A chiropractic adjustment is a form of manual therapy where a licensed practitioner applies a controlled force to a joint, most commonly in the spine, that is not moving properly. The objective is to restore the joint’s natural range of motion, improve function, and reduce surrounding pain and irritability. Many people feel anxious before their first adjustment because they are unsure what to expect from the physical sensations involved. Understanding the sequence of events can help demystify the process and make the experience a positive one.
The Pre-Adjustment Experience and Positioning
The adjustment process begins with the chiropractor assessing the spine through palpation, which involves touching the joints and surrounding muscles to locate restricted movement. The patient typically lies face down on a specialized chiropractic table designed to support the body. This initial contact involves the sensation of firm, investigative pressure from the doctor’s hands as they look for misalignments or areas of muscle tension.
The pressure applied by the practitioner is generally localized and specific, unlike a broad massage. After identifying the target, the patient is carefully positioned or “set up” to isolate the joint that needs adjusting, which may involve twisting the torso or bending a limb. This setup creates a feeling of tension building in the targeted area. The joint is gently brought to the end of its comfortable range of motion, and the patient feels a focused, sustained pressure as the doctor prepares to deliver the controlled movement.
The Sensation During the Adjustment
The core of the adjustment is typically a High-Velocity, Low-Amplitude (HVLA) thrust, meaning a quick, precise burst of force over a very short distance. When this controlled impulse is delivered, the patient feels a sudden, rapid push or tap at the specific spinal segment. This sensation is extremely fast, often lasting less than 150 milliseconds, and is designed to move the joint just beyond its restricted barrier.
The primary physical feeling is one of intense pressure that instantly relieves tension in the joint. It should feel like a localized movement or release, not a general manipulation of the whole back. While the force may feel strong, the sensation should not be painful, though temporary discomfort can occur if surrounding muscles are tense or inflamed. Many patients describe the sensation as movement in the joint, followed by an instant feeling of “letting go” or release in the surrounding soft tissues.
Understanding the Sound of the Adjustment
A common part of the experience is the audible “pop” or “crack” that frequently accompanies the adjustment. This sound, scientifically referred to as cavitation, is a physical phenomenon that occurs within the joint’s synovial fluid. Synovial fluid lubricates the joints and contains dissolved gases like nitrogen, oxygen, and carbon dioxide.
When the adjustment rapidly separates the joint surfaces, it momentarily reduces the pressure within the joint capsule. This pressure change causes the dissolved gases to quickly form and then collapse a bubble, similar to opening a soda bottle, which produces the characteristic sound. This noise is not caused by bones grinding or “cracking” in a damaging way; it is a byproduct of the pressure change and is considered a harmless, normal physiological event. The sound can sometimes be louder to the person receiving the adjustment, and its presence is not necessary for the adjustment to be effective.
Immediate Post-Adjustment Feelings
Immediately following the adjustment, most people experience a distinct feeling of relief and improved mobility in the treated area. Joints that previously felt stiff or “stuck” may now feel lighter and easier to move through their full range of motion. This initial improvement is partly due to the release of endorphins, which are natural pain-relieving compounds, and the immediate reduction of tension on the nerves and muscles.
It is common to feel a temporary, mild soreness, described as similar to muscle fatigue after a workout, as the body adapts to the new alignment. This soreness is typically mild and short-lived, usually resolving within 24 to 48 hours. Some individuals may also notice a sense of relaxation, or even slight lightheadedness or fatigue. This is thought to be the body reacting to the sudden release of built-up muscle tension and the nervous system adapting to the change.