What Is Spinal Manipulation? Definition, Benefits, and How It Works

What Is Spinal Manipulation? Definition, Benefits, and How It Works



“Magic!” That’s what one of our clients exclaimed after we performed a quick spinal adjustment here at Performance One. She was lying down when our physiotherapist made the movement, and she heard that familiar “crack” noise. Moments later, she stood up and found she could move her arm freely again.

Spinal manipulation is not exactly magic, but it can feel that way sometimes. Also known as spinal adjustment, spinal manipulation is a type of manual therapy that chiropractors and other health professionals use to treat back pain, neck pain, headaches, and problems related to the musculoskeletal system. It’s a non-invasive treatment that can provide relief for patients suffering from persistent low back pain and other conditions affecting the spine and joints.

Do any of these conditions sound familiar? Are you curious if the famous spinal manipulation "crack" works? In this article, we’ll explore the definition of spinal manipulation, its benefits, how it works, and who can benefit from this treatment. 

Definition of Spinal Manipulation

What is Spinal Manipulation?

Spinal manipulation is a hands-on technique used to improve spinal function and relieve pain. It's different from spinal mobilization, which involves slower, gentler movements to increase joint range of motion. Both techniques are related and often used together for optimal results.

Imagine this: you come to Performance One for a spinal manipulation session. You’re lying on a comfortable table, feeling tense and sore. One of our physiotherapists applies a quick, controlled force to your spine. You hear a satisfying "crack". Almost immediately, you feel relief and newfound mobility.

“Magic!”, as we said earlier. That’s spinal manipulation in action.

Well, this treatment is certainly not practiced by magicians. Chiropractors typically perform spinal manipulation, but physical therapists and osteopathic doctors can also do it. These professionals are trained to safely adjust the spine, targeting issues like back pain, neck pain, headaches, and joint problems.

Athletes use spinal manipulation to stay in peak condition and recover from injuries. Also, seniors experience increased mobility and reduced chronic pain. With a tailored spinal adjustment session, anyone with musculoskeletal issues can find relief through this non-invasive treatment. 

Historical Background

Spinal manipulation has ancient origins, dating back thousands of years. In Traditional Chinese Medicine, practitioners used manual therapy to treat various ailments. Ayurveda in India has practiced spinal manipulation for over 3,000 years, focusing on body balance and alignment. Ancient Egypt also featured manual therapy techniques in their medical practices.

Hippocrates, the Greek "Father of Medicine," emphasized spinal health and developed early techniques for spinal care. His methods highlighted the importance of spinal alignment for overall health.

In modern times, spinal manipulation has come a long way. As you can imagine,  advancements in medical science have led to safer techniques so we can today fully enjoy its benefits.

Benefits of Spinal Manipulation

Pain Relief

We've all had those tough neck mornings, right?. You know, when you wake up with a stiff neck and turning your head feels like a chore. Or maybe you've been dealing with persistent lower back pain that makes sitting at your desk unbearable. 

When the chiropractor applies precise pressure to the spine, this helps to release tension and reduce inflammation, alleviating pain in the back and neck. Its benefits are truly life-changing, and allow people to return to their daily activities feeling much better.

Improved Mobility

Another benefit of spinal manipulation is it improves joint and muscle function. It makes it possible to move freely and comfortably, even if you have experienced movement restrictions for years.

That movement you thought was impossible? Bam! After spinal manipulation, you can do it! Maybe it was something simple, like raising your arm, bending, or even sitting down. With spinal manipulation, your body can recover its natural range of movement. That crack can be a freeing moment.

Overall Health Improvement

Regular spinal adjustments can also enhance your overall health. They can improve blood flow, reduce stress, and boost your immune system.

By aligning your spine, spinal manipulation helps your body function more efficiently, leading to better sleep, increased energy, and a greater sense of well-being. It's not just about fixing pain; it's about promoting a healthier, more balanced life.

How Spinal Manipulation Works

The Procedure

You know when you visit the chiropractor or physiotherapist, and they often have one of those skeleton models to point out bones and joints? You can see the spine on these models, which is divided into three main sections:

  • Cervical Vertebrae (C1-C7) are in your neck and support your head.
  • Thoracic Vertebrae (T1-T12) are in your mid-back and attach to your ribs, helping protect your organs.
  • Lumbar Vertebrae (L1-L5) are in your lower back and bear most of your body's weight.

Perhaps you are asking yourself: "The spine does look complex, will this hurt?" Well, it doesn’t. Let’s try to demystify the fear of the cavitation crack sound. Here’s what typically happens during a spinal manipulation session here at P1:

One of our physiotherapists will start with a thorough assessment, asking about your symptoms, medical history, and lifestyle. They may also perform a physical examination to pinpoint areas of tension or misalignment.

Next, the physiotherapist will explain the procedure, using the skeleton model we introduced earlier, so you know which spots they will target. After this, we will invite you to lie down on a special chiropractic table. Depending on the area being treated, you may lie on your back, stomach, or side.

And this is your time to just relax and enjoy.

The physiotherapist will locate the specific vertebrae that need adjustment. Some gentle movement first to relax the area and help you get really comfortable. Then, the therapist will apply a quick, controlled force to the targeted area. This may produce the familiar "crack" or "pop" sound. But don’t worry, it is totally safe. That’s just cavitation, the release of gas bubbles from the joint spaces.

After the adjustment, our physio professional will check your range of motion. How are you feeling now? If you feel like saying “magic!” yes, go for it.

We might also give you some advice on posture, exercises, or other treatments to help maintain the benefits of the adjustment. Additionally, we will check if you require more sessions.

Mechanisms of Action

How does this “magic” work? Spinal manipulation works through a combination of biomechanical and neurological effects:

Biomechanical Effects: Spinal manipulation can help correct misalignments (subluxations) and improve the mobility of the spine. This helps reduce tension in the surrounding muscles and ligaments.

Neurological Effects: The spine houses the spinal cord. By adjusting the spine, spinal manipulation can help improve nerve function. This can lead to reduced pain signals being sent to the brain and an overall improvement in the body’s ability to heal itself.

Circulatory Benefits: Adjusting the spine can also enhance blood flow to the affected areas. This can reduce inflammation and promote healing by delivering more oxygen and nutrients to tissues as other therapies, like cupping.

Endorphin Release: Endorphins are the body’s natural painkillers. Spinal manipulation stimulates their release, providing immediate pain relief.

Who Can Benefit from Spinal Manipulation?

Conditions Treated

As we say here at Performance One, there is no such thing as “One Cure Fits All”. We believe that there are as many treatments as there are people. This is why our spinal manipulation sessions are tailored to each patient's needs, as conditions and their origins can vary widely.

Here are some specific conditions and individuals who can benefit from spinal manipulation:

  • People Suffering from Chronic Back Pain
  • Neck Pain Patients
  • Headache and Migraine Sufferers
  • Athletes with Sports Injuries
  • Individuals with Sciatica
  • People with Joint Dysfunction
  • Seniors with Mobility Issues
  • Individuals with Scoliosis
  • Patients with Whiplash Injuries
  • People Experiencing Muscle Tension and Spasms

Whatever your case is, just know that healing is possible. Our physiotherapist team will ensure that you can enjoy the benefits of spinal manipulation, with sessions tailored to your needs.

Who Should Avoid It

While spinal manipulation is beneficial for many, there are certain individuals who should avoid it. Patients with severe osteoporosis, for example, are at a higher risk of fractures, making the procedure unsafe for them. Similarly, individuals with spinal cancer or those who have had spinal surgery should not undergo spinal manipulation.

People with conditions that weaken the bones or spine, such as advanced rheumatoid arthritis or spinal infections, should also avoid this treatment. Additionally, patients with certain vascular conditions should steer clear of spinal manipulation to prevent any adverse events. Pregnant women, especially in the later stages of pregnancy, should also avoid spinal adjustment treatment.

At Performance One, we prioritize patient safety. We always advise that you check with your doctor before requesting spinal manipulation sessions. We want to make sure that only suitable candidates undergo this treatment.

Finding a Qualified Practitioner

What to Look For

If you are seeking a qualified practitioner for spinal manipulation, you need to consider their qualifications and certifications. Recognized boards that offer these certifications include the American Chiropractic Association (ACA) and the Federation of State Boards of Physical Therapy (FSBPT).

Experience is also key. Practitioners need to be able to tailor the treatment according to the patient's needs. As we mentioned earlier, spinal manipulation sessions will not be the same for a seasoned athlete as for a senior looking to regain mobility.

At Performance One, our expert team offers a personalized approach to your needs. We are committed to providing personalized care and ensuring the highest standards of safety and effectiveness.

Questions to Ask

If you are considering this treatment, we encourage you to contact our spinal manipulation expert team at Performance One. We are here to answer your questions to ensure you’re well-informed and comfortable with the treatment.

Here are some frequently asked questions that we get from our clients:

How many Spinal Manipulation sessions will I need?

The number of sessions varies based on individual needs and conditions. Your practitioner will assess your case and discuss a personalized treatment plan with you.

What conditions do you typically treat with spinal manipulation?

Common conditions include chronic back pain, neck pain, headaches, sports injuries, sciatica, joint dysfunction, and muscle tension.

How should I prepare for a spinal manipulation session?

We want you to feel ready for a relaxing experience. We ask you to wear comfortable clothing. Our team will also request a complete medical history so we can have a clear picture of your needs and expectations. No special preparation is typically needed.

How much do spinal manipulation sessions cost?

At Performance One, a full adjustment session costs $50. 


As you have seen, even though it feels like magic, spinal manipulation is an effective physiotherapy technique. Those satisfying "cracks" you hear during a session are simply the release of gas bubbles from your joints. Its biomechanical and neurological effects relieve pain, improve mobility, and enhance overall health. 

Spinal manipulation has evolved into a safe and effective treatment for various conditions. Whether you’re dealing with chronic back pain, neck pain, headaches, sports injuries, or mobility issues, this therapy can provide significant benefits. 

If you are experiencing any of the conditions we mentioned above, we encourage you to consider spinal manipulation. At Performance One we would be more than happy to be part of your journey to better health. Contact us today and take the first step toward improved health and well-being.

Back to blog