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Specialist Orthopaedic Doctors

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Back Pain Injections

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Fluoroscopically Guided Digital X-Ray Injections

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Spinal Manipulation

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Exercise & Rehabilitation Programmes for the Young...

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...and the Not So Young


'Spinal manipulation' is a term used to describe a range of manual therapy techniques applied to the spine. The most common usage relates to a High Velocity Low Amplitude (HVLA) thrust, where the practitioner applies a rapid thrust or impulse. Practitioners perform spinal manipulation by using their hands or a device to apply controlled force to a joint in the spine, moving it just beyond the normal range of motion. Sometimes you may hear a 'click', just like when people 'crack' their knuckles. The aim of the treatment is to relieve pain and improve physical function by regaining normal range of motion and inducing a beneficial neurophysiological effect. Manipulation is not usually intended to be a stand-alone treatment; it tends to be used in conjunction with other techniques within a treatment session.

Spinal manipulation can be performed on any area of the back, from the neck down to the pelvis. Similar techniques can even be used on the ribs. Low back pain is a common condition, for which spinal manipulation is among one of the techniques used in attempts to relieve pain and improve functioning. However, manipulation may be incorporated into a treatment programme for other problems, such as facet lock, facet irritation, disc irritation, trapped nerves, cervicogenic headaches, rib and thoracic spine dysfunctions, sacroiliac dysfunctions and postural related problems. Advanced knowledge and skill in the use of this technique requires training, practice and the development of palpatory skills.

Healthcare professionals such as Osteopaths, Chiropractors, Physiotherapists and some conventional medical doctors are able to practice spinal manipulative techniques. All Osteopaths and Chiropractors and some Physiotherapists learn this technique as part of their initial training. Other therapists are able to learn this skill by completing a postgraduate course in manipulative/manual therapy. Spinal manipulation is relatively safe when performed by a trained and licensed practitioner. The most common side effects experienced include: discomfort in the treated area, headaches or tiredness. These effects are temporary and usually dissipate in 1 to 2 days.