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Is there really such a thing as a gentle, quiet spinal adjustment? Sure there is!

A chiropractic physician is typically trained in a variety of techniques that can be used to safely and effectively adjust your spine. This is important because having this flexibility allows the doctor to tailor his or her treatment to the patient’s specific needs and preferences.

To perform an adjustment, the chiropractor must apply some type of pressure to a specific area of the back, but this pressure can be applied in many different ways to suit the situation. In the most basic terms, the techniques used by chiropractors vary by velocity, amplitude, duration and frequency. They are also sometimes distinguished by whether the chiropractor uses only his hands (termed “manual” adjustment) or uses some type of device (called “instrument” or “computer” adjusting).

Today, most spinal manipulation is done using “high velocity, low amplitude” (HVLA) approaches, in which the chiropractor applies targeted force using a series of quick, short movements to bring the spinal column back into alignment. This is the type of adjustment that often produces a “popping” or “cracking” sound that some people love but others find a bit disturbing.

However, there are also circumstances when other methods may be more appropriate. These usually involve cases where the patient’s body may be fragile (for instance, because of old age or a recent injury) or the patient is particularly nervous about the treatment (perhaps a child, a first-time patient or someone who is bothered by the sound of a traditional adjustment). In these sorts of cases, low-force techniques reduce the risk of accidental injuries while also improving the patient’s experience. They may also increase the treatment’s effectiveness by minimizing the defensive tensing of muscles that sometimes occurs when a patient is anticipating an HVLA adjustment.


The term “low-force” can be applied in a number of different contexts related to chiropractic care:

  • Palpation is a manual technique used by chiropractors to assess the degree of tension and range of motion in a patient. Chiropractors who practice low-force palpation feel for the first barrier to movement and stop there, which is gentler for the patient than manipulating a joint through increasing pain and resistance.
  • Low-force manual adjusting begins slowly with the goal of applying the smallest amount of pressure necessary to achieve the desired adjustment. Low-force adjustments do not give the same “buzz” to patients as HVLA techniques (which often cause neural receptors in the joint to fire), but this is not always a bad thing. This is especially true for those who are especially sensitive or already in a state of nervous tension or excitement.
  • Instrument adjusting—including the Activator Method–-makes use of a small, hand-held tool (basically a spring-loaded plunger) to deliver a highly-targeted adjustment very quickly and gently.
  • Computerized adjusting combines sophisticated sensors with advanced measurement and analysis technologies to precisely target chiropractic treatments. With this type of equipment (the ProAdjuster is one example), patients experience little more than a gentle “tapping” sensation that stops when the adjustment is complete.
  • Some chiropractors have also adopted low-force methods (or methods that can be modified to apply different degrees of force) for manipulating soft tissue. Post-isometric relaxation, myofascial release and trigger point therapy are three examples of such techniques.

Chances are that your chiropractor uses a combination of techniques. If you’re an experienced chiropractic patient, you may already have some ideas about what works for you and what doesn’t. You may also have clear personal preferences. If you do, we encourage you to let us know. All successful relationships are built on good communication!

If you’ve never tried chiropractic care before and are wondering whether it might be right for you, please call or visit our office today. We’ll be happy to explain our approach!


Additional Resources

Spinal Mobilization: Gentle Chiropractic Techniques. http://www.spine-health.com/treatment/chiropractic/spinal-mobilization-gentle-chiropractic-techniques

Activator Method Chiropractic Technique. http://www.spine-health.com/treatment/chiropractic/activator-method-chiropractic-technique

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