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Chiropractic Manipulation/Adjustment 


Doctors of Chiropractic (D.C.) are extensively educated in the assessment and management of conditions that affect neuro-musculoskeletal systems. Based upon the examination findings and indication for care, the chiropractors at Custom Care Chiropractic & Performance will recommend a course of care to help alleviate pain and improve function. Chiropractic care can involve spinal/extra-spinal manipulation/adjustments, soft tissue therapy (mobilization), rehabilitative exercises, and other modalities, when deemed necessary (1).   


The chiropractic manipulation is a manual procedure applying a varying degree of force, directed to one or more dysfunctional hypomobile joint segments. The adjustive techniques are precise and controlled and is designed to introduce motion into a dysfunctional joint. This is done by the doctor using his or her hands or by using a hand-held instrument. The manipulation/adjustment often helps restore joint mobility/function and helps to reduce patient’s pain. Manipulation/adjustment of a joint maybe accompanied by an audible popping sound. The noise is a result of a change of pressure within the joint, as part of the application of the manipulation, and is caused by dispersion of microscopic gas bubbles within the joint (2). This is a natural occurrence and is similar to one cracking the knuckles. 


The chiropractors at Custom Care Chiropractic & Performance Therapy adapts the adjustive technique and procedure to address the age, condition, and specific needs of each patient. 


Benefits of Chiropractic Care include:

  • Relief from neck and back pain (3,4,5,6,7,8)

  • Relief from headaches (9,10,11,12,13)

  • Relief from pregnancy-related backaches (14,15)

  • Correction of hip, gait, and foot problems (16,17)

  • Improved flexibility, stability, balance, and coordination (18,19,20)

  • Prevention of work-related muscle and joint injuries (21,22)

  • Improved function and ability to better perform the activities of daily living (22,23,24) 




1. Scaringe JG, Cooperstein R. Chiropractic manual procedures. In Fundamentals of chiropractic 2003 (pp. 258-260). Mosby Elsevier, St Louis (MO).


2. Evans DW. Mechanisms and effects of spinal high-velocity, low-amplitude thrust manipulation: previous theories. Journal of manipulative and physiological therapeutics. 2002 May 1;25(4):251-62.


3. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of internal medicine. 2017 Apr 4;166(7):514-30.


4. Goertz CM, Long CR, Hondras MA, Petri R, Delgado R, Lawrence DJ, Owens EF, Meeker WC. Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study. Spine. 2013 Apr 15;38(8):627-34.


5. Gross A, Langevin P, Burnie SJ, Bédard‐Brochu MS, Empey B, Dugas E, Faber‐Dobrescu M, Andres C, Graham N, Goldsmith CH, Brønfort G. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews. 2015(9).


6. Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg RP, Shaw L, Watkin R, White E. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Journal of Manipulative and Physiological Therapeutics. 2014 Jan 1;37(1):42-63.


7. Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Annals of internal medicine. 2012 Jan 3;156(1_Part_1):1-0.


8. Dunning JR, Cleland JA, Waldrop MA, Arnot C, Young I, Turner M, Sigurdsson G. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. journal of orthopaedic & sports physical therapy. 2012 Jan;42(1):5-18.


9. Dunning JR, Butts R, Mourad F, Young I, Fernandez-de-las Peñas C, Hagins M, Stanislawski T, Donley J, Buck D, Hooks TR, Cleland JA. Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial. BMC musculoskeletal disorders. 2016 Dec;17(1):1-2.


10. Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, Shaw L, Watkin R, White E. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of manipulative and physiological therapeutics. 2011 Jun 1;34(5):274-89.


11. Haas M, Spegman A, Peterson D, Aickin M, Vavrek D. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. The Spine Journal. 2010 Feb 1;10(2):117-28.


12. McCrory DC, Penzien DB, Hasselblad V, Gray RN. Evidence Report: Behavioral and Physical Treatments of Tension-type and Cervicogenic Headache. Des Moines, IA: Foundation for Chiropractic Education and Research; 2001 Jan.


13. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. Journal of Manipulative and Physiological Therapeutics. 1995;18(3):148.


14. Haavik H, Murphy BA, Kruger J. Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women: A Preliminary Study. Journal of manipulative and physiological therapeutics. 2016 Jun 1;39(5):339-47.


15. George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. American journal of obstetrics and gynecology. 2013 Apr 1;208(4):295-e1..


16. Romeo A, Parazza S, Boschi M, Nava T, Vanti C. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review. Reumatismo. 2013 May 27:63-74.


17. Brantingham JW, Bonnefin D, Perle SM, Cassa TK, Globe G, Pribicevic M, Hicks M, Korporaal C. Manipulative therapy for lower extremity conditions: update of a literature review. Journal of manipulative and physiological therapeutics. 2012 Feb 1;35(2):127-66.


18. Dougherty PE, Hawk C, Weiner DK, Gleberzon B, Andrew K, Killinger L. The role of chiropractic care in older adults. Chiropractic & manual therapies. 2012 Dec 1;20(1):3.


19. Holt KR, Haavik H, Lee AC, Murphy B, Elley CR. Effectiveness of chiropractic care to improve sensorimotor function associated with falls risk in older people: a randomized controlled trial. Journal of manipulative and physiological therapeutics. 2016 May 1;39(4):267-78.


20. Hawk C, Cambron JA, Pfefer MT. Pilot study of the effect of a limited and extended course of chiropractic care on balance, chronic pain, and dizziness in older adults. Journal of manipulative and physiological therapeutics. 2009 Jul 1;32(6):438-47.


21. Krause CA, Kaspin L, Gorman KM, Miller RM. Value of chiropractic services at an on-site health center. Journal of occupational and environmental medicine. 2012 Aug 1;54(8):917-21.


22. Minicozzi SJ, Russell BS. On-Site Chiropractic Care as an Employee Benefit: A Single-Location Case Study. J Chiropr Med. 2017 Sep;16(3):183-188.


23. Bigos S, Bowyer O, Braen G. Acute Lower Back Pain in Adults. Clinical Practice Guideline, Quick Reference Guide Number 14. AHCPR Pub. No 95-0643. Rockville: U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1994.


24. Monzani L, Espí-López GV, Zurriaga R, Andersen LL. Manual therapy for tension-type headache related to quality of work life and work presenteeism: Secondary analysis of a randomized controlled trial. Complementary Therapies in Medicine. 2016 Apr 1;25:86-91.

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