Although researchers have explored and integrated joint manipulation into physical therapy practice since 1916, medical documentation indicates its use as a component of treatment for over 4000 years. Other professions such as chiropractors and Osteopaths use joint manipulation as well; although techniques can differ among our different professions.
What is the definition of joint manipulation?
We define joint manipulation as applying a rapid stretch to a joint with enough force to induce the release of nitrogen gas. This release of nitrogen gas produces the popping sound we hear. Akin to the sound when removing a suction cup from a window due to the rapid change in pressure releasing the gas bubble. With this change in joint pressure, we achieve neurophysiological (nervous system) and biophysiological (muscular and joint) effects; such as improved muscle function, decreased pain perception and improved joint mobility.
Why is it useful?
Utilizing joint manipulations in physical therapy treatments has proven beneficial, as they have demonstrated a reduction in both the overall duration of therapy and healing time. EMG studies have been able to show increased muscle function/activity immediately following the manipulation which makes it beneficial to use prior to doing our therapeutic exercises as it can help restore correct movement patterns to allow performance of exercises without increased pain.
Who benefits from it?
Healthcare professionals primarily employ joint manipulations in the spine. But can also apply them to joints in the extremities. Including the elbow, wrist, fingers, SI joints, hip, ankle, and feet, when a joint feels stiff or movement is restricted.
Does it hurt?
Techniques taught and used in physical therapy are not painful and most patients are able to report immediate improvement afterward.
Is it safe?
Joint manipulation is very safe, in fact it is safer than taking over the counter NSAID medications. The estimate for the most serious adverse effect from spinal manipulation is 1 case per 100 million. While approximately 30% of users experience side effects from NSAID use.