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  • Writer's pictureNate Oliveira

Do Chiropractic Adjustments Hurt?

Do Chiropractic Adjustments Hurt?

The short answer is NO - chiropractic manipulations (adjustments) do not hurt! Most people that receive adjustments report that they are painless and provide quick relief for joint and muscle tension. Those who are new to the therapy technique may feel some level of apprehension around receiving an adjustment, especially when it comes to treating the neck. This may cause them to stiffen and guard against the chiropractor during the setup of the adjustment, but once relaxed there should be little to no discomfort during the actual chiropractic adjustment.

For some people receiving their first adjustment, there can be a period where the joints and muscles around the adjusted area may feel slight soreness, but this should resolve completely within 24-48 hours.

What is a chiropractic adjustment?

An adjustment is a manual therapy technique in which the trained clinician will improve the motion of a restricted joint by applying a controlled, rapid force to the joint. This may be done with their hands or a small handheld instrument. This will usually lead to an audible “click” or “pop” (such as popping your knuckles) when the force is applied and is almost always accompanied with a sense of decreased tension in the area. The overall effects of the adjustment is to improve local biomechanics at the joint, which in turn improves its range of motion, decreases the pain/spasm of the surrounding muscles, and improves the brain’s awareness of how that joint is operating.

What does an adjustment feel like?

Typically, people can feel when they have a joint restriction because they feel a sense of pressure in the joint that builds up as they take that joint to end range. It’s commonly described in our office as “it feels like it needs to pop”. During the adjustment, the joint is taken past that point of tension in a controlled impulse, which will have a rapid build up and release of tension in the restricted joint, followed by a feeling of relief and improved motion.

What is the noise I hear during an adjustment?

First – let’s start with what it’s not. It’s NOT bones cracking, ligaments tearing, or anything of the sort. No tissue is being disrupted or damaged during the adjustment. The noise you hear is the temporary creation and collapse of a gas bubble within the joint space. This process has a fancy name: Tribonucleation. Essentially, the two joint surfaces are like two planes of glass that are stuck together by a film of liquid (synovial fluid). This is a pressurized system that is contained within the joint capsule. When the joint is taken to end range and adjusted, the two surfaces will rapidly gap apart – this rapid gapping causes a change in volume, which causes a temporary vacuum that sucks out the gaseous components within the synovial fluid (nitrogen and carbon dioxide) into a small temporary bubble. This bubble rapidly dissolves back into the synovial fluid solution, creating a small popping sound as it does. This event occurs within a matter of milliseconds but is strong enough to create a sound that we can easily hear.

Are Adjustments Safe?

Yes – they are safe and effective for relieving pain associated with joint restrictions. As research methodology has improved over time, there’s been a continual stream of evidence to support the utilization of spinal manipulation in neck, mid back, and low back pain syndromes. Without getting too lost in the weeds, spinal manipulation is a difficult topic to empirically study because of the challenges associated with administering a consistent treatment to a consistent control group and experimental group. One example is that it’s almost impossible to administer the exact same adjustment between two doctors in the same way that no two massage therapists massages will be the exact same. Another example is being able to double blind the study in a way that the chiropractor doesn’t know what treatment he or she is administering. An additional challenge is that “back pain” is an extremely complex and multi-faceted process that is inconsistent from person to person, which is again difficult to replicate in studies.

Despite these challenges, spinal manipulative therapy (SMT) is a recognized and recommended treatment for low back and neck pain by the American Academy of Family Physicians (AAFP).

If you are interested in finding out whether spinal manipulation is right for you, please give Dr. Nate Oliveira a call at (916) 794-5372 or book online at

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