Also called spine adjustment, spinal manipulation is a therapeutic treatment of the spine to relieve back or neck pain. The practice is thought to date back to the ancient Egyptians. The spine's discs are moved, or manipulated, by physical therapists, chiropractors, or osteopathic physicians. Spinal manipulation is often called cracking the joints due to the often loud popping sounds that result; in reality no bone, discs, or cartilage snaps or breaks to create the loud noise, but rather it is made by escaping air or gas bubbles. Arthritic joints do grind together to create some noise; arthritis is joint inflammation that wears away the smooth cartilage cushioning.
While spinal manipulation may relieve neck or back pain in many cases, the pain-relieving effects may not always be long-lasting. There is also the possibility of spinal manipulations causing a stroke, although this risk is considered rare. Harsh twisting, rather than gentle manipulations of the spine's discs, has the most risk for damage.
Health professionals licensed to perform spinal manipulation often use a gentle approach that may include massaging the spine before manipulating it with the hands or medical tools. Chiropractors and other professionals should conduct a physical examination to check for joint inflammation and disc misalignment before adjusting the spinal column. Subluxation refers to the limited movement and other symptoms caused by the misalignment of the joints. Muscle tone may be affected in subluxation; the joints are often painful and tender.
Spinal manipulation is often done on a padded table. Depending on the part of the spinal column affected, the movements could involve large adjustments of the whole spine or small manipulations of individual discs. Stretching and massaging are other techniques used with spinal manipulations. People who are sedentary, or spend a large amount of time sitting, are susceptible to lower back pain due to excess pressure on the spine.
Daniel D. Palmer started the world's first chiropractic college in Davenport, Iowa in 1897. Since then, many others, including college alumni and Palmer's son, B.J., developed the chiropractic discipline. Mainstream medicine hasn't always accepted the chiropractic model or agreed on the concepts of subluxation and spinal manipulation. Chiropractors assert that the medical manipulation of the spinal column does work, but must be done clinically by trained chiropractic professionals. Most chiropractors state that self-manipulation of the joints, such as what is known as neck or knuckle cracking, can be harmful as it may stretch a joint in a way that causes swelling or damage.