Dealing with your concernsSpinal Manipulation

This booklet has been adapted by Body Balance from the original produced by the Musculoskeletal Medicine Department at the Royal London Hospital for Integrated Medicine.

The aim of the booklet is to provide you with information about spinal manipulation which is a form of physical therapy. It explains what spinal manipulation is, how it can help treat your problem and how to prepare for your treatment.

You should share this information with your family and your carer if you have one. It is not intended to replace discussion with your consultant. Please do not hesitate to contact a member of the Body Balance team if you have any further questions.


What is spinal manipulation?

Spinal manipulation is a physical therapy and may be practised by doctors, osteopaths, physiotherapists or chiropractors.

This is a patient-centred system of healthcare, which means it is tailored to the individual needs of the patient.

How does spinal manipulation work?

Spinal manipulation increases the mobility of spinal and peripheral joints and relieves muscle spasm. The intended benefits of treatment are to reduce inflammation and pain experienced by the patient.


What are the risks?

Physical therapy is extremely safe. Spinal manipulation consists of a wide range of techniques, including manipulation of the spine, joints and muscles.

Reviews have concluded that spinal manipulation is very safe when performed by a trained and qualified clinician. The most common side effects are generally minor and include feeling tired or experiencing temporary soreness.

Reports indicate that cauda equina syndrome (CES), a significant narrowing of the lower part of the spinal canal in which nerves become pinched and may cause pain, weakness, loss of feeling in one or both legs and bowel or bladder problems may be an extremely rare complication of spinal manipulation. However, it is unclear if there is actually an association between spinal manipulation and CES, since CES usually occurs without spinal manipulation.

In people whose pain is caused by a herniated (slipped) disc, manipulation of the low back appears to have a very low chance of worsening the herniation.

Stroke or paralysis in susceptible patients is a serious and very rare risk associated with specific spinal manipulation of the neck. However, this only occurs once in about 2.5 million treatments.


What alternatives are available?

Body Balance offer a wide range of treatments for similar conditions including acupuncture, muscular massage, stretching and mobilisation and a back education programme. Your consultant will talk to you about all alternatives and explain the risks and benefits to you.


How should I prepare for my consultation?

  • Please arrive on time for your appointment. If you are late this may affect the length of your treatment.
  • Allow 45 minutes for your first session. Sessions after that will probably be shorter.
  • You may need to undress for your treatment to be carried out, so wear clothing that is easy to take off and put on.
  • You should take meals and medicine as normal before your treatment.


What will my consultation involve?

Every patient will have an initial assessment, followed by a course of treatment suitable for their condition if clinically indicated. The osteopath will:

  • Listen and ask questions about your problem. They will also ask you about your general health, other medical care you are receiving or medication you are taking and record this in your case notes. The information you provide is confidential.
  • Examine you. It is likely the osteopath will ask you to remove some of your clothing during the examination. If you would like a member of staff to chaperone please ask or you can ask a friend or relative to accompany you during your treatment.
  • Ask you to make simple movements and stretches, to observe your posture and mobility. Because of the body’s structure, pain or stiffness you are experiencing in one area may be linked to a problem elsewhere.
  • Examine the health of your joints, tissues and ligaments using their hands.


You must tell your consultant if you:

  • are pregnant;
  • have ever experienced a fit, faint or funny turn;
  • have a pacemaker or any other electrical implant;
  • have damaged heart valves;
  • have any joint replacements or implants.



Diagnosis and Treatment

  • Osteopathy specialises in the diagnosis, management, treatment and prevention of musculoskeletal and other related disorders.
  • Your consultant will give you a clear explanation of what they found (diagnosis). They will discuss a treatment plan that is suitable for you and which may include lifestyle changes. They will explain the benefits and any risks of the treatment they are recommending.
  • It is important to understand and agree what the treatment can achieve and the likely number of sessions needed for a noticeable improvement in your wellbeing.
  • Treatment is hands-on and may involve skilled movement of the muscles, spine and joints. Spinal manipulation involves movements of the spine and occasionally, quicker movements that result in the joint making a ‘clicking’ sound.
  • Your consultant will explain what they are doing and will always ask for your consent. Ask questions at any time, if you are unsure of what you have been told or if you have any concerns.
  • Self-help measures and advice on exercise may be offered to assist your recovery, and prevent recurrence or worsening of symptoms.



What should I expect after spinal manipulation?

You may feel sleepy, light-headed, or experience some aching in the areas in which you have been treated. This is quite normal. Sometimes the symptoms of your condition may feel worse after treatment. However, if this does not settle down within 72 hours you may wish to seek advice from your osteopath.

It may take several treatments before you notice any significant improvement. We recommend you continue to attend your appointments even if you do not see any effect at first.


Where can I get more information?

The General Osteopathic Council

The Institute of Osteopathy
http:// www.osteopathy.org/


Body Balance  cannot accept responsibility for information provided by other organisations.