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The 5 Ws of Spinal Manipulation

By Samuel W. Ascioti, DC

In our current Golden Age of Information, consumers have access to unprecedented amounts of knowledge in the palms of their hands. Sometimes, though, there can be too much information out there, and confusion can reign supreme. The same certainly can be applied to the spinal manipulation; although it’s a fancy sounding word, it’s just the term used by the medical community to describe what a chiropractor or any other provider does when he twists your spine into a pretzel and pushes on it in a variety of ways.

Because of this, a chiropractic advocacy group called Foundation for Chiropractic Progress (F4CP) published a small infographic called The 5 Ws of Spinal Manipulation, which sheds some light on who is eligible for spinal manipulation, what it is, when it is performed, where/by who it’s performed, and why. This article will elaborate a tiny bit on them!

WHO: Spinal manipulation has been shown to be appropriate for all ages, demographics, and socio-economic statuses. In our office, we treat patients from all walks of life: farmers, mechanics, corporate executives, medical professionals, police/fire/EMS/ etc. From infants to people approaching 100 years old, spinal manipulation is appropriate for most people.

Spinal Manipulation for All

WHAT: Spinal manipulation can trace its roots back to ancient times; Hippocrates, referred to as the Father of Medicine, devised several treatments designed to treat scoliosis and employed the use of a hands-on thrust into the spine for relief of prominent vertebrae. Currently, doctors of chiropractic (DCs) use spinal manipulation as a go-to method of relieving various musculoskeletal aches and pains. Specifically, the doctor puts the patient’s spine into a certain position to “lock” the joints in the back, and then delivers a thrust into a specific direction to induce movement into said joint. Sometimes this creates a “pop” that most people come to associate with the chiropractic spinal manipulation; this is all well and good, but it’s important for the patient to understand that this “pop” does not mean treatment was successful (or, conversely, that the absence of any “pop” does not mean treatment was unsuccessful).

Ancient Roots of Spinal Manipulation

WHEN: In general, chiropractors utilize chiropractic adjustments when certain signs and symptoms are present. These may include, but are not limited to, pain, loss of range of motion, and injury in an area. After a careful and thorough examination, your chiropractor will determine if you are a candidate for the spinal manipulation.

Spinal Manipulation for Pain

WHERE: In the United States, 94% of spinal manipulations are performed by DCs. Other providers that may perform spinal manipulation include doctors of osteopathy (DOs) and physical therapists (PTs). The vast majority of all spinal manipulations are performed in out-patient, private-office settings, but chiropractors can also be found in local hospitals and the Veterans Affairs system.

WHY: According to the Foundation for Chiropractic Progress, “Proper spinal alignment can help to restore the spine’s structural integrity, reduce pain, initiate the body’s natural healing processes and promote general health and wellness”. As with any sort of medical/chiropractic treatment, your input is valuable. If you do not feel comfortable having your spine manipulated, please let your provider know. There are other ways to treat neuromusculoskeletal conditions that do not involve the use of spinal manipulation – just ask your friendly neighborhood chiropractor!


Foundation For Chiropractic Progress. (n.d.). Retrieved from

Low back pain. (2018, March 22). Retrieved April 30, 2018, from

Pettman, E. (2007). A History of Manipulative Therapy. Retrieved April 30, 2018, from

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