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Spinal Manipulation: What You Need To Know

spinal manipulation

Spinal manipulation, also called spinal manipulative therapy or manual spine therapy, combines specific actions on the body to restore motor segment mobility, relieve blockages, and reduce low-back pain.

Manipulation is a passive technique where the chiropractor applies a specially targeted manual impulse or push to a joint at or near the end of the passive (or physiological) range of motion. An audible click often accompanies this. A common feature of spinal manipulation techniques is that they achieve a crunch in the synovial joints. This sound phenomenon is open to some assumptions, but the idea of ​​cavitation of the vertebral facet joint is widespread. When the pressure in the facet joint is below normal, gas bubbles form in it. The moment the pressure rises, the bubbles burst; this is called cavitation.

Physiological therapeutics is a social, medical specialty aimed at helping people with various conditions in which movement is impaired, motor capabilities are limited, and mobility is impaired. It is based on a scientific approach and evidence-based medicine, along with which, however, it requires relevant empirical experience and developed clinical thinking from a specialist.

Physiological therapeutics uses the full range of physical methods of influence but considers mechanical strength and movement to be the main ones. The result of the work of a physical therapist is the most active and correct movements that are planned, initiated, and performed by the client themself within the framework of their motor potential.

The work of a physical therapist begins with an assessment of the state of all structures and functions of the client, which can affect their movements, mobility, and other functional capabilities. Then the specialist, with the client and/or their relatives, sets clear and understandable goals of the intervention for the client and their family members.

The steps in the physiological therapeutics process are:

The steps in the physiological therapeutics process are

  • specially selected physical exercises, strength training, balance, movement components, etc. taking into account violations of the client and several other factors;
  • techniques that help the client to perform a particular movement;
  • selection and formation of the correct postures (body positions) that alleviate the person’s condition and/or prevent the occurrence of complications;
  • techniques and techniques for the correct movement of patients;
  • selection and adaptation of technical aids for rehabilitation;
  • training clients and those who help them (if they have to move the patient) the correct motor behavior.

The goal of physiological therapeutics is to restore and maintain a person’s ability to move and independence as much as possible, develop functional movements, prevent or limit the development of complications such as contractures, deformities, pressure ulcers, help the client control pain, and support the functions of the respiratory and cardiovascular systems. 

Physical therapists work with patients of all ages and in all areas of medicine in neurology, traumatology, orthopedics, cardiology, palliative medicine; patients have a variety of diseases, low-back pain conditions, with a very different course and prognosis.

How effective are spinal manipulation and manual therapy?

There are over 200 treatments available for low-back pain. The main treatments include:

  • pharmacological therapy
  • manual therapy
  • physical exercises
  • physical, educational and psychological methods of influence
  • minimally invasive treatments
  • surgical intervention
  • lifestyle changes
  • alternative medicine

Each of these can be helpful, but none is the best treatment; this is because the correct treatment depends on the cause of chronic back pain.

Spinal manipulation is considered one of the treatment options for back pain. However, this is still a controversial approach to back pain management that not all healthcare professionals accept as an effective treatment. However, manipulation of the spine is very popular not only for back pain but also for other health problems.

While there are justified cases of the use of manual therapy for the treatment of the spine, this method of influence cannot be considered a valid method for the treatment of diseases such as diabetes, hypertension, or thyroid disease, since such claims do not have sufficient scientific evidence, and they have no biological justification.

Spinal manipulation techniques are based on anatomical and physiological principles, and the improvements experienced by patients may also explain the mechanism of action. The reasons why spinal manipulation can reduce back pain are as follows:

  • Restores the mobility and flexibility of the facet joints. The joints between the vertebrae are called facet joints. Sometimes joints become inflamed and swollen, causing muscle spasms and limitations in flexibility and movement. Certain manual therapy techniques improve reactive contractions and help restore normal facet joint function.
  • Disc repositioning, herniated discs, protrusion, and pinched nerves are common causes of back pain. Manual stimulation creates negative pressure within the disc, which helps the disc to regain its shape.
  • Reducing muscle tension: The pressure applied during a manual session reduces muscle tension. The latter is sometimes the only cause of acute back pain, especially when it results from daily stress and poor posture.
  • Destruction of fibrous adhesions around the spine. Sometimes fibrous adhesions and scar tissue or herniated discs form around the spine, resulting in pain around adjacent vertebrae. Spinal manipulation uses passive stretching and other maneuvers to reduce movement restrictions caused by spinal adhesions.
  • Neurophysiological Effects: Certain nerves carry an inhibitory signal to reduce pain sensation when it is too intense and lasts too long. It is believed that manipulation of the spine causes changes in the nervous system, increasing inhibitory reflexes that reduce pain sensation.
  • Other possible reasons: In addition to these hypothetical mechanisms of action, manual therapy affects close psychological contact between the patient and the doctor, especially if a series of procedures are carried out. It has a powerful effect of relaxing muscles and releasing neurotransmitters that reduce pain impulses. The patient belief that spinal manipulation will help contributes to patient satisfaction with treatment.

Is spine manual therapy safe?

Is spine manual therapy safe

There is no consensus on the safety of spinal manipulations and evidence of low-back pain. Some authors suggest that it is safe, while others point to serious complications and conclude that healthcare professionals should not use it. However, better quality research suggests that physiological therapeutics are safe or less harmful than their critics suggest. The truth is that most side effects are minor events such as soreness. But there are reports of spinal cord injury and other serious problems.

It is difficult to predict if spinal manipulation can cause side effects instead of solving the underlying problem. However, based on observation experience, it can be concluded that the risk of injury or complications is highest for procedures involving the neck area. The risk for procedures involving the lumbar region is relatively low, and these injuries are extremely rare, making this method more suitable and safer for treating low-back pain.

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Lone Star Neurology
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Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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