chiropractic manipulation

Chiropractic Manipulation for Back Pain

Chiropractic manipulation is one of the most common health procedures undergone by adults and children in the United States, according to a 2012 National Health Interview Survey.3 It’s a well-known treatment for back pain, and is commonly recommended as an option for alleviating pain. However, many treatments are popular without any real evidence of effectiveness, making it important to be aware of what research shows about this treatment.

What Is Chiropractic Manipulation?

Chiropractic manipulation, or spinal manipulation, as it’s also known, is a procedure performed by chiropractors to apply controlled, sudden force to a spinal joint.1 The amount of force applied may vary, but the goal is always to move the joint past the point that it would normally move in order to improve the motion of the spine and the body’s physical function.3,1 Spinal mobilization is often lumped in with spinal manipulation, but these two procedures are different. Spinal mobilization is only performed within the joint’s natural range of motion, as opposed to trying to move it past this natural range.3

Chiropractors usually perform chiropractic manipulation, but it can be performed by other licensed professionals as well, including osteopathic physicians and physical therapists.3 It’s most commonly performed to alleviate low back pain, neck pain, and headaches.1

In a typical chiropractic manipulation appointment, the person performing the manipulation will place you in specific positions in order to best treat the affected areas. Usually, this means you will be positioned facedown on a chiropractic table as your chiropractor uses their hands to apply force to your affected joints. As this force is applied and your joints are moved, you may hear popping or cracking sounds, which is normal.1

Is Chiropractic Manipulation Safe?

Like any other procedure or treatment, chiropractic manipulation is safe when performed by a trained and licensed chiropractic professional.1 However, there are still some risks, side effects, and possible complications that can be caused by it. Although serious complications are rare, they are issues that can potentially be caused by chiropractic manipulation. Some of these potential complications include:

  • Worsening of a herniated disc or even causing a disc to become herniated.
  • Cauda equina syndrome, which is the compression or damage of nerves in the lower spinal column.
  • Vertebral artery dissection, which is a type of stroke associated with neck (cervical spine) manipulation.1

Some people are also discouraged from seeking chiropractic manipulation due to certain conditions that can put them at risk for complications or injury.1 These conditions include:

  • Severe osteoporosis
  • Numbness, tingling, or loss of strength in an arm or leg
  • Cancer in the spine
  • High risk of stroke
  • A bone abnormality in the upper neck

It’s also common for people to experience some mild side effects after undergoing chiropractic adjustment. These side effects may include headache, especially if the neck was treated, fatigue or pain in the treated areas, temporary muscle soreness, stiffness, and even a temporary increase in pain.1,3 If you don’t see any improvement in your pain after several weeks of chiropractic manipulation, this treatment may not be the right option for you.1

Can Chiropractic Manipulation Solve Chronic Back Pain?

The American College of Physicians (ACP) recommends chiropractic manipulation as a treatment for acute or chronic back pain in its 2017 clinical guidelines. However, the ACP also states that the quality of evidence that proves whether it can actually treat acute or chronic back pain is low.3

Another review, conducted in 2011, covered 26 studies and came to the conclusion that chiropractic manipulation only works as well as other conservative approaches, such as exercise or physical in treating chronic back pain. Unfortunately, studies show that these conservative treatments only have a minimal effect on alleviating back pain.3

Yet another study, conducted in 2016, found that there is moderate evidence that chiropractic manipulation is as effective for back pain as physical therapy, and a 2017 review connected chiropractic manipulation to only modest improvements for people suffering from back pain.4

Overall, the answer is that chiropractic manipulation can help alleviate lower back pain, but it only provides a modest benefit, similar to any other conservative treatment.1

Considering the evidence, chiropractic manipulation is not the best option for anyone seeking relief from severe and debilitating chronic back pain.

We know that most cases of chronic back pain are caused by annular tears, and apart from only providing modest relief of back pain, chiropractic manipulation cannot treat this underlying cause. Unfortunately, without treating the underlying cause of back pain, it’s impossible to obtain lasting relief. The good news is that the Discseel® Procedure has been developed specifically to address these annular tears, sealing them and allowing spinal discs to heal themselves.

If you have chronic back pain resulting from spinal disc issues, the Discseel® Procedure may be the right option for you. Apply today and find out if you’re a candidate!

  1. Chiropractic adjustment. (2018, December 7). Retrieved May 14, 2020, from
  2. Norton, A. (2017, April 11). Chiropractic Treatment May Help a Bad Back, to a Degree. Retrieved May 15, 2020, from 
  3. Spinal Manipulation: What You Need To Know. (n.d.). Retrieved May 14, 2020, from
  4. Weatherspoon, D. (2018, May 24). Chiropractic: What is chiropractic manipulation? Retrieved May 15, 2020, from


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