True Chiropractic Heidelberg • Chiropractic Blog
What Is a Chiropractic Adjustment?
What actually happens during an adjustment, why does it make that sound, and is it safe? Dr Nicholas Lee explains the mechanism, the evidence, and what to expect.
Written by Dr Nicholas Lee • AHPRA Registered Chiropractor • True Chiropractic, Heidelberg VIC 3084
Understanding the technique
What Actually Happens During a Chiropractic Adjustment?
A chiropractic adjustment, also called spinal manipulation, is a controlled, high-velocity, low-amplitude thrust applied to a specific spinal joint. The goal is to restore normal movement to a joint that has become restricted, painful, or mechanically dysfunctional.
To understand why this is useful, it helps to understand what a ‘restricted’ spinal joint actually means. Each spinal joint has a normal range of active movement (the range you can voluntarily produce) and a slightly larger range of passive movement that the joint can be taken to but you cannot achieve voluntarily. Beyond that is the paraphysiological space, the small additional range that can only be accessed through a high-velocity thrust. This is the range targeted in a chiropractic adjustment.
The Sound — What Is It?
The characteristic pop or crack associated with spinal manipulation is caused by cavitation, the rapid release of gas (primarily carbon dioxide and nitrogen) from the synovial fluid within the joint capsule. The sound is similar to cracking your knuckles. It is not bones grinding, not something ‘going back into place’, and not an indicator of whether the technique was effective. Many successful adjustments produce no sound at all.
The research and safety
What the Evidence Shows
Spinal manipulation has one of the most substantial evidence bases of any manual therapy technique. Systematic reviews and guidelines from organisations including the Australian Commission on Safety and Quality in Health Care consistently list spinal manipulation as an evidence-supported treatment for acute and chronic low back pain and cervicogenic headache.
Is it safe?
Chiropractic manipulation performed by a registered practitioner following a thorough assessment is considered safe for the vast majority of presentations. Mild temporary side effects: soreness, stiffness, or fatigue for 24–48 hours after a session, occur in a minority of patients and resolve quickly.
Serious adverse events are rare. The most discussed risk, vertebral artery dissection associated with cervical manipulation, has an estimated incidence that is comparable to the risk associated with visiting a GP for neck pain. Current evidence from the American Heart Association Journals estimate this as 1 in 5.85 million. Dr Lee screens for contraindications before any cervical technique is applied and has a variety of techniques to address cervical spine issues.
Manipulation is not the only tool
At True Chiropractic, spinal manipulation is one component of care, not the entire treatment. Each session may also include mobilisation, soft tissue therapy, postural correction, exercise prescription, and ergonomic advice depending on what the assessment indicates. The approach is tailored to your presentation, not a fixed protocol.
Frequently asked questions
Common Questions About Chiropractic Adjustments
Does a chiropractic adjustment hurt?
For most patients, a spinal adjustment is not painful, it is typically felt as a firm pressure followed by a sense of release or relief in the joint. In acutely inflamed presentations some discomfort during the technique is possible, which is why the approach is modified based on your current pain level. Some mild soreness after the session is common and usually resolves within 24–48 hours.
Can I have a chiropractic adjustment if I have osteoporosis?
Osteoporosis is a relative contraindication for high-velocity manipulation. However, chiropractic care does not have to involve manipulation — mobilisation, soft tissue therapy, and exercise prescription are all effective approaches that can be used safely in the presence of osteoporosis. Always disclose your bone density history at your initial assessment.
Why do I sometimes need more than one adjustment?
A single adjustment can provide immediate symptom relief, but lasting change in joint mobility, muscle function, and movement patterns requires repetition. The nervous system learns through repeated input. Just as a single exercise session does not build fitness, a single adjustment does not produce lasting structural change. The number of sessions needed depends on how chronic the problem is and how your body responds.
Book an assessment in Heidelberg
See Dr Nicholas Lee at True Chiropractic
Dr Nicholas Lee • BSc, BHSc/BAppSc (Chiropractic) • AHPRA Registered • 9 years clinical experience
True Chiropractic is located at 124–126 Mount Street, Heidelberg — 2 minutes from Heidelberg Station. Same-week appointments available. No referral required. HICAPS on-site.
Ready to Get Assessed?
True Chiropractic • 124–126 Mount Street, Heidelberg VIC 3084 • No referral needed • Same-week appointments
Important: The information in this article is general in nature and is not a substitute for professional health advice, diagnosis, or treatment. True Chiropractic complies with AHPRA guidelines for health practitioner advertising.