Spine Care

Chiropractic Spinal Mobilization/Manipulation Techniques


Chiropractic spinal mobilization techniques involve the slow and steady movements of the spine’s joints, reestablishing their range of motion. Because it is a slower treatment style, the techniques are done with the hands. However, a chiropractor can use various instruments/tools as well.

Spinal mobilization treatment has the same focus as spinal manipulation. To get the body back to optimal health and allow the body to heal itself naturally. However, there can be various reasons for utilizing spinal stabilization, with treatment depending on the patient’s needs, if there are underlying conditions, previous injury/s, and individual preference.

Some prefer mobilization because it is gentler and does not generate pops or cracking sounds. And the chiropractor’s style/specialization comes into play. Some work in the firm manipulation high-velocity style, while others utilize the softer mobilization style, and others work in combination.

Manipulation High-Velocity Low-Amplitude Techniques

This adjustment re-alignment utilizes the necessary force to release the joint from its restricted motion to improve mobility and reduce pain. There are various types of high-velocity, low-amplitude manipulation approaches. These are the more common manipulation techniques:

Diversified Technique

This high-velocity, the low-amplitude technique is one that is commonly associated with chiropractic manual adjustments. The chiropractor applies a short – low-amplitude, quick, high-velocity thrust of the restricted joints. This is done one at a time to restore the normal range of motion. The patient is positioned in various positions to optimize the adjustment/alignment.

Gonstead Adjustment

The Gonstead technique is another high-velocity low amplitude adjustment. It is similar to the diversified technique. The difference is the evaluation performed to specifically locate the painful joint and positioning of the body as the treatment is performed. Chiropractic or physical therapy chairs and tables can be used to position the patient for optimal treatment, like a cervical chair or a chest-knee table.

Thompson Terminal Point Drop Technique

Here specialized treatment tables with sections that drop down during a high-velocity, low-amplitude thrust. The idea is that as the table drops, the piece drops allow for easier joint movement. A cracking sound can sometimes be heard. It depends on the patient and their condition. This type of manipulation can also be done in a gentle fashion, making it a form of spinal mobilization.

Spinal mobilization

Slow, steady motion/movements are performed to mobilize the joint. Spinal mobilization can be recommended for certain individuals for different reasons:

  • Individual preference for spinal mobilization over spinal manipulation
  • Individuals with a sensitive nervous system can benefit from the gentle technique. This can keep the body from experiencing a negative reaction that can cause muscle spasms or other issues.
  • Individuals with certain conditions could be recommended for spinal mobilization. This could be:
  1. Advanced osteoporosis
  2. Bone pathology
  3. Spinal deformity
  4. Types of inflammatory arthritis
  • Individuals in the acute stage of their condition and experiencing severe pain
  • Obesity can be a factor as the positioning, and the manipulation procedures can be challenging for the provider and the patient requiring a low-force approach.

Mobilization Approaches

The more common spinal mobilization approaches include:

Activator Technique

The Activator is a hand-held, spring-loaded tool that generates a low-force impulse. A patient lies face down on the adjustment table while the chiropractor:

  • Examines leg length
  • Performs muscle testing
  • Adjusts the spine and/or extremity joints

Cox Flexion-Distraction Technique

Here a gentle adjustment is designed to adjust the vertebrae by gently stretching the lower spine. This is usually performed in a series of repetitive slow movements like a steady rocking motion.

Toggle Drop

Here gravity is utilized to apply the adjustment. The chiropractors’ hands are crossed and on top of each other. Then the chiropractor presses down quickly and firmly on the spine while a table section drops. The table sections can be raised and dropped according to the localization of the spinal adjustment.

McKenzie Technique

This technique incorporates active patient involvement, empowerment, and self-care as part of the treatment.

Spinal Release

The chiropractor separates the misaligned vertebrae by applying gentle pressure using the fingertips to restore the spine to a natural position.

Sacro-Occipital Technique – SOT

This technique utilizes wedges/blocks under the pelvis. This allows gravity with added low force to assist the chiropractor to realign the pelvis.

Sciatica Alleviation

All of these techniques can be utilized by a chiropractor for sciatic nerve pain alleviation or can discover other conditions that could mimic sciatica.

Nerve mobilization techniques have been recently used as a method to adjust radiating pain related to disc disease, and in particular, mobilization techniques for the sciatic nerves improve mobility of the sciatic nerves, decrease mechanosensitivity of the nervous system, and heighten compliance of nerve tissues, relieving low back pain.

Jeong, Ui-Cheol et al. “The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain.” Journal of physical therapy science vol. 28,1 (2016): 46-50. doi:10.1589/jpts.28.46

Sciatica Pain Rehabilitation


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Professional Scope of Practice *

The information herein on "Chiropractic Spinal Mobilization/Manipulation Techniques" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

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Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

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