top of page

The Chiropractic “Adjustment”

How Is It Performed? 

The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.” It is a highly specific, controlled, and manual procedure that focuses on a specific joint, using a low force velocity (pressure) in a specific direction. Basically, a force is applied to the joint of the body, particularly the spine, “unlocking” it from its improper restricted position. This helps reduce pain and restores or enhances joint function.


There are different techniques and procedures that are adapted to meet the specific needs of each patient. We take into consideration a person’s age, sex, weight, and bone/muscle structure to determine the most effective adjustment technique to use.


Very few patients report that there is any pain associated with having an adjustment. It is also common to hear or feel a “popping” sound, which is normal when gases in the joints are released.

What’s That Cracking or Popping Noise?

A joint contains fluids that help keep it healthy and lubricated (like oil for the joints). This “synovial fluid” contains gas (like carbonation in soft drinks). When an adjustment is made, you may hear a noise (called an “audible release”). The audible release or “crack” is simply caused by the change in pressure within the joint which results in the release of gas bubbles in the joint—much like when you open a can of soda. There is no pain or harm involved; it’s exactly the same when you crack you knuckles.

Evidence Shows Chiropractic Effective for Pain Reduction and Restoration of Function

Numerous studies throughout the world have shown that chiropractic treatment, including manipulative therapy and spinal adjustments, are both safe and effective. Many other studies have shown that chiropractic care can be a cost-effective remedy that brings healing in less time than other treatments. The following are excerpts from just a few of these studies:

For Acute Low Back Problems: 

“For patients with acute low back symptoms without radiculopathy, the scientific evidence suggests spinal manipulation is effective in reducing pain and perhaps speeding recovery within the first month of symptoms.” – Clinical Practice Guidelines, AHCPR (1994)

For Long-Term Low Back Problems: 

“There is strong evidence that manipulation is more effective than a placebo treatment for chronic lowback pain or than usual care by the general practitioner, bed rest, analgesics and massage.” – Spine, Van Tulder and Bouter et al. (1997)


“...improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear.” – British Medical Journal, Meade et al. (1995)


“Manipulative therapy and physiotherapy are better than general practitioner and placebo treatment. Furthermore, manipulative therapy is slightly better than physiotherapy after 12 months.” – British Medical Journal, Koes et al. (1992) 

For Pain: 

“...patients suffering from back and/or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments, thus reinforcing previous results showing the benefits of chiropractic treatment for back and neck pain.” – Journal of Manipulative and Physiological Therapeutics, Verhoef et al. (1997)


“...for the management of low back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system.” – The Manga Report (1993)

For the Elderly:

“[Elderly] chiropractic users were less likely to have been hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community. In addition, they were less likely to use prescription drugs.” – Topics in Clinical Chiropractic, Coulter et al. (1996)

For Headaches:

“Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.” – Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001)


“The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches...Four weeks after cessation of treatment...the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” – Journal of Manipulative and Physiological Therapeutics, Boline et al. (1995)

bottom of page