Modern chiropractic treatment includes spinal manipulation, manual therapy, and spinal distraction, and has been practiced for over one hundred years. The use of spinal manipulation for low back pain has been documented as beneficial in many of the published guidelines for the treatment of lower back pain.
Chiropractors often use the word "subluxation" to describe the altered position of the vertebra and subsequent functional loss. This differs from the medical use of the word subluxation, defined as an abnormal separation of the articular surfaces of a joint which can be quantified on radiographic imaging studies such as x-rays and CT scans.
Another term often used by Chiropractors is "adjustment", which refers to the specific manipulation chiropractors apply to vertebrae that have abnormal movement patterns or fail to function normally. A chiropractic adjustment involves using the hands or a device to apply a controlled, sudden force to a joint, moving it beyond its passive range of motion. This is often associated with an audible "pop" or "crack". This sound is due to a release of gas within the joints, which relieves joint pressure. The goal of the chiropractic adjustment is to increase the range and quality of motion in the area being treated.
Chiropractors and physical therapists utilize other forms of manual or manipulative therapy for spinal disorders such as stretching, traction, and massage. Spinal manipulation should be combined with active stretching and strengthening exercises for maximum benefit. Chiropractors and therapists may combine the use of spinal manipulation with several other treatments and approaches such as heat, ice, electrical stimulation, and exercise.
Chiropractors do not utilize drugs or surgery in their practice. However, there are times when a chiropractor will recommend that the patient consult a medical doctor if these or other methods of treatment are indicated.
Side effects and risks of spinal manipulation depend on the specific type of chiropractic treatment used. These can include temporary headaches, fatigue, or discomfort in parts of the body that were treated. The likelihood of serious complications appears to be low and related to the type of adjustment performed and the part of the body treated.
Chiropractic care and spinal manipulation techniques used by physical therapists have been shown to be safe and effective in the management of low back pain when combined with stabilization and strengthening exercises. Pain that persists beyond six weeks or that is associated with radiating leg or arm symptoms should be evaluated by a medical physician.