| Abstract/Notes |
Objective: The goal of this narrative review was to describe research regarding the potential mechanisms behind spinal manipulation.
Methods: The search was conducted through Google Scholar, PubMed, ResearchGate, and the standard Google search engine. The inclusion criteria had no limit regarding the date or type of research. Keywords used to direct the search were: Spinal Manipulation; Chiropractic adjustment; High Velocity, Low Amplitude; Thrust; Manipulation; Manual Therapy; Lumbar Adjustment; Low Back Adjustment; Lumbar Manipulation; Low Back Manipulation; Thoracic Adjustment; Thoracic Manipulation; Cervical Adjustment; Cervical Manipulation.
Results: 164 papers were used in this review. These include experimental evidence case studies, case series, randomized control trials, research reviews, research articles, population studies, cohort studies, case-control studies, as well as medical textbooks. The underlying mechanism of HVLA thrust, or spinal manipulation (SM) has been highly examined for many years and was further explored in this review. Various theories have been established throughout the literature covering both physiological and neurological mechanisms, such as the local physiological and biochemical changes that occur to the synovial joint structures and surrounding soft tissue- altering synovial fluid viscosity, increasing blood flow, altering tissue pliability and modulating pain perception via gate theory and/or descending inhibition. Neurological effects have also been highlighted regarding the impact of spinal manipulation on the brain via changes to afferent/efferent impulses, potentially altering the state of our immune system, brain neuroplasticity, proprioception, cortical drive and function of the prefrontal cortex.
Conclusion: This review provides a framework for a better understanding of the potential mechanisms involved in spinal manipulation.
Author keywords: Chiropractic; Osteopathy; Spinal Manipulation; Cavitation
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