Back pain usually happens because of injuries to the muscles in your lower back and their associated structures, typically because of overuse or trauma. It can be very debilitating, making it difficult to move, sleep, or relax. Spinal manipulation is a treatment based in traditional medicine that has been in use for thousands of years. It is believed that Hippocrates, the “father of medicine” used spinal manipulative techniques, as did the ancient Egyptians and many other cultures. Spinal manipulation techniques gained recognition in mainstream medicine during the 80s and are now re-emerging as an accepted form of therapy for back pain. Spinal manipulation is routinely provided by organized professional groups in the US, including chiropractors, osteopaths, physical therapists and some conventional medical doctors. It is known by several other names – for example, chiropractors often refer to manipulation of a spinal joint as an adjustment or spinal manipulative therapy. Practitioners perform spinal adjustment techniques by using their hands or a device to apply a controlled force to a joint of the spine, moving it beyond its passive range of motion. The amount of force applied depends on the type of spinal manipulation technique used. The goal of treatment is to relieve pain and improve physical functioning. What is spinal manipulation used to treat? This therapy has been found to be most effective for the temporary relief of musculoskeletal pain. It also reduces time to recovery from acute back pain and temporarily increases the passive range of motion. Studies suggest that spinal manipulation is as effective for the relief of back pain as other commonly used therapies – such as pain medication, physical therapy, exercises, and the care given by a general practitioner. For instance, one study found that chiropractic care involving spinal adjustment techniques is at least as effective as conventional medical care for up to 18 months. However, less than 20% of participants in this study were pain free at 18 months, regardless of the type of treatment used. An extensive review published in 2010 found that spinal manipulation results in equal or better improvement in pain and function relative to other treatments. Both the American College of Physicians and the American Pain Society recommend that health care practitioners include spinal manipulation as a treatment option for patients who do not improve with self-care options. Clinical evidence also indicates that people suffering from chronic neck pain – not due to whiplash and without arm pain and headaches – show clinically important improvements when treated with spinal manipulation techniques or mobilization. The most common side effects of spinal manipulation such as discomfort in the treated area are minor and go away within 1-2 days. Serious complications are very rare.