Spinal Manipulation


A picture of hands pressing on lower back painChiropractic Manipulation is recommended, or is an option, for a number of disorders, including acute and chronic low back pain, radicular pain, neck pain, and some types of headache. In practice, manipulation is also used in the management of extremity joint disorders for complaints such as carpal tunnel syndrome, scapholunate dysfunction, and shoulder, ankle, knee, and hip pain.

Historically, claims have been made for manipulation in various other complaints; however, reasonable scientific evidence only exists in the case of infantile colic. Chiropractic manipulation has long been effective in treating neck injuries. Matupulation of traumatized joint structures increases range of motion for damaged facet stuctures. Kirkaldy-Willis. et al. (1985) studied the phenomenon of manipulation and found that therapeutic effects of manipulation involved breaking interarticular adhesions, freeing the fixated joint, and stretching the supporting muscles. It is his opinion that manipulation also lends to widen and improve the opening of the toramina, thereby reducing irritation to a potentially entrapped nerve. He is also of the opinion that stimulating the joint mechanoreceptors relieves pain.

The stimulation of joint mechanoreceptors tends to override the pain impulses at the dorsal horn. For example, if one hits a thumb with a hammer, the first impulse is to shake the hand and fingers. It is postulated that this tends to stimulate the joint mechanoreceptors, thereby overriding the pain impulses at the dorsal horn. This is, of course, also the concept in mobilizing the joints with exercise. Vernon, et al. (1986) also postuluted that there is an increase in endorphins released after spinal manipulation.