The high-velocity, low-amplitude (HVLA) technique is among
the oldest and most frequently used chiropractic techniques. Most chiropractic
clinical research has focused on the evaluating efficacy of this form of spinal
manipulation.
A 2010 review of clinical data concluded that spinal
manipulation is helpful for several conditions in addition to back pain,
including migraine and cervicogenic (neck-related) headaches, neck pain, upper-
and lower-extremity joint conditions, and whiplash-associated disorders. *1
There are many types of HVLA manipulation approaches. This
article describes just the most HVLA spinal manipulation techniques:
Diversified technique: This technique is the form of
high-velocity, low-amplitude thrust that is traditionally associated with
chiropractic manual adjustments. For this method, chiropractors apply a short
(low-amplitude), quick (high-velocity) thrust over restricted joints (one at a
time) with the goal of restoring normal range of motion in the joint. The
patient’s body is positioned in specific ways to optimize the adjustment of the
spine.
Thompson Terminal Point (or Drop) technique: This technique
is the one that I use the most in my office due to the least amount of pain and
the most effective adjustment.
Doctor Clay Thompson patented the Thompson Drop Table in
1957, and today it is used by chiropractors around the world to help patients
improve posture, gain strength and flexibility and prevent injuries.The
Thompson Drop provides a full-spine technique through use of an adjusting table
equipped with a pneumatically driven drop system. This system quickly lowers
the section of your body that corresponds with the area of the spine that’s
being adjusted. This includes the dorsal, lumber and pelvic areas.
Doctor David Thomson offers patients high-speed thrusts,
while using minimal force. While the thrust begins needed movement, the quick
drop brings your joint through the rest of its range of motion.
This involves specialized treatment tables that have
sections that drop a short distance during an HVLA thrust, with the premise
that the dropping of the table piece facilitates the movement of the joint.
This adjustment approach is sometimes used in addition to or, in place of, a
more traditional diversified HVLA adjustment. Here, the traditional
"cracking sound" may or may not occur and therefore this type of
manipulation may also be considered a form of mobilization, or a gentle
adjustment approach.
The sound often heard during an HVLA manipulation is called
cavitation. The pop is caused by a release of gas when the joint is pushed a
short distance past its passive range of motion of the joint. The mechanism is
similar to cracking ones knuckles.
Some clinicians and patients consider an audible pop
necessary for the treatment to be successful, although there is no scientific
physiological data from studies with large patient populations to confirm this
belief. This poping sound is truly just a side effect not true. The objective
is to first align the pelvis, then the mid back with the pelvis and then finally
to align the neck or cervical spine with the rest of the body.