Are you familiar with videos that circulate social media showing someone ‘cracking” joints or the spine? But what makes that satisfying sound and what does it achieve? Seeing an Osteopath will often combine various techniques tailored to you and your pain, one of which may include a spinal manipulation. The technique has been around for over 2000 years. It involves a quick thrust to a joint over a very short amplitude, thus the name high velocity thrust (HVT). Manipulation is also another name for an ‘adjustment’,
What is the crack?
Osteopaths, Physiotherapists and also Chiropractors can use this technique for treating neck and back pain. Manipulation is often also associated with an audible ‘crack’ or ‘click’ (which often feels very satisfying) and can be applied to various joints in the body. Contrary to the old wives’ tale, there is no evidence to suggest that this technique can cause arthritis, which I’m sure many parents have told their children, probably to stop them clicking their fingers at the dinner table. In fact, Dr Donald Unger spent 60 years cracking only the knuckles of his left hand. At the end of which, there was no degenerative differences or ailments. For this research he was awarded an Ig Nobel Prize in 2009.
Another outdated belief is that the click is produced by bone rubbing on bone. Again, this is not correct. The sound happens within the synovial fluid of a joint (a lubricant within the joint capsule which reduces friction). There is no contact between adjacent bones. This click happens when the joint slightly separates, creating gas filled cavities or air bubbles which then rapidly dissipate.
What can spinal manipulation achieve?
- Stop the swelling of a joint capsule.
- Reduce muscle tension.
- Release endorphins (modulate inflammatory processes, promoting analgesia).
- Increase the range of movement.
- Relieve back pain.
Does this technique realign your bones or put them back in place?
This is the oldest theory of spinal manipulation and not very accurate. Osteopaths use manipulations every day with various patients, the myth that spinal manipulations crack your bones back in place is only a myth. Practitioners did once believe they were ‘putting the bone back in place’, which is believable with the relief that often follows. In my clinical experience, patients who think their bones need popping back in are often suffering from acute back pain with associated muscle spasm or a restricted joint of the spine, of which manual therapy can help. Don’t worry, your bones won’t pop out!
(Evans, 2002)Evans, D. (2002). Mechanisms and effects of spinal high-velocity, low-amplitude thrust manipulation: Previous theories. Journal of Manipulative and Physiological Therapeutics, 25(4), pp.251-262
Osteopath & Spinal Manipulation – by Osteopath – Dr Joshua Kelsall
You can see Osteopath Dr Joshua Kelsall at our Brisbane City and James Street New Farm Clinics Tuesday – Saturdays.
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