I have friends who absolutely swear by getting their spine ‘cracked’. It cures their pain straight away, for about a week or so and then the pain returns, followed by another call to the health professional to have the same thing done. Under this paradigm, paying to have your spine ‘cracked’ once a fortnight for all time may help keep your pain at bay. If that’s how you choose to manage your health that is absolutely fine! Honestly- #ProHealthCareProviderChoiceFreedom. If it’s not how you would like to manage your health though, keep reading.

 

Firstly, is it possible for your back to ‘fall out of alignment’, ‘slip out of place’ or need to ‘get cracked back into position’. In my professional opinion and experience: the short answer is no. It is not possible for your skeleton to simply come out of ‘alignment’. There may be positional faults, postural changes, over or under compression of joints, poor muscular control and altered nervous system activity, but…

“At the end of the day, bones do not move themselves,”

therefore if there is a change in position of the joint, something (such as muscles), must have pulled on the bones or produced some sort of torque/rotation. Unless you change whatever force is acting on those bones- cracking them into position is unlikely to change your symptoms in the long term.

 

But it makes my back feel better.

Understanding why getting your spine ‘cracked back into alignment’ feels good is very complex. Certainly a manipulation or adjustment, has the capacity to alter the joint’s position for a small amount of time. The more likely explanation is there are a combination of changes taking place that lead to a change in your symptoms. The manipulation may affect the way the brain processes that area of the body and how it interprets pain being generated at the painful site (higher centre processing). A manipulation can change the nervous system’s circuitry between the painful area and the spinal cord and the local nerves at the site of the pain can also change their behaviour. Don’t get me wrong. These are all good things to happen.

“When you become reliant on adjustments for short term relief, the likely scenario is that the driver of the pain has not been addressed, and therefore long term recovery may not be achieved.”

 

So what is the problem?

The long term consequences of relying on short term fixes such as manipulation may indeed include harm to the joint surfaces. Over a long long time, manipulation and repeated forceful actions may lead to joint changes and early wear and tear. However, the real harm in having manipulations is firstly, that the driver of the pain has not been dealt with. Whether it be poor posture, weakness or control of certain muscles, over compression of joints or non optimal mechanics when moving and exercising, a missed driver for pain is likely to have effects in other areas as well. This can cause a downward spiral, or chain reaction if you like, that may cause other long term health issues, wear and tear and pain later down the track. The second reason that I feel manipulations can be harmful is that it has a really strong potential to create fear for our patients. Fear that their joints could ‘come out of alignment’ at any time. Fear of movement and exercise. Fear that the only thing that can fix them is having them ‘cracked’ back into place, and fear that they will have to continue to have therapy for the rest of their lives. Wouldn’t a more elegant solution be to teach people suffering from pain how to be in control of their condition? By understanding your condition, gaining awareness of your body, the mind-body connection and learning how to harness self-management techniques, you can better gain control of your health, your movement and (sorry for sounding a bit cheesy here) live a more fulfilling and meaningful life! Fear can do awful things to our body, mind and heart, which is why I am so passionate about taking the time to teach patients how to care for their bodies in the most positive and calm way.

 

What should I do instead?

Some pain conditions and injuries are really hard to fix! Some pain drivers are permanent, such as bone damage or congenital conditions. But that doesn’t mean that you can’t be in control of your pain destiny.

“Like all aspects of our health such as diet, hydration and skin care, we must constantly strive toward achieving a healthy and functioning musculoskeletal system.”

Perhaps this means understanding what regular exercise you should be involved in to reduce the effect of the pain driver, or perhaps it just means knowing what strategies to use when your body is over-exerted. But the thing is- you need to be in control of that destiny. Find someone who helps you achieve this and helps you reach the goal of managing your health or pain for the long term. If they can’t help you, try someone else, and try again. Because as health practitioners we all bring different skills and knowledge to our practice. How you care for your precious body is completely up to you. But just remember- this is your one beautiful life!

 

Coming up…

Do you  or someone you care about suffer from pelvis or back pain? For a limited time Calm & Connection are offering pelvis screenings with a qualified physiotherapist for only $20. Reclaim your movement and your life! Book your pelvis check-up with Calm & Connection Physiotherapy by getting in touch online, or phoning 0497 098 881.

Until then…

 

Be kind to yourself,

Julia Berger
Physiotherapist