Spinal Manipulation and the "pop"

I just read an excellent, interesting, and relevant research review of an important concept in the world of physical therapy. Serendipitously, I read this research only moments after a regular patient of mine left the office after we discussed this very topic - the topic of spinal joint "cavitation" - otherwise known as the "popping" sound you hear when you have your joints manipulated.

The question being asked is whether or not it is clinically important to hear the "pop" when manipulating a joint. Does the "pop" lead to improvement of the patient's symptoms or is it simply the act of the manipulation? The latest research sheds some light on this.

First, let's review what the "pop" / cavitation is. The popping/cracking sound you hear when your joint is manipulated/adjusted is the sound of gas escaping the joint space as the two bones are moved. Just like opening a can of soda, as the gas escapes it makes a sound. Bones are not actually "cracking", it just sounds that way. The bottom line with manipulation is that the act of manipulating improves joint mobility, realigns joint position, and reduces pain levels.

Today, in fact moments ago, my patient and I were discussing the fact that her low back spinal joints didn't "pop" when we adjusted them. My previous knowledge of this topic allowed me to explain that the "pop" is not necessary to still achieve mobility, alignment, and pain relief. Well, the research now supports this notion.

This research is and should be encouraging to both therapists and patients. Both therapists and patients can get caught up in the expectation and reliance on the "popping" sound for confirmation that a treatment has been effective. We all should rely more on the process of manipulation, rather than the audible sound it makes.

So, just a quick blog to update you on this important chiropractic topic - just in case you were wondering about the "pop".

Till next time ... thanks for reading!