Manipulation High-Velocity Low-Amplitude TechniquesThis adjustment re-alignment utilizes the necessary force to release the joint out of 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:
Thompson Terminal Point Drop TechniqueHere 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 dropped allows for easier movement of the joint. 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 mobilizationSlow steady motion/movements are performed to mobilize the joint. Spinal mobilization can be recommended for certain individuals for different reasons like:
- 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 given a recommendation for spinal mobilization. This could be:
- Advanced osteoporosis
- Bone pathology
- Spinal deformity
- 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 a challenge for the provider and the patient requiring a low force approach.
Mobilization ApproachesThe more common spinal mobilization approaches include:
- Examines leg length
- Performs muscle testing
- Adjusts the spine and/or extremity joints
Cox Flexion-Distraction Technique
Spinal ReleaseThe chiropractor separates the misaligned vertebrae by applying gentle pressure using the fingertips, with the objective to restore the spine back to a natural position.
Sacro-Occipital Technique – SOTThis technique utilizes wedges/blocks under the pelvis. This allows gravity with added low-force to assist the chiropractor to realign the pelvis.
Sciatica AlleviationAll of these techniques can be utilized by a chiropractor for sciatic nerve pain alleviation or can discover other conditions that could be mimicking 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