Healthy Blog


Monday, March 20, 2017

Many physiotherapists and osteopaths use a specific technique that’s more commonly known as High Velocity, Low-Amplitude Thrust. This High-velocity Thrust (HVT) is relatively pain-free and gentle and is used to restore the normal functionality of the spinal joints. Spinal manipulation involves sending a short-range, but fast impulse through the spinal joints. This impulse causes the joints to move slightly more than what they are normally used to. If you have ever heard about spinal manipulation; this is what it is.

Spinal manipulation might sometimes feel a little hard on your joints, but it’s not something that you would usually experience if you are going to the right chiropractor. Also, spinal manipulation sometimes is followed by a clicking sound which some patients find disconcerting at first. Don’t worry, it’s not your bones cracking. In fact, that clicking noise is actually going to improve your back’s mobility. Patients who undergo spinal manipulation have reported a relief in their low-back pain (lower back pain).

What causes the clicking sound?
The sound that follows up after a High-velocity Thrust (HVT) is believed to come when the gas, i.e. carbon dioxide, in the joints is released.

The joints in our body are held together by ligaments and connective tissues and enclosed by synovial fluid. When these joints are manipulated, like when you crack your knuckles, the bones are pulled apart, thus causing the connective tissues surroundings those joints to stretch and move apart. When the joints are pulled apart, this leads to an increased volume in the joint cavity, causing a drop in the dissolved gasses within the synovial fluid. The synovial fluid becomes less soluble as a result which forms bubbles within the joint cavity. If the pressure in the joint cavity drops down significantly, it could cause the bubbles to burst. That’s when the clicking sound is made. This is a natural process that’s called cavitation.

Does the clicking sound always occur?
It’s not necessary that a joint manipulation technique would inevitably lead to a clicking sound. The larger the joints that are manipulated, the lesser are the chances that a clicking sound will occur. If you don’t hear a clicking sound, it’s not an implication that the joint manipulation didn’t work; rather, it’s the increased flexibility of the back muscles that proves if the joint manipulation has worked.

Remember that joint manipulation should only be performed by a qualified practitioner to ensure that the technique doesn’t backfire.