Exploring Chiropractic & Manual Therapy: How Does It Work?
- Julian Simpson
- 4 days ago
- 5 min read
Exploring Chiropractic & Manual Therapy: How Does It Work?
What is manual theray ?
Manual Therapy (MT) is a type of force-based manipulation which has been defined as “passive application of mechanical force to the outside of the body with therapeutic intent, often as part of pain management care (e.g., low-back pain), rehabilitation care, or general wellness and disease prevention”
Techniques associated with MT include soft tissue mobilization (STM), joint mobilization (non-thrust), and manipulation (thrust).
What are the potential treatment mechanisms
biomechanical (altered tissue movement, fluid loading, etc.): This mechanism focuses on the physical aspects of treatment, addressing how tissues move and interact within the body.
neurological (fMRI activation, altered neural conduction, etc.)Additionally, treatments may aim to enhance or modify neural conduction, potentially improving communication between the brain and body, which can be crucial for recovery from injuries or chronic pain conditions.
neuroimmune (release of inflammatory and anti-inflammatory mediators, etc.): This mechanism examines the interplay between the nervous system and the immune response. Treatments may target the release of various mediators that can either promote inflammation or help to reduce inflammation
neurovascular (sympathetic response, etc.): Neurovascular mechanisms pertain to the relationship between the nervous system and blood vessels. Treatment approaches might aim to regulate the sympathetic nervous system's response, which can influence blood flow and vascular health. By managing sympathetic responses, therapies can help reduce conditions such as hypertension or chronic pain syndromes, which are often exacerbated by vascular dysregulation. This can include interventions that promote relaxation and reduce stress, thereby improving overall vascular function.
neurotransmitter and neuropeptide (release of serotonin, beta endorphin, etc.): This mechanism involves the biochemical pathways that utilize neurotransmitters and neuropeptides to mediate pain and emotional responses. Treatments may aim to enhance the release of beneficial neurotransmitters like serotonin, which can improve mood and reduce the perception of pain. Similarly, beta-endorphins, which are natural pain-relieving compounds produced by the body, can be stimulated through various therapies, leading to improved pain management and a sense of well-being.
neuromuscular (altered neuromuscular tone, muscle recruitment): Neuromuscular mechanisms focus on the relationship between the nervous system and muscle function. Treatment strategies may involve exercises and techniques designed to alter neuromuscular tone, which can help in conditions where muscle tightness or weakness is present. By improving muscle recruitment patterns, therapies can enhance functional movement and reduce pain, fostering a more effective rehabilitation process.
neuroendocrine (release of cortisol, etc.): This mechanism investigates how the endocrine system interacts with the nervous system, particularly in response to stress. Treatments may aim to modulate the release of hormones such as cortisol, which is produced in response to stress and can have both beneficial and detrimental effects on the body. By managing stress through various therapeutic modalities, it is possible to achieve a better balance in hormone levels, which can lead to improved health outcomes and enhanced recovery from various conditions.
What can manual thearpy do for you and your health journey ?
MT techniques have demonstrated efficacy/effectiveness in improving range of motion,
reducing disability,
improving function and
modulating pain
Lets discuss the biomechanical changes that occur after a chiropracotr delivers manual thearapy?
reviews reported changes in joint position associated with MT techniques
reviews supported physiological changes in soft tissue associated with MT (such as viscoelastic properties)
reviews reported changes in disc characteristics following MT techniques (e.g., intradiscal pressure)
reviews supported increased disc diffusion
Lets discuss the Neurological changes that occur after a Chiropractor delivers manual thearapy?
Increases in local pressure pain threshold (PPT)
Changes in EEG activity
Changes in Nerve Characteristics
Changes in cerebral blood flow
Improved pain modulation
Reduced temporal summation
Most studies found the time frame for the effects lasted for 4 to 6 weeks after the session with the theapist
What happens to your chemicals after Chiropractic manual therapy?
↑ Substance P (acts as a neurotransmitter and neuromodulator, playing crucial roles in the transmission of pain signals, the regulation of inflammatory responses, and various other physiological processes that are essential for maintaining homeostasis within the body. This neuropeptide is particularly significant in the context of pain perception, as it is released in response to tissue injury and inflammation, thereby amplifying the sensation of pain and contributing to the overall experience of discomfort.
↑ Oxytocin (often referred to as the "love hormone," is produced in the hypothalamus and released into the bloodstream by the posterior pituitary gland. This hormone not only plays a pivotal role in social bonding and emotional regulation but also has been shown to contribute to pain modulation and the reduction of stress levels. Following chiropractic manual therapy, oxytocin levels may increase, promoting a sense of relaxation and well-being, which can be beneficial for recovery and overall health.
↑ β -endorphin (is a type of endogenous opioid peptide that is naturally produced in the brain and acts as the body's natural painkillers, providing relief from discomfort and promoting a sense of euphoria. The release of β-endorphins during chiropractic adjustments can lead to significant pain relief and an improved mood, making it a valuable component of the therapeutic effects of manual therapy.
↑ Neutrophils (are a type of white blood cell that serves as the first line of defense against infection, particularly bacterial infections. They play a critical role in the immune response by quickly responding to sites of injury or infection, where they engulf and destroy pathogens. Chiropractic manual therapy may enhance the circulation and mobilization of neutrophils, thereby improving the body's ability to combat infections and promoting faster healing of tissues..
↑ Neurotensin(is a neuropeptide that modulates various physiological processes, including pain perception, feeding behavior, and the regulation of body temperature. Following chiropractic adjustments, there may be an increase in neurotensin levels, which can contribute to improved pain management and a balanced metabolic state, further enhancing the overall therapeutic effects of the treatment.
Trends towards a decrease in pro-inflammatory cytokines (such as IL-1β and TNF-α) are often observed after chiropractic manual therapy. These cytokines are involved in promoting inflammation and can contribute to various chronic pain conditions. By reducing their levels, chiropractic care may help alleviate inflammation and associated pain, leading to a more favorable healing environment within the body.
Additionally, there is an increase in anti-inflammatory cytokines (such as IL-2 and IL-10) following chiropractic interventions. These cytokines play a vital role in counteracting inflammation and promoting healing processes. The elevation of these protective cytokines can foster a more balanced immune response, aiding in recovery and enhancing the overall benefits of chiropractic treatment.
For more information about how we can help YOU with your pain and improve your underlying dysfunction so the problem doesn’t come back .
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Keter DL, Bialosky JE, Brochetti K, Courtney CA, Funabashi M, Karas S, Learman K, Cook CE. The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews. PLoS One. 2025 Mar 18;20(3):e0319586. doi: 10.1371/journal.pone.0319586. PMID: 40100908; PMCID: PMC11918397.
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