• Williams B
• Gyer G

• Manipulation, Spinal
• Open Access Document
• Sound

Objective: Spinal manipulation (high-velocity, low-amplitude) and spinal mobilization (low-velocity, low-amplitude) are both popular manual therapy techniques used by chiropractors, osteopaths and physiotherapists. The most common assumed difference between these two techniques is the cavitation that can occur during spinal manipulation. Through the influence of social media, some have begun to glamorize and prioritize the “cavitation” aspect of spinal manipulation, treating it as a key hallmark of what makes an effective adjustment or treatment. This article examines the key differences between spinal manipulation and spinal mobilization, while highlighting relevant factors such as joint cavitation, clinical efficacy, post-assessment outcomes and contraindications.

Methods: Various sources of literature were used to provide this commentary, including Google Scholar, ResearchGate, PubMed and ScienceDirect. Keywords used to locate the most appropriate and relevant research were spinal manipulation, chiropractic adjustments, high-velocity low-amplitude thrust, low-velocity low amplitude thrust, osteopathic articulation, spinal mobilization, cavitation and tribonucleation.

Results: Research suggests the only difference between mobilization and manipulation as therapeutic modalities is the speed with which they are applied. The priority of the clinician or therapist should not be to chase the “cavitation” nor to pursue the loudest “audible” possible, but rather to achieve effective post-intervention changes that are tangibly recorded during the post-assessment check.

Conclusion: Spinal manipulation and mobilization both provide great utility and versatility across a wide patient demographic while remaining very effective at eliciting significant neurophysical changes. A competent clinician/therapist will know when to use the right tool on a case-by-case basis for the right patient, resulting in the best outcome possible.

Author keywords: Manual Therapy; Cavitation; Spinal Manipulation; Spinal Mobilization; Tribonucleation

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