Friday, 15 September 2017 | Author : Flex Free

Joint Manipulation


Joint manipulation is one of manual therapy technique that is used for musculoskeletal problem treatment. Joint manipulation is a type of passive movement of a skeletal joint, using high velocity low amplitude thrusting maneuvers. It is usually aimed at one or more target synovial joints to get a therapeutic effect. The reason behind joint manipulation is to return the joint to a normal level of function by reducing stiffness, increasing the range of motion and/or reducing pain in the joint. Joint manipulation is not a painful technique. You may feel slight discomfort or a sensation of increased pressure around the area of therapy and afterwards you may feel fatigued.

Joint manipulation differs to joint mobilization in terms of the technique used. Joint mobilization is a passive treatment technique that can be performed on peripheral joints (shoulder, knee, ankle, etc) or on the spine. Joint mobilization uses repetitive, oscillatory, gentle pressure to the joint in a specific direction, whereas joint manipulation usually consists of four specific phases:

  1. Positioning of the patient into the most desirable orientation for joint manipulation
  2. Applying pressure to the area to be manipulated
  3. Applying a thrust force to the joint which results in manipulation. This is usually associated with a click or pop that can be heard from the joint (similar to cracking your knuckles)
  4. The unloading phase where the therapist releases the pressure

‘Click’ or ‘Pop’ Sound


Joint manipulation is associated with the ‘click’ or 'pop' sound. This sound is believed to be the result of a phenomenon known as cavitation. When a joint manipulation is performed, the applied force separates the articular surfaces of the joint. This deforms the joint capsule and intra-articular tissues, which in turn creates a reduction in pressure within the joint cavity. In low pressure environment, some of the gases that are dissolved in the synovial fluid create a bubble or cavity. It rapidly collapses upon itself, resulting in a 'clicking' sound.

Joint Manipulation Effects

The clinical effects of joint manipulation include:

  1. Relieving musculoskeletal pain
  2. Unlocks joints, e.g. stiff neck/acute back sprains
  3. Improving joint range of motion

Spinal Joint Side Effects and Risks

Common side effects of spinal joint manipulation therapy are characterized as mild to moderate and may include: local discomfort, headache, tiredness, or radiating discomfort.

There are risks associated with joint manipulation, especially spinal joint manipulation. Potentially serious side effects include: vertebrobasilar accidents (VBA), strokes, spinal disc herniation, vertebral and rib fractures, and cauda equina syndrome.

Spinal Joint Manipulation should only be performed for suitable conditions, and not to be used as routine techniques. (Get more information about spinal manipulation in: Chiropractic dan Manipulasi Tulang Belakang).







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