Physiotherapy Or PhysiohealthVerified data

Spinal Manipulation Therapy - Indications, Contraindications, Procedure and Benefits

Creator: Dr. Kayathri P.
Published: 2023-03-27T18:11:15

4 min read

0

Share

Verified data

0

4 min read

Share

Spinal manipulation is a type of manual therapy that is used for the treatment of back, shoulder, and neck pain. Read this article to know more.

Written by

Dr. Kayathri P.

Medically reviewed by

Mohammed Wajid

March 27, 2023

July 24, 2023

Contents

Share

Contents

What Is Spinal Manipulation Therapy?
Why Is Spinal Manipulation Therapy Done?
What Are the Criteria for Undergoing Spinal Manipulation?
What Are the Indications of Spinal Manipulation Therapy?
How Is Spinal Manipulation Therapy Done?
What Are the Benefits of Spinal Manipulation Therapy?
What Are the Contraindications of Spinal Manipulation Therapy?

What Is Spinal Manipulation Therapy?

Spinal manipulation therapy is used in the treatment of spinal conditions like scoliosis and also to help relieve pain and pressure in joints. Scoliosis refers to the condition in which there is an abnormal curvature of the spine. Spinal manipulation is done by a chiropractor or an osteopathic physician.

Why Is Spinal Manipulation Therapy Done?

Spinal manipulation is done to relieve problems like pain and pressure. They also help in improving overall health and wellness. After spinal manipulation therapy, the individual will feel boosted and have improved energy. It also helps improve immune function, memory, and concentration.

What Are the Criteria for Undergoing Spinal Manipulation?

The criteria for undergoing spinal manipulation therapy are as listed:

Pain that does not last for more than 16 days.
Symptoms should be confined to the back and should not extend up to the distal part of the knee.
The internal rotation of the hip should be greater than 35 degrees, at least in one hip.
There should be involvement of both sides of the part, such as both sides of the neck and hip.
The patient should not perform sedentary work for more than five hours a day.
Patients should not feel discomfort while extending the neck.

What Are the Indications of Spinal Manipulation Therapy?

The indications of spinal manipulation therapy are as follows:

Low Back Pain: Spinal manipulation has been used as a short-term relief from acute lower back pain.
Sciatica: Sciatica is a condition in which there is pain along the course of the sciatic nerve from the back to the lower leg. The leg pain and back pain associated with sciatica can be put at ease through spinal manipulation.
Headache: For headaches and migraines, spinal manipulation can be done as a non-pharmacological treatment.
Neck Pain: In acute neck pain, spinal manipulation combined with a few home exercises has been effective in relieving the pain.
Fibromyalgia: It is a musculoskeletal disorder characterized by generalized muscle pain and tiredness. There will be altered mood and deteriorated memory in affected patients. Spinal manipulation can be done to relieve muscle pain.
Chronic Obstructive Pulmonary Disease (COPD): It is a lung disease that causes limited airflow to the lungs. Spinal manipulation has been useful in improving the flexibility of the chest wall and muscles of the vertebral segments, thereby improving airflow.
Bedwetting: Bladder control can be achieved by manipulating the vertebral segment that contains nerves affecting bladder movements.

How Is Spinal Manipulation Therapy Done?

1. Cervical Spine Manipulation: In cases of acute and chronic neck pain, spinal manipulation has been proven to be effective in getting rid of the symptoms in the short term. In combination with this, a home exercise that involves strengthening and range of motion exercises has helped relieve neck pain. For the prevention and treatment of migraines also, cervical spine manipulation is done. Thoracic spine manipulation: Thoracic region is simply present near the thorax and comprises the vertebral segments from T1-T12. Thoracic manipulation is not widely used. However, in some cases of neck pain and to improve respiratory function, thoracic spine manipulation is done. Thoracic manipulation is done by asking the patient to lie flat on the bed and wrapping around the arms with the palms touching the opposite side of the body. The steps involved in cervical spinal manipulation are:

The therapist asks the patient to lie down on a bed with the neck flexed.
The therapist uses two pillows for the patient to rest so as to be able to move the neck freely.
The therapist puts his hand under the neck of the patient locating the C3 and C4 vertebral segments (present near the base of the neck) and holds using the hand with the metacarpophalangeal joint (MCP), or simply the knuckle holding these segments.
Then the neck being in a flexed position is further bent sideways by the therapist, and the therapist allows the neck muscles to be relaxed while stretching the muscles.
Then the therapist keeps the other hand on the opposite side of the neck and rotates the neck to that side, making the neck to be internally rotated.
Again the therapist uses that forearm to rest on the patient's face and tries to induce side-bending of the neck further.
The therapist will release the lock by allowing the patient to breathe throughout the process.

2. Lumbar Spine Manipulation: In cases of low back pain, lumbar spine manipulation is done. They are also considered one of the non-invasive options for treating low back pain. Lumbar spine manipulation is done by allowing the patient to lie sideways in a bed. The patient is asked to bend the free leg and the free hand placed on that side of the hip. The therapist locates the PSIS (posterior superior iliac spine) and then feels the lumbar spine segments L4 and L5, after which slowly rotates the hip.

What Are the Benefits of Spinal Manipulation Therapy?

Spinal manipulation therapy is used for treating various musculoskeletal disorders.
The reduced functional status due to disabilities or impairments has been significantly improved through spinal manipulation techniques.
It is a non-invasive therapy that can help treat many musculoskeletal painful disorders that can be debilitating.
Significant pain relief in many acute and chronic painful conditions.
The range of motion of the hip, neck, and spine has been brought about by the combination of spinal manipulation and exercise therapies.
The quality of life of patients has been improved through spinal manipulation techniques.

What Are the Contraindications of Spinal Manipulation Therapy?

Spinal manipulation is contraindicated in the following cases:

Any disease that has led to a weakening of the bones.
If there is any bleeding in the joints and also in vascular diseases such as an aortic aneurysm.
If there are any underlying neurological problems such as cord compression and other neurological deficits.
If the patient cannot be properly placed for treatment due to pain and resistance.
When there is no appropriate diagnosis for the cause of pain.

Conclusion:

The effectiveness of spinal manipulation as a single therapy to treat multiple conditions is still being researched. However, with the combination of exercise and pharmacological therapies, spinal manipulation therapy has wide-ranging applications in treating painful conditions. Clinical outcomes of patients being treated with spinal manipulation therapy have been very welcoming. However, the mechanism by which pain reduction happens through spinal manipulation is still being researched.

Frequently Asked Questions

1. What Are the Various Classifications of Spinal Manipulation Techniques?

The different types of spinal manipulation techniques are the following:
- High-velocity low-amplitude Thrust (HVLA) Spinal Manipulation: High-velocity, low-amplitude thrust is the most prevalent method. This requires force by the therapist and typically makes a "pop" sound. This sound is caused by unexpected pressure thrust to a joint while positioned.

- Low-Force Chiropractic Spinal Mobilization
Therapists employ delicate, low-force chiropractic treatments. A therapist may recommend spinal mobilization based on a patient's comfort, age, size, or desire. This technique may also suit patients who dislike twisting or pushing.

2. Is the Effect of Spinal Manipulation Long-Lasting or Permanent?

Spinal manipulation treatments rarely result in permanent structural alterations. Numerous medical procedures, such as the consumption of pain medicines, just serve to disguise the underlying issue. However, because the underlying problem still exists, the treatment can only provide a short-term remedy to the problem.

3. To What Extent Can the Safety of Spinal Manipulation Be Ascertained?

A specific type of spinal manipulation that concentrates on the neck has been related to cervical artery dissections (CAD), which are minor but potentially dangerous tears in the arterial walls of the neck. These tears are unusual yet have the potential to cause a stroke.

4. What Are the Potential Adverse Effects Associated With Spinal Manipulation?

Following the completion of the operation after getting an adjustment at the chiropractor, some patients report experiencing some mild discomfort for a few days after the treatment. These can include symptoms such as headaches, exhaustion, or soreness in the areas of the body that were treated.

5. Do Physiotherapists Employ Manipulation Techniques in Their Practice?

Physiotherapists use manipulation and mobilization to enhance the flexibility and function of your soft tissues, joints, muscles, tendons, and ligaments. On the neck or back, manipulation is typically conducted as a rapid, precise movement that relieves pain and increases flexibility.

6. What Distinguishes Massage From Manipulation?

The benefits of massage include the alleviation of pain and adhesions, the promotion of drowsiness, the mobilization of fluids, the enhancement of muscular relaxation, and the facilitation of vasodilation. Massage can serve as a preliminary treatment for manipulation; nevertheless, the primary focus of massage is on the health of soft tissues, whereas the primary focus of manipulation is on joint segments.

7. What is the duration of the effects of spinal manipulation?

Chiropractic therapy requires 2–4 weeks with 3–4 visits each week to be successful. After improvement, a chiropractor may recommend self-care using ergonomic equipment like elastic bands, foam rollers, and dietary support.

To complete all three chiropractic phases (pain alleviation, stabilization, rehabilitation), the average person needs 18-24 adjustments over 9-14 weeks.

The first appointment usually reduces pain by 40–80%, depending on the spinal damage. However, chiropractic therapy improves within 1–4 weeks.

8. What Are the Benefits Associated With Spinal Manipulation?

Spinal manipulation is one of numerous non-drug techniques that may be used to treat acute and chronic low-back pain. Other non-drug treatments include exercise, massage, and acupuncture. This may result in modest improvements in the patient's discomfort and function. When we talk about function, we're referring to how people's lower back discomfort impacts their ability to perform things like walking, standing, sleeping, and completing chores around the house.

9. Is There a Correlation Between Spinal Manipulation and Stroke?

A lot of strain may be placed on the carotid and vertebral arteries due to the high-velocity push employed in cervical manipulation. When a dissection has already occurred, there is a significantly increased likelihood of thrombus formation, leading to ischemic stroke, paralysis, and even death.

10. Is there evidence to support the claim that spinal manipulation can reduce blood pressure?

Spinal manipulation and manual adjustment both stimulate the reflexes of the nervous system, which might result in a decreased heart rate and blood pressure in the patient.

11. Is There Evidence to Support the Efficacy of Spinal Manipulation in the Treatment of Sciatica?

The discomfort caused by sciatica can sometimes be alleviated by spinal manipulation. Chiropractors can assist in relieving the pressure placed on your sciatic nerve by employing procedures such as spinal manipulation and other natural practices.

12. What Is Manipulation of the Spine Under Anaesthesia?

The term "manipulation under anesthesia," abbreviated "MUA," refers to a sequence of operations that involve mobilization, stretching, and traction that are carried out on the patient while they are under the influence of anesthesia (often general anesthesia or moderate sedation).

13. What Are the Disadvantages of Manipulating a Patient Under Anaesthesia?

However, the most significant drawback associated with MUA techniques is the possibility that uncontrolled manipulation would result in structural injury to the glenohumeral joint and the soft tissues surrounding it.

14. What Are the Hazards of Anesthesia-Based Manipulation?

Patients with MUA have a greater risk of complications, including fractures, elbow instability, HO, and nonunion. It is essential to begin therapy as soon as possible following manipulation, preferably within the first few days after MUA, to keep the passive range of motion accomplished during the procedure.

15. What Is the Efficacy Rate of Anesthesia-Based Manipulation?

After a diagnosis of knee stiffness has been established, the condition can be treated with manipulation under anesthesia, which is successful 85 percent of the time.

Sources

Mohammed Wajid

Physiotherapy

Rate this article

Tags:

spinal manipulation therapy

Do you have a question on

spinal manipulation therapy

Ask a doctor online

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.