Many chiropractic treatment techniques are available for use by chiropractors.
Although the chiropractic profession is primarily based on the use of the spinal adjustment, many other techniques exist for treating the spine, as well as other joints and tissues. A modern chiropractor may specialize in spinal adjustments only, or may use a wide range of methods intended to address an array of neuromusculoskeletal and general health issues. Examples include soft tissue therapy, strength training, dry needling (similar to acupuncture), functional electrical stimulation, traction, and nutritional recommendations. Chiropractors may also use other complementary alternative methods as part of a holistic treatment approach.
Contents |
| procedure | % of DCs using it |
% of patients getting it |
|---|---|---|
| Diversified technique |
96.2 | 71.5 |
| Physical fitness/exercise promotion |
98.3 | 64.9 |
| Corrective or therapeutic exercise |
98.3 | 63.2 |
| Ergonomic/postural advice | 97.3 | 61.9 |
| Self-care strategies | 96.6 | 60.6 |
| Activities of daily living | 96.6 | 57.9 |
| Changing risky/unhealthy behaviors |
96.6 | 54.9 |
| Nutritional/dietary recommendations |
97.7 | 51.8 |
| Relaxation/stress reduction recommendations |
96.4 | 50.1 |
| Ice pack/cryotherapy | 94.5 | 48.5 |
| Extremity adjusting | 95.4 | 46.8 |
| Trigger point therapy | 91.0 | 45.3 |
| Disease prevention/ early screening advice |
90.8 | 39.7 |
Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care;[1] in the U.S., chiropractors perform over 90% of all manipulative treatments.[2] Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation.[3] The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates, the "father of medicine" used manipulative techniques,[4] as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine and chiropractic medicine.[5] SMT gained mainstream recognition during the 1980s.[6] Chiropractors consider themselves to be expertly qualified providers of spinal adjustment, manipulation and other manual treatments.[7]
Manipulation under anesthesia or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia.[8] Typically, it is performed on patients who have failed to respond to other forms of treatment.[9]
"Spinal adjustment" and "chiropractic adjustment" are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term "adjustment".
Claims made for the benefits of spinal adjustments range from temporary, palliative (pain relieving) effects to long term wellness and preventive care. Some claims are controversial, particularly with regard to indications and health benefits. There is debate concerning the safety of some of the procedures used in spinal adjustments, particularly those including upper cervical manipulations.
The original spinal adjustment was a variation of a procedure known today as spinal manipulation. This form of treatment has documented use as far back as Hippocrates and the ancient Egyptians and was carried through the ages by families of bonesetters. The modern form of spinal manipulation techniques have characteristic biomechanical features, and are usually associated with an audible "popping" sound. There is strong evidence that this sound is the result of a phenomenon known as cavitation.
Chiropractors may include any of hundreds of available techniques and methods in their practices. The National Board of Chiropractic Examiners has rated the following as the most frequently used techniques, here listed with percentages of chiropractors who use them and patients who are treated with them as of 2003:[1]
| Technique | % of Chiropractors using technique |
% of Patients treated with technique |
| 1. Diversified technique | 96.2 | 71.5 |
| 2. Extremity manipulating/adjusting | 95.4 | 46.8 |
| 3. Activator Methods | 69.9 | 23.9 |
| 4. Thompson | 61.3 | 28.2 |
| 5. Gonstead | 57.2 | 26.2 |
| 6. Cox Flexion/Distraction | 56.5 | 23.5 |
| 7. Sacro Occipital Technique [SOT] | 49.6 | 15.3 |
| 8. Manipulative/Adjustive Instruments | 40.3 | 15.7 |
| 9. Cranial | 38.0 | 10.3 |
| 10. Applied Kinesiology | 37.6 | 12.9 |
| 11. NIMMO/Receptor Tonus | 33.6 | 13.4 |
| 12. Logan Basic | 26.0 | 5.2 |
| 13. Palmer upper cervical [HIO] (Hole-in-One) | 25.7 | 6.7 |
| 14. Pierce-Stillwagon | 15.4 | 5.1 |
| 15. Meric | 15.1 | 4.3 |
| 16. Other | 12.5 | 10.4 |
Over the years, many variations of these techniques have been delivered, most as proprietary techniques developed by individual practitioners. WebMD has made a partial list:[10]
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Most of these techniques can be divided according to the purpose:[11]
Manipulation under anesthesia (MUA) is spinal manipulation performed while the patient is under general anesthesia. This procedure is used in the hospital setting for patients whose condition is unresponsive to other forms of treatment.
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