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4 Most Common Chiropractic Back Adjustment Techniques

back pain

Back pain may develop if there is a mechanical issue in the spine. The severity of the pain does not always reflect the seriousness of the underlying back problem. Some minor issues may diminish on their own for a time, only to return later.

The pain may disappear, but a significant number of people are most likely to experience a recurrence in about six months. Therefore, patients suffering from back pain need to know that they may become vulnerable to chronic pain and may benefit from chiropractic and medical care.

With that said, you need a back pain recovery plan to manage the problem. This plan requires you to develop a reliable support program that will help you manage your condition strategically.

The foundation of chiropractic care involves the treatment of back pain through manipulative therapy. Listed below are the four most common types of chiropractic treatment for back pain:

1. Spinal Manipulation

This is a manual technique for treating back pain. While some musculoskeletal physicians refer to this procedure as a joint manipulation (a technique that corrects subluxations in the spine), doctors of chiropractic refer to it as an adjustment.

The term manipulation is usually used to describe a range of manual therapy techniques, but our focus is on the rapid thrust or impulse used to correct misalignments. This form of treatment helps to relieve localized inflammation and muscle spasms in the spine.

When you visit a chiropractor for back pain, he or she will want to do a full physical evaluation of your spine prior to spinal manipulation. Therefore, you may be asked to rest in a prone position on a chiropractic bench.

Most chiropractic benches are incorporated with drop-down parts that help raise or lower your body at specific points along the spine. Your doctor may examine your spinal column by palpation all the way from the lumbar region to the neck region.

Through palpation, the physician is assessing each individual vertebra for movement. He or she will be trying to determine whether or not one or more spinal discs are not moving properly in affiliation with the ones below or above.

Subluxations are noted when your chiropractor comes across a restrictive barrier along the spine. If one or two vertebrae are not moving properly or are engrossed, then that is an indication of a barrier, fixation, or misalignment that may be causing back pain.

For instance, if there is a subluxation at T6 and T7 (thoracic spine), the chiropractor will strategically place his hands on the affected area. Then he or she will exert a gentle force into the joint to correct the problem. This should restore the joint to its regular movement.

A chiropractor may also check your leg length. He or she will hold your ankles and the soles and push towards your head. What the physician is looking at is the level of your heels to establish whether or not they are in line.

If the heels do not line up properly, then that is a sign that you have a misalignment somewhere along your spinal column. If one of your legs is shorter than the other even by a small fraction, care may be given in this regard.

Some chiropractors may conduct cervical spine manipulation to help get rid of back pain. Your doctor may adjust your cervical spine in the supine position where you rest flat on your back while facing up. Some adjustments may also be made while you are sitting on a special chair.

From a supine position, the doctor may press along the sides of your cervical spine just to get a conclusive assessment. He or she may turn your neck to the sides to determine the set of vertebrae that is fixated. Then he or she will perform a neck adjustment.

Spinal manipulation will seek to address the smallest details that may be causing abnormalities in your body by applying a gentle force on the affected joints. When you experience spinal misalignment symptoms, spinal manipulation is often a required treatment.

2. Spinal Mobilization

On the other hand, mobilization does not use a thrust or impulse to restore movement to a joint. This procedure involves a number of graded movements under controlled measurements. Exact measurements are set to fit each patient's needs.

Spinal mobilization is not generally associated with the common sound of cavitation – the audible crack. Audible cracks are more with spinal manipulation. The presence of an audible crack does not have an effect on the effectiveness of treatment.

3. Manual Traction Distraction

This is one of the types of manual treatment used by chiropractors to mobilize articular tissues. It is not a distinct therapy but is simply a type of passive mobilization. When applied to an affected area, the aim is to develop intermittent separation of joint surfaces.

This therapy is conducted through hands-on contact along with the use of mechanized tables or devices. Traction usually helps an adjustment by alleviating compression caused by axial loading. The process opens the intervertebral foramina.

Traction therapy produces long-axis distraction in the affected joint, which helps to restore movement. With that said, traction is all about pulling one body part in relation to another, which leads to a better alignment of the two body parts.

Traction is a passive movement of a joint that takes place at right angles to the plane of the involved joint. This treatment option can be applied manually or mechanically with a fast or slow rate of application.

The force applied may be gentle or strong. The effects may be localized or maybe more specific through careful positioning. Traction is highly effective when applied to the cervical and lumbar spine.

4. Soft Tissue Manipulative Techniques

These are physical processes that employ the use of force to improve the functions of the body. The system consists of procedures developed to manipulate, stimulate, or massage the soft tissues of the body.

Your chiropractor may use the following methods: traction, deep pressure, linear stretching, and lateral stretching. He or she can apply them on either articular or non-articular soft tissues. They may include kneading, friction, pumping, tapping, vibration, or rolling. Your chiropractor will also discuss with you what to do and how to avoid back pain in the future.

Soft tissue manipulative processes are known to be very effective at doing the following: reduce joint inflammation, alleviate pain, reduce muscle spasms and congestion, and improve soft tissue extensibility and circulation.

Apart from the fact that they can be used as primary treatments for back pain, soft tissue manipulative procedures may be used by your chiropractor as preparatory techniques for a major spinal adjustment.

Why See a Chiropractor for Back Pain?

You may not fully appreciate the resourcefulness of chiropractic care in treating your back pain – unless you know what causes the condition and what can a chiropractor do for lower back pain.

1. Long Sitting Hours

One of the most significant reasons people experience pain in the lower back is because they sit in chairs for long durations. Regardless of years of evolution, we are still stubborn beings and will work until we are exhausted. Modern jobs often require us to sit for extended periods of time. This combination can be hard on our bodies.

You sit at work, at home, during a flight, in a bus, in a personal car, and so on. We cannot always take on a yoga pose style of sitting while trying to accomplish our many goals each day. Therefore, we are bound to experience chronic vulnerability to back pain among other problems.

The natural aging process, along with long sitting hours, contributes greatly to the growing back pain epidemic. The other causes of the condition are as follows.

2. Bone and Joint Conditions

These may be congenital (exist from birth), a result of wear and tear on the joints, or due to inflammation and injury.

  • Congenital Bone Disorders

These include spina bifida and scoliosis. Spina bifida refers to a birth imperfection in the bony vertebral arch located over the vertebral canal. This birth defect usually affects the lumbar spine at the lowest point and at the top of the sacrum.

Scoliosis refers to a sideways curvature of the vertebrae. A patient may have structural or non-structural scoliosis. The two types may be treated differently and exact care will depend on each person's spinal condition. Scoliosis exerts pressure and stress on the facet joints, ligaments, muscles, spinal discs, and nerves.

  • Degenerative Bone and Joint Disorders

The water and protein content of the body’s cartilage is known to undergo changes as people age. Such changes lead to thinner, weaker, and more vulnerable cartilage. The joints and spinal discs are composed of cartilage.

Therefore, all these regions are susceptible to wear and tear over time due to the degeneration of the weak cartilage. Degenerative arthritis of the facet joints or osteoarthritis has been a common cause of localized lumbar pain for a long time.

  • Bone and Joint Injury

Any injury to the spinal bones and joints is likely to cause back pain. In most cases, fractures of the low back and sacrum commonly affect the elderly population with osteoporosis (a condition in which the body makes too little bone or loses too much bone).

  • Arthritis

The most common forms of arthritis that can cause back pain are osteoarthritis, arthritis of inflammatory bowel disease, psoriatic arthritis, ankylosing spondylitis, and Reiter’s disease. These conditions may begin in a patient's twenties or thirties but most often occur in later years.

3. Bony Encroachment

This is a condition that leads to growth or movement of the lumbar spine which encroaches upon the space meant for nerves and the adjacent spinal cord. The primary causes of bony encroachment of the vertebral nerves are foraminal narrowing, spondylolisthesis, and spinal stenosis.

This particular problem can lead to spinal nerve compression which, in turn, can lead to sciatic nerve pain that radiates down the lower extremities. On the other hand, spinal stenosis can also lead to lower extremity pain that increases with walking.

4. Lumbar Radiculopathy

This is a painful ailment that occurs when a nerve in your lower back is irritated or pinched. The nerve irritation is caused by damage to the spinal discs due to wear and tear or degeneration of the outer ring of the disc.

Lumbar radiculopathy is a common cause of sciatic nerve pain that shoots down the leg followed by tingling and numbness. The pain usually increases with movement at the waist. Discomfort can increase with sneezing or coughing.

5. Lumbar Strain

A lumbar strain is a muscle soft tissue injury and is the most common cause of back pain. A lumbar sprain refers to an injury to the muscles, tendons, and ligaments of the lumbar spine, leading to pain in varying intensities within the tissues.

A spasm can happen when a section of the body is strained. An injury can cause stimulation in the nervous system to transmit signals for the muscles to contract dynamically. Aching muscle spasms might restrict your movements.

A strain injury can occur during everyday events. A simple thing such as bad landing during a run can precede the injury. Physical changes that come due to pregnancy may also significantly cause lumbar strains and back pain.

6. Nerve Irritation

A common complaint that chiropractors deal with is nerve irritation. The nerves of the lower back can be irritated or herniated by mechanical impingement. The common culprits are bony encroachment, lumbar disc disease, and nerve inflammation due to viral infection.

The aforementioned are the main causes of back pain that chiropractic care can effectively handle.


Treatment of back pain is a chiropractor’s specialty. According to research, most people who step into a chiropractic office complaining of pain in their low back. You want to do things to help back pain and seeing a chiropractor is the best thing you can do! At Better Health Chiropractic & Physical Rehab, we welcome you to come and join us for all of your chiropractic care needs.

We offer a multidisciplinary approach to chiropractic treatments for back pain. Treatments may include spinal manipulation and mobilization, rehabilitation therapy, massage therapy, and other treatments as preferred. See the nearest Better Health Chiropractic clinic today to heal your lower back naturally.

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Dr. Brent Wells - Anchorage Chiropractor
About the Author

Dr. Brent Wells, D.C.

Dr. Brent Wells has been a trusted chiropractor since moving his family from Oregon to Alaska back in 1998 and founded Better Health Chiropractic & Physical Rehab – B.S. from Univ. of Nevada, Doctorate from Western States Chiropractic College, volunteer for Reflex Sympathetic Dystrophy Foundation, and member of the American Chiropractic Association. As a chiropractor his focus is on family, including his 3 children and wife of 20+ years, his clinics, and ongoing education.

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