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  • Writer's pictureShawn Kocab

The Science Behind Chiropractic Adjustments: How They Work

Chiropractic care has gained widespread recognition and acceptance as a non-invasive treatment for musculoskeletal issues, particularly those involving the spine. Central to chiropractic care is the chiropractic adjustment, a technique used to improve spinal function and alleviate pain. Despite its popularity, there remains some mystery and skepticism about how chiropractic adjustments work. This article delves into the science behind chiropractic adjustments, exploring their mechanisms, benefits, and the evidence supporting their efficacy.

Understanding Chiropractic Adjustments

A chiropractic adjustment, also known as spinal manipulation, involves the application of controlled force to a joint of the spine. The goal is to improve the alignment and function of the spine, reduce pain, and enhance the body’s natural ability to heal itself. Chiropractors are trained to identify areas of spinal dysfunction, known as subluxations or joint restrictions, and correct them through specific manual techniques.

The Mechanisms of Chiropractic Adjustments

The exact mechanisms by which chiropractic adjustments produce therapeutic effects are complex and multifaceted, involving several physiological and biomechanical processes. Here are the key mechanisms:

  • Restoring Joint Mobility

Spinal adjustments aim to restore normal joint mobility by addressing joint restrictions or fixations. When a joint is restricted, it can cause pain, inflammation, and decreased range of motion. Chiropractic adjustments apply a precise force to the affected joint, helping to restore its normal movement and function. This can reduce pain and improve overall mobility.

  • Neurological Effects

Chiropractic adjustments have significant neurological effects, primarily through their impact on the nervous system. The spine houses the spinal cord, a crucial part of the central nervous system that transmits signals between the brain and the rest of the body. Misalignments or dysfunctions in the spine can interfere with these nerve signals, leading to pain, muscle tension, and impaired function. Adjustments help to correct these misalignments, improving nerve function and reducing symptoms.

  • Pain Modulation

Adjustments can modulate pain through several mechanisms. One involves the stimulation of mechanoreceptors in the joints and surrounding tissues. These receptors send signals to the brain that can help to reduce the perception of pain. Additionally, spinal adjustments can release endorphins, the body’s natural painkillers, further alleviating discomfort.

  • Reducing Muscle Tension

Spinal misalignments and joint restrictions can lead to muscle imbalances and increased muscle tension. By restoring proper alignment and joint function, chiropractic adjustments help to reduce muscle tension and promote relaxation. This can alleviate muscle pain and improve overall musculoskeletal function.

  • Improving Circulation

Chiropractic adjustments can improve blood flow to the affected areas by reducing inflammation and restoring normal joint function. Improved circulation facilitates the delivery of oxygen and nutrients to tissues, promoting healing and reducing pain.

Evidence Supporting Chiropractic Adjustments

The effectiveness of chiropractic adjustments is supported by a growing body of research. Numerous studies have investigated the benefits of chiropractic care for various conditions, particularly those related to the spine. Here are some key findings:

  • Low Back Pain

Low back pain is one of the most common reasons people seek chiropractic care. Research indicates that chiropractic adjustments can be effective in managing acute and chronic low back pain. A systematic review published in the Journal of the American Medical Association (JAMA) found that spinal manipulative therapy, including chiropractic adjustments, provided moderate improvements in pain and function for patients with acute low back pain

  • Neck Pain

Neck pain is another condition commonly treated with chiropractic adjustments. A study published in the Annals of Internal Medicine compared spinal manipulation to medication and exercise for acute and subacute neck pain. The results showed that spinal manipulation was more effective than medication and as effective as exercise in reducing pain and improving function

  • Headaches

Chiropractic care has also been shown to benefit patients with headaches, particularly tension-type headaches and migraines. A study in the Journal of Manipulative and Physiological Therapeutics found that chiropractic adjustments significantly reduced the frequency and intensity of headaches in patients with chronic tension-type headaches.

  • Sciatica

Sciatica, a condition characterized by pain radiating along the sciatic nerve, can be effectively managed with chiropractic care. A randomized controlled trial published in the Journal of Manipulative and Physiological Therapeutics demonstrated that patients receiving chiropractic adjustments experienced significant improvements in sciatica symptoms compared to those receiving simulated spinal manipulation.

  • Functional Improvements

Beyond pain relief, chiropractic adjustments can improve overall function and quality of life. Research has shown that chiropractic care can enhance physical function, reduce disability, and improve patient-reported outcomes for various musculoskeletal conditions.

Safety and Considerations

Chiropractic adjustments are generally considered safe when performed by a trained and licensed chiropractor. However, like any medical intervention, they are not without risks. The most common side effects are mild and include temporary soreness or stiffness. Serious complications are rare but can include injuries to the spine or nerves.

To ensure safety and effectiveness, it is crucial to seek care from a qualified chiropractor who conducts a thorough assessment and tailors the treatment to the individual patient’s needs. Contraindications, such as certain types of spinal instability, fractures, or severe osteoporosis, should be carefully evaluated before performing an adjustment.

Integrating Chiropractic Care with Other Treatments

Chiropractic care is often integrated with other treatments to provide a comprehensive approach to managing musculoskeletal conditions. This multidisciplinary approach can enhance the effectiveness of care and improve patient outcomes. Common integrative treatments include:

  • Physical Therapy

Combining chiropractic care with physical therapy can provide a holistic approach to rehabilitation. Physical therapists focus on improving strength, flexibility, and function, complementing the spinal adjustments performed by chiropractors.

  • Massage Therapy

Massage therapy can be used alongside chiropractic adjustments to reduce muscle tension, improve circulation, and promote relaxation. This combination can enhance overall musculoskeletal health and well-being.

  • Exercise and Lifestyle Modifications

Chiropractors often prescribe specific exercises and lifestyle modifications to support spinal health and prevent recurrence of symptoms. These recommendations can include ergonomic adjustments, posture correction, and nutritional advice.

  • Pain Management

For patients with chronic pain, chiropractic care can be part of a broader pain management strategy that includes medications, injections, and other interventions. This integrative approach can help reduce reliance on medications and improve overall pain management.

Real-Life Examples and Case Studies

Real-life examples and case studies can provide valuable insights into the benefits and effectiveness of chiropractic adjustments. Here are a few illustrative cases:

  • Athlete Recovery

Many athletes, including high-profile professionals, use chiropractic care to enhance performance and recover from injuries. For example, NFL quarterback Tom Brady credits chiropractic adjustments for his longevity and sustained performance in football. Regular adjustments help athletes maintain proper alignment, reduce pain, and prevent injuries.

  • Postural Correction

A patient with chronic neck pain and headaches related to poor posture found significant relief through chiropractic care. The chiropractor identified spinal misalignments and muscle imbalances contributing to the symptoms. Through a series of adjustments and postural exercises, the patient experienced reduced pain, improved posture, and enhanced quality of life.

  • Sciatica Management

A patient with debilitating sciatica sought chiropractic care after experiencing limited relief from conventional treatments. The chiropractor performed a thorough assessment and identified a lumbar spine misalignment contributing to the sciatic pain. After a course of adjustments, the patient reported significant improvements in pain and function, allowing them to resume daily activities without discomfort.

The Future of Chiropractic Research

While the current body of research supports the efficacy of chiropractic adjustments for various conditions, ongoing research is essential to further understand their mechanisms and expand their applications. Future studies may explore:

  • Long-Term Outcomes

More research is needed to evaluate the long-term outcomes of chiropractic care, including its impact on chronic conditions and overall health and wellness.

  • Comparative Effectiveness

Comparative studies that evaluate chiropractic care against other treatment modalities can provide insights into its relative effectiveness and inform clinical decision-making.

  • Mechanistic Studies

Investigating the precise physiological and biomechanical mechanisms underlying chiropractic adjustments can enhance our understanding of how they produce therapeutic effects.

  • Integrative Approaches

Research on integrative approaches that combine chiropractic care with other treatments can provide evidence-based guidelines for comprehensive patient management.


Chiropractic adjustments offer a non-invasive, drug-free approach to managing musculoskeletal conditions, particularly those involving the spine. The science behind chiropractic adjustments involves restoring joint mobility, modulating pain, improving nerve function, reducing muscle tension, and enhancing circulation. Supported by a growing body of research, chiropractic care has been shown to be effective for conditions such as low back pain, neck pain, headaches, and sciatica.

When performed by a qualified chiropractor, chiropractic adjustments are generally safe and can be integrated with other treatments to provide a holistic approach to patient care. As research continues to explore the mechanisms and applications of chiropractic adjustments, their role in promoting health and wellness is likely to expand, offering valuable benefits to patients seeking relief from musculoskeletal pain and dysfunction.

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