“Bone manipulation” refers to manual techniques applied to the body’s joints to improve their function or reduce discomfort. This practice, known by several names, involves skilled, hands-on methods aimed at restoring normal movement and addressing musculoskeletal issues. The field is diverse, with various practitioners utilizing distinct yet sometimes overlapping techniques.
Primary Terminology
Professional terms for bone manipulation include “spinal manipulation,” “chiropractic adjustment,” and “osteopathic manipulative treatment” (OMT).
Spinal Manipulation
Spinal manipulation is a broad term describing a controlled force applied to a spinal joint, aiming to influence its alignment, motion, or function.
Chiropractic Adjustment
Chiropractic adjustment is a specific type of spinal manipulation performed by chiropractors. It involves hands or specialized instruments to apply a quick, controlled force to a joint, to improve spinal motion and physical function.
Osteopathic Manipulative Treatment (OMT)
Osteopathic manipulative treatment (OMT) is a hands-on approach utilized by Doctors of Osteopathic Medicine (DOs). OMT encompasses techniques from gentle pressure to forceful thrusts, designed to diagnose, treat, and prevent illness or injury by addressing musculoskeletal imbalances.
Joint Mobilization
Joint mobilization, often used in physical therapy, involves passive movement of specific joints to decrease pain and improve range of motion.
What the Procedures Involve
Bone manipulation procedures involve the application of controlled force to a joint. This force can vary in speed and amplitude, ranging from gentle, sustained pressure to a rapid, low-amplitude thrust. These techniques aim to restore normal range of motion, alleviate pain, and improve overall physical function. Practitioners may position the patient in specific ways on a padded table to target the affected area effectively.
During some manipulative procedures, a “popping” or “cracking” sound may be heard, which is known as joint cavitation. This sound occurs when a rapid change in joint volume causes dissolved gases within the synovial fluid to form and then collapse into bubbles. While common, its occurrence does not indicate treatment success or effectiveness. Many effective techniques do not produce this sound.
Who Performs Bone Manipulation
Several healthcare professionals are trained and licensed to perform bone manipulation.
Chiropractors
Chiropractors are primary providers of chiropractic adjustments and spinal manipulation, with training focused on the musculoskeletal system and manual therapy.
Doctors of Osteopathic Medicine (DOs)
Doctors of Osteopathic Medicine (DOs) also use manipulative techniques as part of their medical practice, receiving additional training in osteopathic manipulative medicine (OMM) during their medical education.
Physical Therapists
Physical therapists also employ manual therapy, including joint mobilization and, in some cases, joint manipulation. Physical therapists use these techniques to improve joint function, reduce pain, and restore range of motion as part of rehabilitation. Regardless of the specific profession, these practitioners undergo specialized training to ensure the safe and effective application of manipulative techniques.