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What is the Difference Between an Adjustment and a Manipulation?

Chiropractic care provides a natural approach to pain management that focuses on the belief that the body can heal itself. Manual therapy is safe and effective, unlike invasive surgery, which often includes a long recovery time and an increase in pain. If you’ve heard of chiropractic medicine then you may have come across the terms spinal manipulation and spinal adjustment, but what’s the difference? The terms adjustment and manipulation are commonly used interchangeably. However, there is a difference between these two techniques.

What is the Distinction Between a Manipulation and An Adjustment?

After a physical exam, a chiropractor can determine if you would benefit more from spinal manipulation or spinal manipulation. Knowing the difference between these two techniques will help you make informed decisions about treatment.

Spinal Adjustments

Before you visit a chiropractor, it’s important that you understand what goes on in the body when you get an adjustment.

A subluxation is a common malfunction of the spine. A subluxation is when misaligned vertebrae pinch spinal nerves. These subluxations can irritate both muscles and nerves causing pain in the extremities and spine. The job of a chiropractor is to identify and remove the subluxations by adjusting the misaligned vertebrae. This technique is called a spinal adjustment.

A chiropractic adjustment is done to unlock the vertebral joint and get the joint to move in the correct direction. By moving the vertebrae back into place via an adjustment, it takes the pressure off the nerves. This lack of pressure minimizes irritation to both the muscles and nerves in that region. Additionally, an adjustment can initiate the healing process in the body. By removing the pressure placed on the nerves, the spinal adjustment will relieve pain and restore normal function to the organ and muscles. A chiropractor will ensure that their patient stays healthy by making sure the spine is subluxation free and that the nerves are working properly.

A chiropractic adjustment is performed by applying a controlled force into the restricted spinal joints. During the process, a patient will hear a popping noise. This noise is gasses that are escaping between the joints. A spinal adjustment should never hurt and most patients report feeling more relaxed and looser after an appointment.

After a Chiropractic Adjustment

After a chiropractic adjustment, a patient may feel a little achy or sore. Fortunately, this resolves within twelve to twenty-four hours. This is very common and normal since the chiropractor moved joints that were unable to move for a long time. If a patient feels sore after an appointment, a chiropractor may recommend applying some ice to the area for fifteen minutes every two to three hours to alleviate or minimize the soreness.

Spinal Manipulation

Joint manipulation targets misaligned joints in the spinal column, to relieve pain and improve physical function.

Spinal manipulation is a simple movement of a joint that focuses on removing a buildup of fluid from the joint and relaxing tight muscles.

A chiropractic manipulation improves nerve function, reduces inflammation, and relieves pressure on the joints.

With spinal manipulation, force is introduced into several segments with the goal of mobilizing the area. Specific vertebrae or joints are not isolated during this process. Contact is made manually with the hands placed over many segments at a time. Whatever joints pop do so without a specific goal in mind. The chiropractor will provide every patient with the same approach. Each patient is first manipulated on their right side, then the left side when the lower back is treated. Next, a patient will lie on their stomach and the chiropractor will move up and down their mid-back, finally approaching the cervical spine, or neck, which is also manipulated from the left and right.

How a Chiropractor Determines the Best Course of Treatment

Unlike adjustments, manipulation does not target a specific joint or region. A manipulation that’s specific is called an adjustment.

Adjustments are very precise. A chiropractor will perform a functional assessment, providing hands-on palpation of each joint to identify and locate any subluxation. This information is then applied to motion x-rays to determine the best course of action. A motion x-ray can help a chiropractor identify which areas should be treated and provide a clear view of the quality of the structure. It will show them what phase of degeneration patient is in, whether chronic or acute, based on the presence or absence of degenerative changes.

The chiropractor will make contact with the subluxated vertebrae segment, position the patient and perform the appropriate adjustment using calculated depth and a specific direction to produce a controlled movement of the vertebrae and inputting kinetic energy in a system that is designed to heal! This precise adjustment is very case-specific and varies from patient to patient.

The Goals of Chiropractic Care

A chiropractor focuses on providing specific, effective, and gentle treatment, without the use of harmful medication. Their goal is also not to mask pain or other symptoms. This is why treatment can effectively reduce pain in the joints and remove pressure on the nerves.

A chiropractor’s goals are not to chase symptoms or pain but to eliminate the cause of pain and other symptoms by improving nerve function. This is why they treat the spine with a patient’s whole body in mind. It’s also important to keep in mind that while a manipulation may seem exactly like an adjustment, only a chiropractor is allowed to adjust the spine. Always be wary of a physical therapist who claims they can adjust a spine. Unless they’re also a licensed chiropractor, they are not trained to provide a specific adjustment like a chiropractor is.

How Can a Chiropractic Adjustment or Joint Manipulation Help?

With consistent chiropractic care and a treatment plan tailored to your needs, our health care professionals can help patients who are suffering from:

  • Acute neck pain/chronic neck pain
  • Acute low-back pain/chronic low-back pain
  • Spinal joint pain
  • Knee and arm pain
  • Pain due to sports-related injuries
  • Pain due to an auto accident

And other types of musculoskeletal pain.

An Effective Nonpharmacologic Treatment

Chiropractic care is a type of nonpharmacologic treatment that’s gentle, safe, and does not come with unwanted side effects or the risk of addiction.

You don’t have to live in chronic pain. With active treatment and regular medical care from a licensed chiropractor, our hands-on treatment can improve your quality of life, reduce pain, increase range of motion, and allow you to reach your wellness goals.

Complementary Health Approaches

Our chiropractors can also work with your other health care providers to create a tailored treatment plan that will provide more effective medical care based on your health condition. Many people who see a chiropractor for chronic pain can also benefit from the following treatments:

  • Massage therapy
  • Physical therapy
  • Acupuncture
  • Heat therapy

Integrative health approaches, combined with chiropractic care can ensure your symptoms and chronic pain are well-managed. Whether you’re suffering from chronic low-back pain, acute low-back pain, or chronic neck pain, chiropractic therapies combined with physical therapy and massage therapy, and other forms of therapy can significantly improve your quality of life, speed up recovery time, and provide effective patient care.

Contact The Chiropractic Doctors Today

If you’d like to learn more about spinal manipulation or spinal adjustments and how they can help eliminate your pain and improve your range of motion, contact our office today to schedule an appointment with one of your experienced, licensed chiropractors. Let us help you on your path to wellness using a natural approach that will promote healing and improve your well-being.

Call our office to book your next appointment, and discover why The Chiropractic Doctors are consistently rated 5 stars by your neighbors!


This article was reviewed and approved by Dr. Matthew Phinney.

If you enjoyed this article, check out these other articles about chiropractic care:
What Happens if I Skip a Chiropractic Appointment?
What is the Impact of Your Mattress on Your Spine?
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