Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

For Online Access

2001, Volume13

Issue 2-3

174 pages

Issue price - $326.00

W. Herzog, Ph.D.
University of Calgary, 2500 University Drive, NW, Calgary, AB, T2N 1N4, Canada

The purpose of this review is to critically evaluate the research that has been published in the area of the biomechanics of spinal manipulation. The external forces applied by clinicians on patients during high-speed, low-amplitude treatments are assessed. Then, the corresponding evidence on the effects of these treatments is reviewed. These effects include the relative vertebral movements, the internal forces, the reflex responses and reflex inhibitions, and selected viscerosomatic responses. Finally, the efficacy of spinal manipulation is summarized from a clinical point of view. In summary, high-speed, low-amplitude spinal manipulative treatments are associated with peak forces in excess of the body weight of the treating clinician. These forces create relative vertebral movements in the paraphysiologic zone, but do not cause stresses or strains on the vertebral artery that are of mechanical concern. Spinal manipulative treatments typically produce facet joint cavitation, always result in wide-spread muscular reflex responses of multireceptor origin, cause decreases in muscle inhibition associated with back or joint pain and dysfunction, and have beneficial effects in alleviating pain.

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