Spinal Manipulation: Then vs Now 15 years ago, manipulation was sold as “putting joints back in place.” 👉 Same techniques. Outdated story. Today, the evidence is clear: ✅ HVLA works through neurophysiological effects (descending pain control, sensorimotor changes) – not bone realignment. ✅ The pop isn’t the point — cavitation ≠ better outcomes. ✅ Benefits are usually short-term, and strongest when combined with exercise, education & load management. Why it matters: As clinicians, we have to: ✔️

Does the ‘crack’ really matter? A new clinical commentary by Giles Gyer & Brogan Williams @therehabprofessionals explores whether the audible cavitation in spinal manipulation changes clinical outcomes — and what the research really says. Key takeaways: 🔹 Cavitation is not the main driver of patient outcomes — biomechanical, neurophysiological, and contextual effects are just as important. 🔹 Spinal manipulation and spinal mobilisation both have evidence for improving pain and function. 🔹 Clin