Spinal Manipulation Therapy (SMT)

Spinal manipulation therapy (SMT)  is a manual therapy technique used by chiropractors and some physical therapists to treat spinal joint pain and discomfort. It involves applying controlled force to specific vertebral joints in the spine to improve mobility and relieve pain.

How does spinal manipulation therapy work?

Spinal manipulation therapy (SMT) involves manual adjustment of the spinal joints by a practitioner, with the aim to reduce pain and improve function.

Force is applied using techniques such as thrusting, twisting, and pulling, which are meant to improve the mobility of the joint and reduce pain or discomfort.  The adjustment involves applying a force to the vertebrae, which can help realign the spinal column and improve its range of motion.

Additionally, it is believed that spinal manipulation therapy may also help to stimulate the release of endorphins, which are natural pain-relieving chemicals in the body.

The exact mechanism of how SMT works is not well understood and requires further scientific investigation.

Who performs spinal manipulation therapy?

Spinal manipulation therapy is typically performed by chiropractors, osteopathic physicians, and physical therapists. These healthcare professionals have received specialized training in the diagnosis and treatment of musculoskeletal conditions, including the use of spinal manipulation therapy.

Benefits of spinal manipulation therapy

Spinal manipulation therapy can offer a number of benefits, including:

  1. Pain relief: Spinal manipulation therapy is effective in reducing pain and discomfort in the back, neck, and other areas of the body.
  2. Improved mobility: Spinal manipulation therapy can help to improve the flexibility and range of motion of the spine and other joints, leading to improved mobility and decreased pain.
  3. Reduced muscle tension: By reducing muscle tension, spinal manipulation therapy can help to reduce pain, improve flexibility, and reduce the risk of injury.

How long does SMT take to work?

Spinal manipulation therapy results vary and can start to provide relief within one to two sessions, although full improvement may take several sessions. It depends on the individual and the severity of their condition.

Risks of spinal manipulation therapy

While spinal manipulation therapy is generally considered safe, there are some potential risks associated with the treatment. These include:

  • Stroke: In rare cases, spinal manipulation therapy has been linked to stroke caused by damage to the vessels in the neck.
  • Nerve damage: Spinal manipulation therapy can sometimes result in nerve damage, causing numbness, tingling, or weakness in the affected area.
  • Disc injury: Spinal manipulation therapy can sometimes result in a disc injury, causing pain, discomfort, or decreased mobility.
  • Headache: Spinal manipulation therapy can sometimes cause headaches, especially if the therapist applies too much force to the neck.

It is important to always discuss potential risks with a licensed healthcare professional before starting spinal manipulation therapy. Additionally, it is important to choose a qualified, experienced therapist who is well-trained in proper techniques to minimize the risk of potential complications.

Who should avoid spinal manipulation therapy?

Spinal manipulation therapy is not suitable for everyone. People who should avoid spinal manipulation therapy include those with:

  1. Spinal fractures or dislocations: Spinal manipulation therapy can further injure broken bones that are not yet healed. 
  2. Osteoporosis: People with osteoporosis have brittle bones, making them more prone to fractures, which could occur during spinal manipulation therapy.
  3. Tumors in the spine: The forces applied may result in tumors spreading or bleeding
  4. Spinal cord compression: People with spinal cord compression could experience further compression during spinal manipulation therapy, leading to paralysis
  5. History of systemic diseases: SMT may worsen inflammation in rheumatoid arthritis or ankylosing spondylitis

It is recommended to seek the advice of a healthcare professional before undergoing spinal manipulation therapy to determine if it is appropriate for you.

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for SpineInfo.com.