From a chiropractic perspective, the word ‘manipulation’ could mean a variety of physical interventions, but most of the time when we use this term we mean ‘spinal manipulative therapy’ (SMT). SMT is also often referred to as an adjustment by chiropractors.
What is spinal manipulative therapy?
SMT is a hands-on technique delivered by chiropractors which aims to restore proper movement and alignment of vertebrae. By applying controlled, sudden force to a spinal joint, we aim to improve joint function, relieve pressure on nerves, and reduce pain. SMT will usually result in an audible crack noise as the joint is stretched.
However, SMT goes beyond simple “cracking” sounds; this intervention is grounded in biomechanical principles.
How does SMT work?
At its core, SMT aims to address vertebral subluxations—misalignments or restrictions that may disrupt normal function and normal nervous system communication. Chiropractors conduct a thorough assessment to identify restricted joints and muscle imbalances. During the adjustment, a quick, low amplitude thrust is applied to the target segment. This manoeuvre aims to:
- Restore normal joint mobility and function
- Reduce inflammation around the affected area
- Encourage neurological reset by stimulating proprioceptors
Over time, repeated adjustments could help the body reestablish healthier movement patterns.
Common conditions which may be treated with SMT
Chiropractic care and SMT can benefit a wide range of musculoskeletal issues. Typical conditions include back and neck pain, headaches, joint stiffness, and tension. The table below summarises common presentations and potential outcomes.
| Condition | Typical Symptoms | Potential Benefits of SMT |
| Low back pain | Dull ache, stiffness | Reduced pain, improved mobility |
| Neck pain | Limited range of motion | Increased flexibility, less tension |
| Headaches (of a mechanical origin) | Tension, migraine episodes | Decreased frequency, milder intensity |
| Tension | Tightness, aches, poor posture | Improved suppleness, more relaxed musculature. |
Chiropractic care and SMT can benefit a wide range of musculoskeletal issues. Typical conditions include back and neck pain, headaches, joint stiffness, and tension. The table below summarises common presentations and potential outcomes.
| Condition | Typical Symptoms | Potential Benefits of SMT |
| Low back pain | Dull ache, stiffness | Reduced pain, improved mobility |
| Neck pain | Limited range of motion | Increased flexibility, less tension |
| Headaches (of a mechanical origin) | Tension, migraine episodes | Decreased frequency, milder intensity |
| Tension | Tightness, aches, poor posture | Improved suppleness, more relaxed musculature. |
What to expect during your appointment
Your first visit begins with a detailed history and physical exam. We assess posture, spinal range of motion, and neurological function. After explaining our findings, we will guide you onto the treatment table. You will lie comfortably while we use precise hand placements to perform adjustments. Each thrust is quick and targeted, and often accompanied by other treatment techniques such as soft tissue work or rehabilitative stretches to support lasting results.
Safety and side effects
SMT is widely recognised as safe when performed by trained professionals. Mild soreness or achiness may occur, like what follows a workout. These effects generally subside within 24–48 hours. Serious complications are rare and typically preventable through thorough screening. We review your medical history, imaging, and any red-flag symptoms before recommending SMT. If we feel SMT is not appropriate or warranted we may recommend other treatment techniques.
Anxiety about seeing a chiropractor
Some patients just don’t like the crack! Whether it is anxiety or just a sincere dislike of it. But there are always other options and if you prefer not to have a certain technique, we will endeavour to find what works for you physically and emotionally.
Benefits of integrating SMT into your treatment plan
Incorporating SMT into your health routine could offer multiple advantages:
- Natural pain relief without reliance on medications
- Improved joint function and spinal stability
- Enhanced posture and reduced risk of future injuries
- Support for overall nervous system health
- Complementary therapy alongside exercise, nutrition, and stress management
Why choose Acomb Chiropractic Clinic
Our team combines years of clinical expertise with a patient-centred approach. We tailor every treatment plan to individual goals—whether you are seeking relief from chronic pain or aiming for peak athletic performance. We have advanced training in diversified techniques, activator methods, and drop-table adjustments ensuring safety and precision. Beyond adjustments, we offer rehabilitative exercises, ergonomic advice, and lifestyle coaching to empower you in every aspect of your well-being.
Next Steps: Book your consultation
At Acomb Chiropractic Clinic, we are committed to helping you if we can. If you suspect that your discomfort may be helped by SMT or another technique, we encourage you to contact us for a personalised consultation. Our experienced chiropractic team will conduct a thorough assessment, explain our findings and what we think is possible in clear terms. If appropriate, we will develop a personalised treatment plan tailored to your specific condition and goals, aiming to maximise your possible benefit.
Not all complaints are suitable for chiropractic care or a specific treatment technique. If we think we cannot help your complaint, or you require more investigations, we will do our best to support you in finding another path forward.
Contact our clinic to book a consultation and see if SMT may be an appropriate treatment for you.