Snap Crackle Pop: Manipulation vs. Adjustment

Snap Crackle Pop: Manipulation vs. Adjustment

Spinal Manipulation is known in the healthcare world as ‘High-Velocity Low-Amplitude Thrust’ or ‘Spinal Manipulative Therapy’. It is an ancient science which can be traced back to the earliest of medical practitioners. Physical therapists and chiropractors are the main practitioners who use this. Doctors of Osteopathy and other orthopedic specialist have been know to use them as well. Spinal manipulation is a different kind of manual therapy. The clinician generally applies a rapid impulse, or thrust, in order to achieve an increased joint spacing and subsequent cavitation of the target joints. Joint cavitation can often be accompanied by an audible sound recognized as a ‘popping’, or ‘cracking’.

NEWS FLASH: Spinal Manipulation is Used By Physical Therapists

If you feel like you may need a manipulation performed, there are many physical therapists that are certified in the therapeutic technique. It is used to facilitate movement, relieve pain, increase circulation, relax muscles, improve muscle function. I often get asked, what is the difference between a spinal manipulation and a spinal adjustment? I have even been asked if I am a chiropractor or a physical therapist.While technique and use of the treatment between the two professions can be very similar, the two professions operate under very different treatment models. (A discussion for another day perhaps).

Snap Crackle Pop: Manipulation vs. Adjustment

Differences in the two roads/paths

Chiropractors generally follow the theory of the ‘spinal subluxation complex’, which says that the subluxation of a vertebra actively alters neurological function, which, if left untreated, will lead to disorders and disease of the various organ systems. Chiropractors also generally claim to treat all systems of the body, and this is done with the spinal adjustment. The term ‘adjustment’ implies treatment of the ‘spinal subluxation complex’ with the intent to manage or prevent conditions known or unknown in any system of the body.   Not many other medical practitioners adheres to this theory, so the ‘adjustment’ is almost solely a chiropractic term. It is important to realize that spinal manipulation and ‘adjustments’ aren’t really the same thing. Spinal manipulation one technique used by chiropractors to achieve an ‘adjustment’.

Physical Therapy Approach

Physical Therapy uses a slightly different treatment approach. The disablement model and evidence-based practice are the central themes to the Physical Therapy scope of practice. Performance of  ‘adjustments’ is generally not a physical therapy treatment. Physical Therapists however do perform spinal and extremity manipulation, along with other manual therapy techniques and exercise, in the treatment of neuro-musculo-skeletal pain and dysfunction in order to restore mobility within these systems. Physical Therapists do not utilize manipulation to manage, co-manage, or prevent diseases or conditions in the other body systems. The Physical Therapist’s approach to treatment is based on identifying specific somatic dysfunction—in the spine, pelvis, or extremities—for the sole purpose of achieving clinical improvement within the neuromusculoskeletal system.


I need to be careful when choosing my words when educating. Educating on the difference between Physical Therapists and Chiropractors and techniques makes me happy. I need to make sure I am explaining it in detail to a level my colleagues or patients understand. If you have any questions on the differences in treatments, or think you may need a manipulation, feel free to contact me at Epic Therapy and Wellness (254)447-7760.

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