How does spinal manipulation work?

Spinal manipulation involves taking a spinal (zygapophyseal) joint to the end of its physiological range and giving the joint a very quick, very short thrust.  This usually elicits an audible pop or crack, decreases the local pain and tenderness, and increases the range of movement in that particular segment of the spine.  It shouldn’t be painful if done sensitively, but some people may find the sound of the crack discomforting, particularly when done in the neck.

So how does it work?  Well, unfortunately there isn’t a short answer.  The standard osteopathic explanation is based on the work of Dr Irwin Korr.  Technically speaking, it postulates that the sudden stretching of the spinal joint capsule sends a rush of proprioceptive (sense of where the body is in space) information that modulates neuromuscular tone segmentally in the spine.   In other words spinal manipulation normalises muscle tightness, relieves muscle pain and resets the spinal cord’s sensitivity to pain.

Korr’s model is based within a theory of somatic (musculo-skeletal) dysfunction, that lasting body pain is as a result of a vicious circle of pain causing tension, causing a lack of blood flow in the area of tension causing pain.  The spine with its high level of innervation, dense interlocking musculature and central role in movement and load distribution is particularly prone to somatic dysfunction.

For a layperson, I hope that’s a detailed enough description.  If however you want to know Jonathan’s academic opinion of what may be going on in the nervous system when Osteopaths manipulate you may read his Dissertation.