The Truth About Chiropractic Adjustments

Introduction

Spinal and extremity adjustments are among the most common treatments we incorporate into our care plans here at Movement Spine and Sport.

I mean, go figure. We are chiropractors after all.

But have you ever wondered why these techniques are so effective in alleviating joint pain and stiffness?

What occurs inside of your body following an adjustment?

And, most importantly, what produces that cracking noise you hear when you doom scroll through ASMR chiropractic videos on TikTok?

In this month’s blog post, we’ll unveil the answers to all of these burning questions and take a deeper look into the physiology and proposed neurological mechanisms that underpin the chiropractic adjustment.

What is NOT Occurring  

Before we address any of the topics mentioned above, I’d like to take a moment to clear the air about what does NOT happen when you get adjusted.

Despite what you may have been told somewhere along the way, under no circumstance do adjustments ‘realign your spine’ or ‘move bones back into place.’

We actually have research dating as far back as the late 1990s on this topic.

If you were to receive an x-ray of your lower back and sacroiliac (SI) joint, get adjusted, and then have another taken immediately afterwards, you wouldn’t observe any changes in the position of your bones.

Barring any sort of severe traumatic event or preexisting medical condition that leads to ligament laxity or joint hypermobility, the odds of your spine slipping ‘out of alignment’ are effectively zero.

What Really Happens

Now that we’ve gotten that out of the way, let’s talk about what truly occurs when you get adjusted.

Fundamentally, the aim of spinal and extremity adjustments is to help restore and/or maintain the optimal function and range of motion of the joints to which they are applied.

Limitations in these capacities can stem from a wide variety of factors, including our occupational demands, training and athletic history, and any previous injuries.

Following an examination to screen for any possible contraindications and assess movement at both the global and joint-specific levels, we then selectively apply adjustments to areas of restricted motion.

These controlled, high-velocity pushes or pulls induce movement within joints, sometimes followed by a cracking or popping noise known as a cavitation.

Snap, Crackle, Pop: Synovial Joints

Though still an ongoing area of research, we believe cavitation arises from the release of gasses dissolved within the synovial fluid of our joints.

When we apply a sudden force between two adjacent joint surfaces, a rapid separation and resultant drop in pressure occurs, allowing those dissolved gasses to come out of solution and form small cavities (hence the name) within the joint space.

It is through this process that the cracking or popping noise is generated.

Satisfying as it may be, sound alone does not seem to indicate whether joint cavitation truly occurred or reflect the success of an adjustment.

In fact, it’s believed that the therapeutic benefit of hearing the cracking noise is mostly psychological, rather than physiological, in nature.

Plausible Mechanisms

Now that we have an understanding of what happens during an adjustment and where the cracking noise comes from, let’s tie this all together and dig into what makes them so effective in treating a wide variety of musculoskeletal complaints.

How does, “We’re not entirely sure yet.” sound?

Certainty and exactitude are far less common than you may expect in healthcare.

Nonetheless, our current working hypothesis centers around what are termed neurophysiological effects.

That’s a very eloquent way of saying that adjustments alter the inflow of sensory information returning to the brain and central nervous system by stimulating structures responsible for things like muscle tone and joint position sense.

In conjunction with the mechanical changes we observe within the joints themselves, it is believed that this downregulation of the nervous system is what leads to pain relief and widespread improvements in range of motion following an adjustment.

Parting Thoughts

At this point, I hope I’ve made it abundantly clear that many of these topics are currently under ongoing exploration and lack a clear scientific consensus.

And although they can be extremely powerful tools, adjustments are not the panacea that some have made them out to be.

As is the case with any intervention, extraordinary claims require extraordinary evidence.

Have questions or want to learn more about how we incorporate adjustments into our individualized treatment plans here at Movement Spine and Sport? Give our office a call at (704) 980-9049 or click here to speak with one of our clinicians. 

Ryan Lesik, D.C., CSCS

Movement Spine and Sport