Spinal Manipulation

Spinal manipulation allows us to treat the arthokinematic component of various neuromusculoskeletal conditions.

Physical Therapy for back pain

What is Manipulation?

  • According to Grieve et al, manipulation is “an accurately, localized, single, quick and decisive movement of small amplitude, following careful positioning of the patient. It is not necessarily energetic and is complete before the patient can stop it.”
  • Spinal manipulation often results in sounds or audible cavitations. Although still a topic of debate in the literature, these sounds are likely due to the release of gas from the joint capsule, the bending of collagen fibers that make up the joint capsule, or the separation of membranes that line the joint capsule. Most practitioners anecdotally believe that the audible sounds associated with joint manipulation are an indicator of the successful delivery of the technique.
  • Although manipulation is most commonly applied to the facet joints, which connect the vertebrae in the spine, the technique is also commonly used for the joints of the upper and lower extremity.

Correct Joint Dysfunction

Spinal manipulation allows us to treat the arthokinematic component of various neuromusculoskeletal conditions. When used as part of a comprehensive physical therapy treatment strategy, it leads to significant improvements in pain and disability.

How can Spinal Manipulation help?

Immediate Change

A number of studies show that spinal manipulation can result in an immediate and lasting change in pain and disability.

Faster Progress

By resetting the balance between sensory afferent and motor discharge, spinal manipulation results in an immediate improvement in muscle tone and perception of joint position.

Tissue Specific

Evidence from the literature suggests that spinal manipulation directly targets deep, uni-axial muscles that are responsible for stabilizing the spine.

Pain Reduction

Manipulation has been shown to result in immediate an lasting reductions in pain via opioid and non-opioid mechanisms.


A number of studies have found that manipulation is a useful strategy to improve performance associated with work-related and athletic tasks.

Effective and Versatile

Manipulation has been shown to be an effective adjunct for a number of neuromusculoskeletal conditions including: headaches (e.g. migraines, tension-type, and cervicogenic), cervicogenic dizziness, somatosensory tinnitus, rib dysfunction, low back pain, lateral epicondylitis, osteoarthritis, carpal tunnel, plantar fasciitis, etc.

Spinal Manipulation

Therapeutic and Specific Results:

  • Manipulation is associated with improved joint position and range of motion along with decreased muscle hypertonicity, reduced pain, and cellular changes that correspond with tissue repair.
  • Manipulation has been shown to rebalance Ad and C pain fiber activity, which has been shown to decrease neural connections associated with centralization at the level of the spine, regardless of patient expectation.
  • Manipulation activates mechanoreceptors in join capsules and associated muscle and connective tissue structures, which quiets motor neuron activity in the spine, thereby decreasing excessive muscle activity and trigger points.
  • Manipulation helps to reset the balance between sensory input and motor output , thereby improving proprioception and biomechanical control.
  • A recent study by Beattie et al reported that spinal manipulation helps to improve transport of water into intervertebral discs, thereby countering changes associated with degenerative disc disease.
  • Manipulation is associated with biochemical, segmental, and central pain inhibition.
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Symmetry Physical Therapy is a privately owned one-on-one, patient-centered physical therapy clinic in Downtown Miami/Brickell. Every treatment is with the same Doctor of Physical Therapy for the entire hour. Symmetry’s specialized, dedicated, and passionate team of physical therapists is fully committed to each patient’s success.

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