By Mayo Clinic staff
Chiropractic adjustment
Chiropractic adjustment — also called spinal manipulation — involves moving a joint beyond its usual range of motion but not beyond the range of motion the joint is designed to move, anatomically speaking. You often will hear a popping or cracking noise during chiropractic adjustment as the joint is manipulated.

The goal of chiropractic adjustment is to relieve pain and improve your body's physical function. Chiropractic adjustment is performed by a chiropractic doctor; spinal manipulation may be provided by an osteopathic doctor or physical therapist.

Most often people seek chiropractic adjustment as a remedy for pain conditions, including:
Low back pain
Neck pain

Each year in the United States, 1 in 4 adults experiences low back pain — a condition that can be frustrating and difficult to treat. Low back pain is the main reason why people seek chiropractic care. Research shows that chiropractic adjustment may offer mild to moderate relief from low back pain. In some studies, chiropractic adjustment proved to be as effective as other, more conventional treatments.

Chiropractic care is an outgrowth of belief in these concepts:
Your body has a natural and powerful ability to heal itself.
Your body's structure — bones, joints and muscles — and capacity for healthy function are closely intertwined.
Chiropractic treatment helps balance your body's structure and function and promotes self-healing.
Chiropractic adjustment is safe when it's performed by someone trained and licensed to deliver chiropractic care. However, some people experience side effects for a few days after chiropractic adjustment. These may include:
Continuing pain from an injury treated in the past

Chiropractic adjustment poses few serious risks. Possible complications include:
A herniated disk
Compression of nerves in the lower spinal column, a condition known as cauda equina syndrome, leading to pain, weakness, loss of feeling in your legs, and loss of bowel or bladder control
A certain type of stroke (vertebral artery dissection) after neck (cervical) manipulation

Chiropractic care isn't recommended for everyone.
Don't seek chiropractic adjustment if you have osteoporosis or signs or symptoms of nerve damage, such as numbness, tingling, or loss of strength in an arm or leg.
If you've had spinal surgery, check with your surgeon before consulting a chiropractor.
If you have back pain accompanied by fever, chills, sweats or weight loss, see a medical doctor to make sure you don't have an infection or tumor.
No special preparation is required before a chiropractic adjustment.

Chiropractic treatment may require a series of visits to your chiropractic care provider. Ask your care provider about the frequency of visits and be prepared to work them into your schedule. It might be a good idea to bring your calendar along or have an idea of when in your schedule you can fit in visits to the chiropractic office.
Depending on the reason for your visit, your chiropractor may make adjustments to joints in your back or, less frequently, to joints in your neck or some other part of your body, such as your shoulder.

At your initial visit, your chiropractor will:
Ask questions about your health history
Perform a physical exam, particularly of your spine

Your chiropractor may also recommend other examinations or tests, such as an X-ray.

Based on these initial exams, your chiropractor will put together a treatment plan to suit your needs and treatment goals.

During the adjustment
During a typical chiropractic adjustment, your chiropractor places you in specific positions to treat affected areas. Often, you're positioned lying facedown on a specially designed, padded chiropractic table. The chiropractor uses his or her hands to apply a controlled, sudden force to a joint, pushing it beyond its normal range of motion. You may hear popping or cracking sounds as your chiropractor works your joints during the treatment session.

Some chiropractors use adjustment methods that are less forceful. Although safe, these methods haven't been studied to determine their effectiveness.

Additional therapies
Your chiropractor, physical therapist or osteopathic doctor may recommend other treatment approaches in combination with chiropractic adjustment, such as:
Application of heat and ice to affected areas
Electrical stimulation
Lifestyle counseling about healthy eating and weight loss
Dietary supplements

At some point during your treatment course, your chiropractor will evaluate your progress, to see how much your treatments are helping. If you're not making any progress, your treatment plan may be adjusted or your chiropractor may request that you see your medical doctor for further advice.
Chiropractic adjustment can be effective in treating back and neck pain. Just how effective it may be depends on your particular situation. Much of the research done shows only a modest benefit — similar to the benefit of other standard treatments for back pain. Still, a modest effect may be better than tolerating pain, making this therapy something to consider — or at least ask your doctor about.