What is Joint Manipulation?

Joint manipulation is a growing practice, used for over a century by chiropractors and becoming more popular with physiotherapists, medical doctors and more.  There is an increasing amount of research showing that spinal manipulative therapy, or SMT, can have varied benefits on pain, disability, costs of low back pain and utilisation of prescription medications. In this blog, we will be examining joint manipulation or SMT in more detail as well as explaining how it could provide benefits to a person's health.

​Of course, you can’t just go and find anyone to carry out this process, you should seek the services of a chiropractor. All of our chiropractors are fully qualified and registered with the General Chiropractic Council. A chiropractor is specially trained over a minimum of 4 years at university to carry out these techniques as well as annual continuing education requirements. But how exactly does joint manipulation work and what can it do for you?
​

The Benefits Of Joint Manipulation ​

This technique is used by many healthcare professionals as a way to reduce pain. While undergoing this practice the range of motion that the joints are capable of can increase. Joint manipulation usually takes place along with other relevant treatment techniques to help improve a patient's comfort levels.
​

How Does Joint Manipulation Work?

Initially, when undergoing treatment for back pain, your chiropractor will often ask you to lie on a treatment table where they will apply specific, quick and controlled pressure with their hands to manipulate the joints.

Through the manipulation of the spinal joints, there are several benefits that researchers have found.  For example, manipulation applied to the spine results in separation or stretch of the facet joints (a type of joint that allows each vertebra to sit on another) that is often accompanied by an audible pop or crack, otherwise known as cavitation. The benefits of manipulation include local pain relief and increased range of motion, e.g. manipulation in the neck can be associated with an increase in motion of 8-13° (1). 

A systematic review carried out at Harvard Medical School found that manipulation can help to achieve a decrease in intensity and number of days of migraines (2).

A huge study conducted by the BMJ, the British Medical Journal, looked at nearly 250,000 low back patients and the short-term and long-term opioid use based on who they saw first.  Those that sought treatment for lower back pain from a Chiropractor or physiotherapist had reduced chances of short or long term opioid use than those that saw a primary care physician, a GP, first. Opioids include Codeine, Tramadol, Morphine for example. A closer look at the research paper showed that chiropractic patients were less likely to rely on short or long term opioids (0.10) than physiotherapy patients (0.15) (3). More recently, a 2020 study in the USA comparing manipulation and primary care with a physician has found, a 64% reduction of opioid use compared to non-chiropractic patients, better improvement in pain and disability alongside medical care compared to medical care alone as well as shorter duration of back pain episodes (4).

The study also found that joint manipulation is very safe, there are associations with mild side effects such as 24-48 hours of low-level soreness or aching after treatment and injury from manipulation was rare. Interestingly the risk of injury in the 7 days following manipulation was lower in Chiropractic patients than those who had sought normal medical care (only 40/100,000) (4).
​

Is Joint Manipulation Right for Me?

This is one of several joint pain treatments and it’s only right to consider all options and see what is best for you. Your chiropractor is highly trained to be able to determine if joint manipulation is the right technique for you and if it is, they will be able to devise an action plan that involves the procedure, amongst other treatment modalities such as stretching, massage techniques, acupuncture, ergonomics and rehabilitation. Not everybody wants manipulation as a treatment and we see many patients every week where manipulation is not used at all, we have a large toolbox of treatment techniques and one skill in clinical practice is deciding which ones work best for each individual.

I hope you have found out a little bit more about joint manipulation. Suffering from joint pain is never easy and can be the cause of a lot of discomforts daily, having a profound effect on a person’s life. This is something that can cause a knock-on effect upon other areas of people’s lives such as lost days of work and mental health, for some advice on dealing with pain see our blog on chronic pain. So it’s crucial to look into and consider all effective techniques that may help joint pain sufferers to cope with any pain and discomfort.

If you would like to find out more about how we can help you with your joint pain, get in touch today on 01604 754456 or visit our contact page for more details.

References

1. Anderst WJ et al. Intervertebral Kinematics of the Cervical Spine Before, During and After High Velocity Low Amplitude Manipulation. The Spine Journal Volume 18, Issue 12, December 2018, Pages 2333-2342 
   
2. Rist PM et al. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis.Headache. 2019 Apr;59(4):532-542. 
   
3. Kazis LE, Ameli O, Rothendler J, et al. Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use. BMJ Open 2019;9:e028633. doi: 10.1136/bmjopen-2018-028633.
   
4. Hinkeldey N, Okamoto C, Khan J. Spinal Manipulation and Select Manual Therapies: Current Perspectives. Physical Medicine and Rehabilitation Clinics. 2020 Nov 1;31(4):593-608.