You may have heard of the terms spinal manipulation, chiropractic adjustment, and spinal mobilization but what is the difference? Why is one performed over the other? What conditions require mobilization vs adjustment and who is the right doctor to perform these techniques? 

There are so many questions surrounding these topics so this blog helps answer some including: 

  • What your options are if getting your neck adjusted scares you
  • How adjustment helps with a variety of issues
  • Who to see if you need an adjustment or mobilization 
  • And much more

Please note as you read this blog, do know that the terms adjustment and manipulation mean the same thing!! The term manipulation is introduced to the profession by the insurance industry and the medical counterpart as their best way to describe the ‘adjustment’ performed by Chiropractors. I personally prefer the term adjustment and will be using that in this blog; after all, I don’t want to be ’manipulated’ no matter what topic we are talking about!! 🙂

What is Spinal Mobilization and Physiological Zone?

To better explain adjustment/manipulation v.s mobilization, let’s explore the term physiological zone.

When you move a joint by yourself, that range of movement is called your active range of motion. When it is done by someone else (ex. your neck is moved to the right by someone else so you do not activate your muscles to make the movement) it is called passive range of motion. When the movement is done by yourself or due to let’s say an accident (so passively done) beyond what you can normally do, you enter the physiological zone of movement. 

When you get adjusted or even when you sprain your ankle, you are within that physiological zone!! Okay, don’t freak out thinking your neck or back adjustment are the same as spraining your ankle; the similarity is that they both lead to the physiological zone of the joint. The video below, about 2 minutes in specifically, explains this.

When within the physiological zone, the brain instinctively releases tranquilizers so in case you are in danger (the lion is chasing you), pain can’t stop you and get you killed. This is the reason why you getting adjusted or ‘cracking’ your own neck feels good. You are ‘riding’ on the tranquilizer’s train!

My blog explaining Chiropractic adjustment AKA Spinal Manipulation explains this more in detail.

How Does Spinal Mobilization Work?

To mobilize any joint, including the joints of the spine, the specific joint we are working on can be put through both active range of motion (you do it) or passive range of motion (when your doctor or therapist moves it). When it comes to the spine,

If a joint does not go through the full range of movements regularly, either because of the lifestyle (of let’s say sitting) or previous injuries, fixation, and limitation set in.

Let’s give an example of turning your neck to the right and left. The ideal range of movement is 90 degrees! That means you should be able to turn your head all the way to the right and left so your chin and the top of your shoulder line up. Most people, lose that ideal range of movement; it used to be as they age but now we see it in children because they are on their digital devices quite often. 

The fixation and limited range of movement leads to deterioration of the joint which is referred to as degenerative joint disease, osteoarthritis, or arthritis. Of course, in the past, we only saw it in older patients only because older patients would be going to the doctor for pain, we’d X-ray and see those changes in the joint. 

Now, we see much younger patients with the ‘old patient’ complaints and when x-raying them, we see the same changes in their joints. The notion of arthritis being the disease of the elderly is NOT valid. 

Here is why! Let’s think of a door hanging on its frame; It can be 6 months old but hanging crooked and you will see the wear and tear at the edges. It can be 100 years old and if aligned properly on the frame, all you see is the aged wood! Don’t get fooled by the whole age limitations. Having been in practice for over 2 decades I can comfortably but sadly state that I see the “old people’s” problems in people in their 20’s and 30’s now.🙁

Why Mobilization and Not Adjustment?

Sometimes there is a contraindication to adjustment. Maybe the person has a fused spine, in which case no adjustment can be performed. Of course, in the case of fusion, the fused area cannot be mobilized either.

Maybe the patient is with severe osteoporosis in which case, the amount of pressure over the joint is questionable. In that case, mobilization is a better choice of treatment. 

Sometimes people are afraid to get manually adjusted when there is a cracking noise; the alternative then is to choose a different method of adjustment or mobilize the area. See both techniques used on the same patient but different parts of the spine in the video below. 

What is an Adjustment and How Does it Work?

There are many claims behind what an adjustment is but science now proves that adjustment of the spine, stimulates the nervous system- the very system that controls all functions of your body.

Adjustment is like a dance, a waltz. When two people waltz, there is perfect harmony, there is a flow in movement! It should never be forced and an astute chiropractor looks for subtle signs and clues that the body gives just as she sets the patient up for the manual adjustment. Let me explain here a little bit!

When I perform a manual adjustment on a patient, let’s say of the neck, lifting the head up should be accompanied with no resistance; turning the head to each side, side bending it, and moving it through a rhythm should be done with ease. If the ease is not present, the body is communicating something. Tension, pain, apprehension? Further investigation is in order and it should not be disregarded. Your body has the most amount of information about you than any machine or tool will ever have. Technology is for US, the doctors, to learn more about what is happening on the inside; your brain and body already know all of that!!

The problem rises when chiropractors are too eager to adjust and disregard these subtle communications. If despite many attempts to ‘settle’ the ‘resistance’, it still persists, it is the best choice to use mobilization vs manual adjustment.

Are Adjustments All the Same?

No. There are different adjustment techniques for different patients and they differ based on other factors, however, the goal of all adjustments is the same. Look at it this way: there are different ways to get to your house, some faster than others but they all get you to your home. If one road is under construction, you use the detour to get home, right? Your chiropractor, through examination and history, will determine which ‘path’ is the best way to treat you.

How Do I Find the Best Doctor for Spinal Adjustment and Mobilization?

While Chiropractors are the only doctors that perform adjustments, joint mobilization can be done by both chiropractors and physical therapists.

In today’s day of age when everything is done online, word of mouth is now replaced by reviews. When it comes to reviews, Yelp is NOT the best source! So many legitimate reviews done by real patients get hidden away from the public and Yelp claims their computers randomly do so. What logically does not make sense is how ‘randomly’ over 90 percent of many reviews are hidden away and have been hidden for a long time.

Who knows what their ‘system’ is after all. So far, Google reviews are truthful. When it comes to doctors, the best place to go, is Google. You can always Yelp them after and make sure you scroll all the way down to see the ‘not recommended by yelp’ reviews that are in the lightest shade of gray and semi-readable. Not sure who makes Yelp the authority to even have recommendations! Does it depend on who advertises with them and who does not? They claim no, but I question that!!

Remember, the best techniques done by the wrong people do not work and the right doctor is the one that listens to you, spends time examining you, and is not in a rush to go to the next patient on each visit.

As a DIY’er, I love learning from Youtube and for that reason, have over 600 videos for everyone to use to learn. If you have any questions or are still with an issue that you need help with, contact me.

Dr. Shakib