Spinal manipulation techniques can differ

Dear Mayo Clinic: What happens during a spinal adjustment? Can professionals other than chiropractors safely do spinal adjustments?

Chiropractors commonly perform spinal adjustments, also known as spinal manipulation. But, osteopathic doctors, physical therapists and medical doctors may provide the service, as well.

Specific techniques may differ among practitioners. In general, during spinal manipulation, the practitioner applies a controlled amount of force to a spinal joint, either manually or using a device. Alternatively, a rhythmic force is applied to improve joint motion in your neck, spine and pelvis. The practitioner may use a special table to help perform adjustments better.

Available evidence indicates that spinal manipulation can help with low back pain, especially if the pain is recent and not due to compression of a nerve root. For some people with low back pain, spinal manipulation may be just as effective as conventional care, such as exercise and pain relief medications. There’s also some evidence that spinal manipulation may help common headaches and neck pain.

Spinal manipulation generally is considered to be safe when it’s performed by a trained and licensed practitioner. Common side effects are soreness in the treated area, dizziness or tiredness. These problems typically clear up within one or two days. Serious side effects are very rare, but may include pinching of spinal nerves, resulting in leg pain and weakness or worsening of a herniated disk. High-velocity neck manipulation rarely has been associated with stroke.

Spinal manipulation generally isn’t recommended if you have severe osteoporosis, cancer in your spine, previous spinal surgery or inflammatory arthritis.

If you’re considering spinal manipulation therapy, ask your doctor for a referral. Importantly, let the provider doing the spinal manipulation know about any other conditions you may have and other treatments you may be receiving.