Spinal Manipulation

(american academy of spine physicians)

Joint manipulation is a method used to mobilize joint and surrounding soft (periarticular) tissues in a manner that is not possible through other means. For example Chiropractic Physicians carefully apply specific manipulative forces, utilizing the bones as levers in order to place the desired motion into the joint and periarticular tissues. The resulting forces influence the axis of rotation and other movement patterns of restricted (hypomobile) joints. Proper joint and soft tissue motion is essential for proper alignment and healing of tissue. The absence of proper joint movement during the tissue repair process may lead to the development of more restrictive tissue, which can limit joint and soft tissue movement. Joint manipulation influences neurological input from the densely innervated joint linings and surrounding joint tissue through the peripheral and central nervous system thus influencing muscle firing patterns around the spine, autonomic function and modulating of pain thresholds. The Physician makes the determination as to what joints may benefit by the use of manipulation by performing a regional examination. The examination may include diagnostic imaging and palpatory assessment of the quality of the joint play (joint movement) and of the muscles around the joint. Regions with abnormal restrictive barriers to motion or joint play can often be detected. A manipulative thrust may be carefully and gently delivered to the spinal region with a restrictive barrier to motion.

Spinal joint manipulation may be associated with regional and more distant physiological effects. The relationship between structure and function in the human body is a significant factor in health and disease. The relationships are highly significant because of the influence of structure and function on the nervous system control of bodily function.

Joint manipulation is used to help promote an optimum of the tissue repair process through the various stages of healing. Tissues tend to recover and remodel consistent with the stresses placed upon them during the healing process. Some movement is required for the tissues to heal strong and flexible enough to allow normal joint movement and to adequately withstand physical loads placed upon the tissue. In each stage of repair, methods are used to lessen pain, reduce the extent of injury, aid in remodeling of granulation tissue, break adhesions as they develop, and most important, attempt to prevent chronic joint stiffness and/or a potential chronic pain syndrome from developing. Spinal manipulation is most effective if it is used in combination with muscle therapy, correction and maintenance of proper posture, home and in office exercises and stretches and proper home and work ergonomics.

There are numerous techniques available for spinal manipulation. Studies have shown that spinal joint manipulation may help reduce spinal degenerative disease and related disability. Adequate joint mobility is required to help sustain nutritional and fluid exchange in joint tissues and the intervertebral disk of the spine. The process greatly influences the health of joint cartilage. Increasing joint stiffness leads to global stiffness and accelerated degeneration of joint tissues.