Spinal Manipulation
Spinal manipulation... what is it?
Spinal manipulation is a treatment technique commonly used by osteopaths, chiropractors, and other manual therapists. You might also hear it referred to as an adjustment, HVLA thrust, or high‑velocity, low‑amplitude technique. HVLA simply describes how the technique is delivered:
a quick, precise movement through a small range at a specific joint.
“What’s That Pop?”
When you hear the click or pop during a spinal manipulation - or even during massage treatment and thought, “Did something just go back into place?”
Here’s what’s really happening:
Imagine pulling apart two wet glass plates quickly.
You feel resistance… then suddenly — pop! — they separate.
That’s a lot like what happens during spinal manipulation. When we apply a quick, controlled force to a joint, the pressure inside the joint drops rapidly. That change causes gas bubbles (mostly carbon dioxide) to form and collapse inside the fluid — like opening a fizzy drink.
✅ This is called cavitation, and it’s totally normal.
✅ It doesn’t mean anything was out of place.
✅ It’s just the physics of fluid, gas, and movement doing their thing.
The goal isn’t the noise — it’s to help your nervous system relax, reduce muscle guarding, and improve movement.
The “pop” is just a side effect.
👉 Important point:
The sound does not mean a bone was “out” or has been “put back in”.
Your spine is not being realigned, and joints are not slipping in and out of place.
So what does spinal manipulation actually do?
Rather than “realigning” anything, spinal manipulation primarily works through the nervous system.
When a joint is moved very quickly, the body doesn’t have time to tense or resist. This can trigger powerful reflex responses that:
Reduce protective muscle guarding
Lower pain sensitivity
Improve joint movement
Change how the brain perceives threat in that area
You can think of it as a reset of how the joint and nervous system are communicating, rather than a structural correction.
A temporary window — not a magic fix
Spinal manipulation often creates a short‑term window of opportunity where pain eases and movement feels easier.
That window is valuable — but it doesn’t last on its own.
This is why I don’t rely on manipulation as a stand‑alone treatment. The real benefit comes when it’s combined with:
Movement and exercise
Gradual loading
Education and reassurance
Improving confidence in the body
Without these, symptoms often return once the nervous system settles back into its previous protective pattern.
What about joints outside the spine?
The same principles apply to joints like the shoulder, hip, ankle, ribs, or pelvis.
Manipulation in these areas aims to:
Reduce stiffness and guarding
Improve joint motion
Make movement feel safer and easier
Again, it’s about optimising function, not forcing joints into position.
Is spinal manipulation safe?
When appropriately assessed and applied by a qualified practitioner, spinal manipulation is considered a safe and effective technique for many people.
It takes years of training to:
Assess whether manipulation is appropriate
Choose the correct joint and technique
Apply it safely within a wider treatment plan
It’s never used automatically — and it’s not suitable for everyone.
The takeaway
Spinal manipulation is not about cracking bones back into place.
It’s about influencing the nervous system to reduce pain and stiffness — creating an opportunity to restore movement and function.
Used thoughtfully, and combined with the right movement and education, it can be a very effective part of osteopathic care.
If you’re dealing with pain, stiffness, or movement restriction and wondering whether spinal manipulation might help, feel free to get in touch — I’m always happy to explain how it fits into your care.
Check out these videos of me applying a HVLA thrust to a neck and to the lower back.