Spinal manipulation, also called spinal manipulative therapy or manual therapy, combines moving and jolting joints, massage, exercise, and physical therapy. It’s designed to relieve pressure on joints, reduce inflammation, and improve nerve function. It’s often used to treat back, neck, shoulder, and headache pain. Chiropractors use it to treat other disorders too, such as menstrual pain and sinus problems.

In spinal manipulation, the practitioner uses their hands to apply a controlled, sudden force to a specific joint. Patients often hear popping noises, like when you crack your knuckles.

In spinal mobilization, practitioners use less forceful thrusts and more stretching. They will sometimes use an “activator,” which is a small metal tool that applies force directly to one vertebra.