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  • John K Maltby II, D.C.

Adjustment vs Manipulation

Adjustment vs. Manipulation. These two words seem to get confused in regards to what Chiropractors do. Spinal Manipulation is the most common term seen written in research papers and other documents. The Medical community prefers this term to the word adjustment. I personally prefer the phrase Specific Spinal Adjustment. It might seem like splitting hairs trying to explain the difference between an adjustment and a manipulation, but I believe it is important.


B.J. Palmer (the developer of Chiropractic) wrote in The Subluxation Specific The Adjustment Specific a definition of the adjustment:


“Each adjustment is individual, special for the person who carries the subluxation; no two adjustments fitting each other, because no two subluxations are exactly the alike.”


In other words, the Specific Chiropractic Adjustment is different for each person because everyone is different.


With a manipulation, a force is introduced into multiple segments with the intent of "mobilizing" the area. No care is taken to isolate the specific joint or vertebrae that might be the cause of an issue. A contact is made with one's hands over several segments at one time and whatever "cracks" does so without a specific goal in mind other than global movement. Physical therapists and massage therapists often manipulate an extremity or a joint while performing their therapy and have been known to give some temporary relief of symptoms.


Another example of a manipulation is when you try and “crack” your own neck or back. What happens is a specific vertebra is subluxated and not moving correctly. Your body adapts the joints around the subluxated one to help your body move more in order to make up for the lack of movement in the subluxated vertebrae. Over time these over worked joints seize up and you get stiff and sore. When you attempt to manipulation your own neck or back yourself you are only releasing compensating joints, and the subluxated one is not being addressed at all. Eventually the same situation happens again and again until you can no longer manipulate anything and by this time there might be some serious damage to the surrounding structures of the subluxated vertebrae. This is when my job is harder and going to a Chiropractor for several Adjustments might be necessary. The above example of someone who is self-manipulating, is someone moving only the compensating vertebra and is not moving the actual cause that is making the stiffness and discomfort happen.


This is what really happens when you "self adjust"
Manipulation vs Adjustment

Manipulation that is SPECIFIC is called an Adjustment.


The adjustment implies that a detailed examination is performed. A functional assessment by the doctor's hands on palpation of each joint to determine where a subluxation might be. Then x-rays are used to see exactly which how the vertebrae has moved in order to know exactly how to apply the specific chiropractic adjustment for this specific subluxation. I would like to mention the importance of proper positioning of a patient when taking the x-rays as well. Proper positioning is important in order to obtain an authentic x-ray of the patient’s spine. This does not mean that some slight variation in position will change the patient’s spinal architecture and nullify the film. There is an overabundance of research to show the position of the patient does not change the listing of the vertebra that is subluxated. By the Chiropractor taking special care to always follow the proper procedures to position the patient correctly every single time an x-ray is taken, means that the greatest amount of information can be taken from the x-ray when the proper positioning and procedures are followed.


When the Chiropractor is setting up for a specific adjustment, we are placing our hands and positioning our whole body to give a specific quick thrust in the proper direction in order to accomplish the specific chiropractic adjustment needed to correct that specific subluxation. Every single adjustment is different for every single subluxation. This is why the adjustment is considered an art form by many chiropractors. We are constantly perfecting our adjusting skills to be able to give the proper adjustment each and every time.


Hand positioning on a C1 vertebra for a specific adjustment
Specific Adjustment

There is a difference and it is important to understand. Gross manipulation of the spine and other joints can give some relief to aches and pains, but do little to address the root cause of those aches and pains. That is why the distinction between the adjustment and manipulation is made, one is for temporary relief of symptoms, the other is to correct the cause of those symptoms and to keep them from returning.


Which would you prefer?



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