Understanding Spinal Manipulation

Spinal Manipulation (High-Velocity Low-Amplitude Thrust)
The most frequently used chiropractic technique, spinal manipulation, is the traditional high-velocity low-amplitude (HVLA) thrust. The manipulation often results in an audible “pop,” as chiropractors use their hands to apply a controlled sudden force to a joint while the body is positioned in a specific way.

Spinal Mobilization (Low-Force or Gentle Chiropractic Techniques)
Some conditions (such as osteoporosis), pathology, the patient’s size, patient comfort, or patient preference, may require a gentler approach generally referred to as spinal mobilization. In addition, some patients and/or clinicians prefer mild spinal mobilization techniques that do not involve twisting of the body or a forceful thrust.

The goal of spinal mobilization is the same as HVLA spinal manipulation – to restore or to enhance joint function. However, unlike HVLA spinal manipulation, slow movement, usually to a firm endpoint of joint movement, is used to mobilize the joint.

Chiropractors may choose spinal mobilization for certain patients for a variety of reasons, such as:

  • Patient preference – certain patients prefer spinal mobilization over spinal manipulation
  • Patients with sensitive nervous systems may benefit from gentle chiropractic techniques to keep the body from overreacting and causing reactive muscle spasms
  • Patients with some conditions may be contraindicated for spinal manipulation, such as possibly patients with advanced osteoporosis, bone pathology, some forms of deformity, and certain types of inflammatory arthritis
  • Chiropractors may choose spinal mobilization for patients when they are in the acute stage of their condition and in severe pain
  • Obesity can make the positioning of the patient and the manipulation procedures challenging for both the provider as well as the patient, which might favor a low force

Is the Audible Pop Necessary?

The sound often heard during an HVLA manipulation is called cavitation. The pop is caused by a release of gas when the joint is pushed a short distance past its passive range of motion of the joint. The mechanism is similar to cracking ones knuckles.

Some clinicians and patients consider an audible pop necessary for the treatment to be successful, although there is no scientific physiological data from studies with large patient populations to confirm this belief.2-

Spinal Mobilization Methods

There is a wide range of spinal mobilization approaches and techniques. Several of the more common gentle spinal mobilization methods include:

  • Activator method: The Activator is a hand-held, spring-loaded, manual tool that provides a low-force impulse. With the patient lying face down on the adjustment table, the chiropractor evaluates leg length, performs muscle testing, and adjusts the spine or extremity joints using the Activator tool.
  • Cox Flexion-distraction: This technique involves a gentle adjustment that is designed to adjust vertebrae by applying a gentle stretch to the lower spine, usually in a series of repetitive slow movements similar to a rocking motion.
  • Sacro-Occipital Technique (SOT): This method involves placing wedges or blocks under the pelvis, allowing gravity – with some addition low force assistance by the provider – to realign the pelvis.


Functional Movement and Training

Functional movements are movements based on how we move in the real world. These movements involve coordination of several joints and muscles and place a demand on the body’s core musculature.

Functional movement assessment is  the assessment of how well we perform movements used in our daily life activities, including our unique workplace, recreational and sporting activities. Due to the sedentary nature of modern life and labour saving devices many of us move poorly. This inefficience to move well results in greater stress and energy demands on the body, and consequently injury. Functional Movement Screen or FMS a movement assessment system developed by Gray Cook

Functional movement training involves using the information from the movement assessment to develop a program to correct the faulty movements unique to that person. No two people move the same. We come in different shapes . Technology is evolving that allows the identification of an individual from their walking pattern on video, just as our fingerprints are unique to each of us.

What is Low-Level Laser Therapy (LLLT)?

Low-Level Laser Therapy (LLLT) was discovered over 50 years ago and is known by researchers as PhotoBioModulation. In simple terms, our cells can convert light energy into a form ofAn example is seen in plant cells utilizing sunlight to photosynthesize. Humans have long known the healing effect of the sun, but only recently have been able to understand it with advances in cellular biology and quantum physics. Special lasers, as the ones used here at Spine Central, can deliver a specific dosage in a manner that cells can utilize.

What to expect

Treatment is a gentle, safe and painfree. The lasers used in our clinic are also known as Cold Lasers, as there is no thermal (heating) effect there is no risk of burns or eye damage. In over 50 years of use there has been no documented serious side-effects. Most people experience a breakthrough after 6-8 treatments. Depending on the severity of injury, the best tissue repair can take up to 20 visits.

Conditions Treated

Because LLLT acts at the cellular level to boost the healing capacity of the cell, it has been shown to be beneficial in a wide range of conditions. Below are a list of conditions supported by Research.

Systematic Reviews and Clinical Trials.

  • Neck pain (1,2)
  • Knee pain (3,-5)
  • Low Back pain (6-7)
  • Osteoarthritis (4-6)
  • Muscle fatigue / DOMS (8)
  • Rheumatoid Arthritis (9)
  • Ankylosing Spondylitis (10)
  • Chronic Tinnitus (11-12)
  • Lymphoedema (13-14)
  • Shoulder tendonitis (15)

Practice-Based Evidence

  • Nerve Repair (16)
  • Fibromyalgia (17)

“Where inflammatory processes have become stuck and chronic, as happens in many diseases, laser light can unblock the stalled process and quickly move it to a normal resolution”. Norman Doidge M.D. The Brain’s Way of Healing