjusting tool or a specialized table to “nudge” the joint into moving the way that it was intended.

When the chiropractor puts precise pressure on the joint, it causes the joint to separate, or stretch, just a little bit.  Sometimes this separation creates a “popping” noise, called a cavitation.  The cavitation is simply caused by shifting liquids within the joint, not by any bones breaking.

Nerve reflexes are stimulated around the joint, causing the muscles to relax and pain levels to immediately decrease.  If a spinal joint is manipulated, the movement created by the pressure on the joint also decreases spinal disc pressure and brings more fluid into the area (1).

Is chiropractic manipulation safe?

As with any medical procedure, there are risks and benefits.  According to the literature, the overwhelming benefits of chiropractic manipulation outweigh the risks making chiropractic a smart choice for many patients.  Just take a look at the facts in the research journals:

“The risk of spinal manipulation causing a clinically worsened disc herniation or cauda equina syndrome in a patient presenting with low back pain has been calculated to be less than 1 in 3.7 million manipulations. (2)”

“The increased risks of VBA stroke associated with chiropractic and primary care physician visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke.  We found NO EVIDENCE of excess risk of VBA stroke associated chiropractic care compared to primary care. (3)”

Compare the risk for chiropractic manipulation to the use of NSAIDs (Acetaminophen, Ibuprofen, Naproxen etc):

“Gastrointestinal complications due to NSAIDs cause more than 100,000 hospitalizations and an estimated 16,500 deaths each year in the United States. (4)”

“Significant complications occur in 1-4% of NSAID users each year. (5)”

How does the chiropractor decide how to adjust me?

Several factors including examination and history, the patient’s current complaint and the patient’s perceived comfort level with manipulation help us decide if the patient should be adjusted with the hands, with an adjusting tool (Activator), with a drop-piece table or with a Cox Flexion-Distraction table.  If you prefer a certain method, be sure to mention that to us and we’ll discuss your options together.