A chiropractic adjustment, or spinal manipulation, is a procedure where a licensed doctor of chiropractic applies a controlled, sudden force to a specific joint, usually in the spine, to restore proper movement and function. This manual therapy focuses on the musculoskeletal system, aiming to reduce pain and improve physical function. While the process involves precise movements, it is generally considered a low-risk procedure that causes little to no sharp pain during the treatment itself. Any discomfort experienced is typically mild and temporary, often resembling muscle soreness after a new exercise. The primary goal is to improve nervous system communication by ensuring the joints are moving correctly.
Immediate Sensations During Manipulation
The most distinctive sensation experienced during a manual chiropractic adjustment is often a feeling of pressure and a deep stretch as the joint is prepared for the controlled thrust. This pressure is delivered by the practitioner’s hands to position the joint at its end range of motion. The actual adjustment is a swift, directed motion designed to move the joint past its passive range of motion.
Many patients hear an audible “pop” or “crack” during this high-velocity, low-amplitude thrust, a phenomenon known as joint cavitation. This sound is the rapid release of gas bubbles from the synovial fluid that lubricates the joint, not the result of bones grinding or cracking. The sensation associated with this release is generally one of relief, rather than pain. If a patient experiences sharp, stabbing pain during the manipulation, they should communicate this to the practitioner immediately.
Expected Feelings After Treatment
The physical response to a chiropractic adjustment often occurs in the hours following the session, as the body begins to adapt to joint mechanics. The most common delayed side effect is mild muscle soreness or stiffness, often compared to the feeling after a moderate workout. This happens because muscles and ligaments that were compensating for misalignment must now work differently to support the spine’s corrected position.
These transient feelings of discomfort, along with occasional fatigue or a mild headache, are considered normal signs that the body is adjusting. Such symptoms are typically mild, localized to the area that was worked on, and resolve quickly. Most patients find that any post-adjustment soreness disappears within 24 to 48 hours. Staying hydrated and engaging in light movement, like walking, can help reduce this temporary stiffness.
Why Experiences Vary
The intensity of a patient’s sensation during and after an adjustment is highly individualized and is influenced by several factors. A patient’s underlying physical condition plays a significant role, particularly the degree of inflammation present or the chronicity of the injury. When tissues have been restricted or compensating for a long time, the restoration of movement can cause greater initial tenderness as the nervous system and surrounding musculature acclimate.
Different chiropractic techniques also produce varying sensations for the patient. A traditional manual adjustment involves a quick, hands-on force that often results in the audible cavitation sound. In contrast, instrument-assisted techniques, such as the Activator Method, use a small, spring-loaded device to deliver a rapid, low-force impulse. This instrument-based approach is often perceived as gentler and typically produces no audible “pop.” The use of a drop-table, which allows a section of the table to fall slightly during the thrust, also uses gravity to facilitate the adjustment with less manual force.
Patient Safety and Communication
Before any treatment begins, a qualified chiropractor will conduct a detailed patient history and physical examination to ensure the procedure is appropriate and safe. This screening process is designed to identify any contraindications, such as severe osteoporosis or certain vascular conditions, that would require modifying the technique or seeking alternative care. Open communication is paramount throughout the entire process, as the patient is the best judge of their own body’s response.
Patients should feel comfortable telling the practitioner about any discomfort or anxiety before or during the adjustment. If the patient can relax their body, the adjustment is often more effective and less likely to cause muscle guarding or tension. Following the adjustment, patients must be aware of “red flag” symptoms that require immediate medical attention, even though they are rare. These include severe, worsening pain, new onset of numbness or tingling in the limbs, sudden muscle weakness, or loss of bowel or bladder control.