Do you to hear the “crack” for an adjustment to be effective?

by Dr. P. Carl Rafey 8. August 2014 09:27

dr. carl rafey

Depending on which patient to ask the crack or pop of a chiropractic adjustment can a gratifying experience.  Some patients "need" that sound and it makes them feel satisfied with the treatment.  Others dread the sounds and would omit it if at all possible as long as the treatment was effective.  But does an adjustment to the spine or extremities need to make a sound to be effective?

The following research article is not so sure:

An audible pop is associated with a high velocity low amplitude manipulation; however, the clinical and mechanistic relevance of the pop is not known. The study observed high velocity low amplitude manipulative-related hypoalgesia to thermal pain sensitivity, and this finding was not dependent upon the presence of a pop.

The verdict is out and it seems to still lack evidence that an audible noise is clinically relevant. 

Source: The Relationship of the Audible Pop to Hypoalgesia Associated with High-Velocity, Low-amplitude Thrust Manipulation: A Secondary Analysis of an Experimental Study in Pain-Free Participants. Joel E.  Bialoksy, PT, Ph.D. et al.Journal of Manipulative and Physiological Therapeutics. February 2010

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The Spinal Column

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