I tell patients Chiropractic is a profession not a treatment and spinal manipulation is one of MANY treatments a Chiropractic Physician offers. Spinal Manipulative Therapy (SMT) remains one of the most effective forms of treatment for low back pain and is currently being recommended as a preferred treatment to prescription medications for the treatment of low back pain.
So what is SMT?
Quite simply SMT is manipulation of the spine to have a positive effect on the nervous system. The traditional theory of chiropractic manipulation was that your spine houses your nervous system and at each level of the spine is a nerve root that innervates many different muscles tissues and organs in the body. If there is nerve interference due to mis-alignment of the spine (pinched nerve) then whatever that nerve goes to won’t function correctly and can cause pain.
Are there different types of manipulation?
Yes there are many different techniques with the most common being diversified manipulation which is your traditional chiropractic adjustment. There is also many mechanical assisted manipulation techniques with the most common one being called Activator Method. Some other common techniques are table drop techniques, toggle recoil, Gonstead, SOT, Logan basic and the list goes on and on. The basic premise of a manipulative technique is that it is a High Velocity Low Amplitude (high speed, low force) thrust through the spinal joint that stimulates the spinal nerve.
How Does it work?
There is an overwhelming amount of research has shown manipulative therapy to be a highly effective treatment but the understanding of the exactly physiologic mechanism in which it works is still poorly understood. While manipulative therapy remains one of the most researched therapies we still have a lot of questions of how it actually works and what the majority of its effects truly are. We do know that it works and it has better long term outcomes, lower costs and is much safer than traditional medical approach.
Several recent studies that have shown that SMT is effective reactivating deep core muscles such as the Transverse abdominis and the multifidus muscles which are deep spinal stabilizers. These studies have also shown that when a low back injury occurs these deep core and spinal stabilizers will actually shut down and do not always re-activate on their own. A high velocity manipulation that stretches the spinal joint capsule will activate the reflex mechanism in muscles stimulating the nervous system which results in muscle re-activation of the deep core muscles and spinal stabilizers.
While chiropractors perform over 94% of all SMT delivered by healthcare providers today we didn’t invent it and there is actually record of it being used all the way back to ancient times. Chiropractors have been using SMT as a primary treatment of choice over medications for over 100 years now and today it is covered by every major health insurance carrier.