Does Spinal Manipulation Work?

Welcome everyone to the next episode of our Redefining Physical Therapy podcast. I’m your host, Dr. Scott Gray. Happy Tuesday everyone, for those of you that are listening.

And so today I want to ask the simple question, does spinal manipulation work?

Of course, it does.

And so in this quick episode, I’m going to kind of explain the effects that it works and why you should really start using it now if you haven’t already.

And so before I go deeper into some of these key components of spinal manipulation, what I’m talking about, manipulation is graded one through five and if you’re not manipulating the spine and I would say probably more along the lines of a grade five, a high velocity, low amplitude thrust, I think you’re missing a big piece of clinical practice.

Manipulation has been around for thousands and hundreds of years and it works.

And so if anything, I think it’s one of the best forms of treatment we’ve got in our arsenal, especially as physios.

And so if you’re not doing it, I’m going to challenge you and do it. I think a lot of people or clinicians don’t do it because they’re afraid and they haven’t had enough practice.

And so it’s a new skill that anyone can learn. And then another topic, of course, I’ll obviously go over that stuff, but that’s kind of my little rant for the day is that you need to be doing it and I would start today.

Because it is just that powerful. And so here are four reasons why it works.

The obvious one here is the psychological component. So many people of our patients and our clients have false beliefs.

They believe that they’re out of alignment.

They believe that they’re crooked. And so when we crack a joint and get cavitation, it’s going to create maybe a placebo effect. But we’re also meeting that patient where they are.

If they believe that they’re crooked and we can try to explain, no, that you’re not, you’re going to probably lose that patient because they’re going to go down the street to the chiro, who’s going to crack them.

And so you really have to meet patients where they’re at, at a psychological component. And so, manipulation does just that.

And so as long as there are no red flags or adverse side effects, I would say, “Manipulate and manipulate often.”

There’s the psychological component of it.

The next is the neuromuscular component.

If someone has to guard, maybe they have acute lower back pain, subacute, whatever it might be, you’re noticing guarding and tonicity.

Instead of working, trying to get to some of those deep muscles, like the QL, the psoas, which a lot of research shows maybe we’re not able to, obviously you can needle that area.

You could do different PNF and active muscle pumping, but one of the fastest ways to get muscles to relax neuromuscularly is to manipulate a joint of the spine.

And so when we do that, we’re going to cause relaxation of all those segments.

And so even if, for instance, if you think they may have an L4/5 component to it, you can still lockout that spot and manipulate above it because a lot of those muscles cross multiple segments.

And so we know that typically, the facet joints have an innervation from the medial branch, the ascending and descending decent branch, or the medial branch of the vertebral nerves that we can manipulate the segments above or below it and get the same outcome.

I would recommend that in that case. Neuromuscularly we can reduce guarding and tone.

The next one is pain. Some people don’t use manipulation because their clients are in pain, but really manipulation is used to get them out of pain so that you can do other interventions or get to the root cause of their pain, whatever it may be.

Don’t forget about that.

And then last but not least, I would say, I’ve seen it clinically is it’s the mechanical component.

And so if someone has a facet joint that isn’t moving the way that you want, it’s not opening or closing the ideal way, you can manipulate that tissue and get that effect.

And so there you have it, those are really the four key reasons why you should be manipulating now.

And I would do it today.

You got the psychological component, the neuromuscular component to it, you’ve got then the reduction of pain, but then lastly, you’ve got the mechanical component.

There you have it, implement these things into your practice and leave any comments below.