Services
Spinal adjustments
Reviewed by Dr Voula Roumel, Chiropractor , registered since 1987, AHPRA CHI0000942872
Last updated
A spinal adjustment is a controlled movement applied by hand to a specific segment of the spine, the neck, the mid back or the lower back. The chiropractor applies a quick, low-force movement to a joint that has lost part of its normal range.
It restores movement, not position. Vertebrae do not slip out of place and get pushed back. That framing has stuck in everyday language, but it misdescribes what is happening. What the chiropractor is addressing is a segment that is not moving as it should, and what changes is how it moves.
How the chiropractor picks the segment
The segment that hurts is often not the segment that stopped moving. A stiff joint changes how the ones either side of it work, and the pain frequently shows up in the one taking up the slack.
So the assessment tests the region rather than the sore spot:
- How each segment moves individually, and where the restriction actually sits
- What the surrounding muscles are doing, guarding, tightness, tenderness
- How posture and habitual position are loading the region
- Whether anything neurological is involved, particularly where symptoms travel into an arm or leg
That is why a first appointment runs about 30 minutes, and why most of it is assessment rather than treatment.
What it feels like, and the sound
Usually a quick pressure rather than pain.
There is often a popping sound. That is a cavitation, gas coming out of solution in the fluid inside the joint as pressure changes, the same mechanism as cracking a knuckle. It is not bones moving against each other, and it is not a measure of whether the adjustment worked. A good deal of effective technique makes no sound at all, particularly the lower-force approaches.
An irritable joint can be tender for a day afterwards, much like a muscle after unfamiliar exercise.
When lower-force technique is used
Frequently, and for a lot of people. Technique is matched to the person, not to the presentation:
- Older patients, and anyone managing osteoporosis
- Patients within a few months of surgery
- Highly irritable or acutely inflamed joints
- Pregnancy. See pregnancy chiropractic
- Children, where age-appropriate technique bears no resemblance to what is used with adults. See paediatric chiropractic
- Inflammatory arthritis, or a history of fracture
Tell the chiropractor about your health history and any medication before your first appointment. Blood thinners, bone density, recent surgery and inflammatory conditions all change what is appropriate, and the chiropractor needs that before the assessment rather than after it.
When adjustment is not the right approach
Establishing that is part of what the assessment is for. The orthopaedic and neurological screen exists to identify presentations that need something else, and where that is what it finds, you will be told rather than treated.
Where specialist care is the next step, you will get a detailed letter outlining the findings and recommendations, including the specialist we believe is best suited to your needs.
What it is used with
- Massage therapy for the muscular guarding around a restricted segment
- Dry needling, where trigger points are part of the picture
- Rehabilitation exercises, so the range gained in an appointment gets used between appointments
- Posture correction, where sustained position is what keeps re-creating the restriction
Most commonly used for lower back pain, neck pain, sciatica and headaches with a neck component.
Frequently asked questions
What is the difference between a spinal adjustment and a chiropractic adjustment?
Nothing, in practice. 'Chiropractic adjustment' names who is doing it; 'spinal adjustment' names where. Both describe a controlled movement applied to a specific joint. This page covers the spine specifically, the neck, mid back and lower back, while adjustments are also used at the shoulder, hip, foot and jaw.
Does the spine go out of alignment?
Not in the way the phrase suggests. Vertebrae do not slip out of place and get put back. That framing has stuck in everyday language but it misdescribes what happens. What a chiropractor is addressing is a segment that has lost part of its normal movement, and what an adjustment restores is that movement rather than a position.
How often would I need adjusting?
There is no standard schedule here and no package to sign up to. The chiropractor tells you what they expect after the assessment rather than before it, and if chiropractic is not helping you should hear that from them rather than work it out yourself.
Can I be adjusted if I have osteoporosis?
Usually yes, with lower-force technique chosen for it, but tell the chiropractor before your first appointment, because it changes the approach materially. The same applies to recent surgery, a history of fracture, inflammatory arthritis, or if you are taking blood thinners.
Is an adjustment the whole treatment?
Rarely. It usually sits with soft tissue work for the muscular guarding around a restricted segment, and exercises to take home so the movement gained in the appointment is used between appointments. An adjustment on its own, into a body that goes back to the same loads, tends to be needed again.
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