Restoring Mobility: The Effectiveness of Chiropractic Care

• Chiropractic care utilizes a variety of techniques to treat musculoskeletal pain by focusing on the skeletal system, soft tissue, and nervous system. These techniques include soft tissue mobilization, prescribed exercises, movement pattern correction, joint mobilization, and joint manipulation. Among these, joint manipulation is the profession’s most well-known tool. To understand its effectiveness, it’s essential to first explore why a joint may become restricted and painful, and how manipulation or mobilization can help reduce pain, relieve muscle tension, and increase range of motion.
• A key method for assessing whether a joint could benefit from manipulation is evaluating its range of motion. Limited range of motion within the joints can be caused by tight or overactive muscles, poor movement patterns, or neurological responses that protect the joint from pain.  During a visit, I assess how a person moves by observing their body mechanics while performing specific movement patterns. In this way, I can view restricted range of motion functionally, and provide solutions to correct these patterns.
• Joint manipulation involves a quick, controlled movement that slightly separates the surfaces of a joint, creating a gap in the synovial fluid. This gap often results in the characteristic “popping” sound, which occurs due to tribonucleation—the formation of gas, usually carbon dioxide, within the synovial fluid (2). This fluid helps lubricate the cartilage, facilitating smoother movement and nourishing the joint (4).
• The proposed mechanism of joint manipulation includes both biomechanical and neurophysiological effects (1). It is believed that manipulation induces changes through its mechanical effects on the nervous system and biochemical responses triggered by the stretching of the surrounding joint structures and capsule (3). A recent systematic review simplified this process, stating, “Manipulation causes physical changes, but the exact mechanism is still unclear. It is likely that it opens the small joints of the spine and reduces spinal stiffness, contributing to the relief people experience” (5).
• To promote long-term pain relief and empower you to take an active role in your healthcare, each appointment with me includes a thorough assessment of your musculoskeletal system and functional movement patterns. From there, I provide personalized exercises, stretches, and movement modifications aimed at optimizing your movement patterns and reducing stress on your body. My goal is to support you in alleviating pain while equipping you with the tools to manage and enhance your healing process.

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(1) Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531-538. doi:10.1016/j.math.2008.09.001

(2) Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation. PLoS One. 2015 Apr 15;10(4):e0119470. doi: 10.1371/journal.pone.0119470. PMID: 25875374; PMCID: PMC4398549.

(3) Kovanur Sampath K, Treffel L, P Thomson O, Rodi JD, Fleischmann M, Tumilty S. Changes in biochemical markers following a spinal manipulation – a systematic review update. J Man Manip Ther. 2024;32(1):28-50. doi:10.1080/10669817.2023.2252187

(4) Orthobullets Synovium Available from:https://www.orthobullets.com/basic-science/9018/synovium-and-synovial-fluid (accessed 18.6.2021)

(5) Young, K.J., Leboeuf-Yde, C., Gorrell, L. et al. Mechanisms of manipulation: a systematic review of the literature on immediate anatomical structural or positional changes in response to manually delivered high-velocity, low-amplitude spinal manipulation. Chiropr Man Therap 32, 28 (2024). https://doi.org/10.1186/s12998-024-00549-w