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Chiropractic treatment techniques

Chiropractors typically manipulate the spine to treat patients. DD Palmer is known to have found these techniques in the 19th century.

Spinal manipulation became popular down the line and by now over 200 techniques are used however, there are many differences between them and some with minimal changes.

American Chiropractic Association states that Chiropractors commonly use diversified technique, extremity manipulating/adjusting, Activator methods, Gonstead technique, Cox Flexion/Distraction, Thompson, Sacro Occipital Technique, Applied Kinesiology, NIMMO Tonus, Cranial, Manipulative/Adjustive Instruments, Palmer upper cervical, Logan Basic, Meric and Pierce-Stillwagon.

Chiropractic manipulation does not assist with a medical condition and it treats lower back pain. Its safety is debatable and there are rare cases of strokes and even deaths.


Manual and manipulative therapy

In the late 19th century, osteopathy and chiropractic therapies became popular and in 1980s spinal manipulation received coverage on media. In this technique, hands are utilized to either manipulate or massage the spine and treat issues and it is the most common method used in chiropractic care.

Diversified technique

A non-proprietary and eclectic approach to spinal manipulation used by chiropractors. Joe Janse is credited for using this technique. 96% of chiropractors use it on 70% of their patients. Also used by students studying chiropractic studies. This method uses a high-velocity, low-amplitude thrust and it is a basic chiropractic manipulative technique where the goal is to maintain the original movement of the spine and to correct the joints.

Atlas orthogonal technique

A cervical chiropractic technique credited to Fredrick M. Vogel & Roy W. Sweat (1979). It uses a percussion instrument and adjusts the vertebral subluxation using the x-rays provided. Based on the studies of B. J. Palmer, it uses straight chiropractors. This technique is known as one of the predominant methods to treat the upper cervical spine.

Activator methods

Developed by Arlan Fuhr as a second route to manual manipulation of the spine or joins, this uses a device using mechanical force and is regarded as a light chiropractic treatment technique.

The activator, a small object held in hand is a spring-loaded instrument that sends light impulses to the spine. It sends no more than 0.3 J of kinetic energy in a 3-millisecond pulse. It generates enough force to not cause harm to the vertebrate.

This test asks for the patient to lie in a prone position to compare the leg lengths. Usually, one leg is shorter than the other. The chiropractor then asks the patient to move their arms in a certain position and tests their muscles to make the specific vertebrate muscles active. Improper leg lengths show problems in the vertebra. The problems are treated by the chiropractor along the spine from the feet to the head.

This is a common tool for chiropractors however, it is not identified as an anthropometric technique since legs can usually be of unequal lengths and patients lying in prone positions do not accurately make up for standing x-ray results. Standing positions are more accurate.

The National Board of Chiropractic Examiners found that around 70% of chiropractors used this technique and 23.9% of patients took it. The majority of the chiropractic schools teach this method and around 45,000 chiropractors around the world use this technique.

There are still unanswered queries related to this method even after several studies. However, some studies indicate that the activator may be as effective as manual adjustment of back pain.

Graston Technique

This technique has been trademarked as a therapeutic method to diagnose and treat disorders related to skeletal muscles and related connective tissue. Initiated by David Graston, it uses a collection of 6 stainless steel tools of a certain shape and size and the practitioner rubs the patient’s muscles to soothe tendons. The practitioner must have a license by Graston Technique, LLC to use this technique.

However, this technique has not been completely tested and its evidence is under doubt.

Korean specific technique

Known as KST, this was created by Tedd Koren in 2004. Koren classifies it as “analysis protocol” or “healthcare protocol”. KST may either use hands or “ArthroStim” an electric device that assesses and adjusts. Many universities cover several chiropractic techniques but do not include KST because they believe it is still under observation.

Gonstead technique

Developed by Clarence Gonstead in 1923 is focuses on hands-on adjustment and claims to be better than other diversified techniques by adding x-rays, Gonstead Radiographic Parallel, a measuring device to understand the x-ray better and the Nervo-scope (detects neurophysiologic activity) to the normal hands-on treatment. Around 30% of patients are treated with this technique.

Trigenics Technique

A neurological-based manual or instrument-assisted assessment and treating system created by Allan Oolo Austin, this technique is not commonly used by chiropractors when comparing to other techniques.


Neuro-musculoskeletal disorders

This treatment is related to neck or lower back pain and disorders.

Studies suggest that for acute lower back pain, there is evidence that there are no distinctions between real and sham spine manipulation.

There are varying guidelines, where some advise this therapy for those who receive no help from other treatments. It can be useful for lumbar disc herniation with radiculopathy, mobilizing neck pain, headache, and some joint conditions. Studies and reviews have shown conflicting results and assessments regarding the effectiveness of chiropractic manipulation for treating medical conditions.

Non-musculoskeletal disorders

This is a heated topic under controversy. There is no concrete scientific data that proves SMT to treat these conditions.


Spinal manipulation is known to be cost-effective when it is grouped with other treatments. Evidence states that this is indeed cost-effective to treat lower back pain.


Every treatment requires a detailed medical history, diagnosis and other things.

The topic of safety is under debate and osteoporosis (a contraindication) is ruled out by chiropractors. Even though deaths and severe injuries are rare, there is still controversy around it. Negative events are not reported, and small adverse events regarding SMT happen however, severe injuries related to SMT can happen. But with skill, they can be neglected as well.