Spinal/joint manipulation: 

It is called as well adjustment or thrust is a High-Velocity Low-Amplitude (HVLA) manoeuvre, where the clinician performs a high-velocity manoeuvre to:

  • reduce the pain;
  • restore the normal range of movement in a joint;
  • reduce the pain; reset the information to the neuromuscular system.


There are different techniques in spinal/joints manipulation. The main distinction is between if the manoeuvre is done within the physiologic range of motion or over the normal range of motion.

Within the physiologic range of motion:  looking at the figure above the manoeuvre will be done within the normal range of movement of the joint. In this case between 0 degrees and 90 degrees.

Over the normal range of motion: looking at the figure above the manoeuvre will be done a few degrees outside the normal range of movement of the joint. In this case, going over the 90 degrees.


At 5 STAR CLINIC, we believe in the importance of our patients’ safety and therefore we perform manipulation within the physiologic range of motion of the joint to further reduce any risks.

Different studies have demonstrated the safety on the neck manipulation. The stresses and strains on the vertebral artery during spinal manipulation were much smaller than those produced during some routine neck movements as well as during some diagnostic procedures.


Spinal/Joint mobilization: 

It is a passive movement applied to a spinal segment or in a joint. It is an accessory physiological movement. It is usually performed to achieve a therapeutic effect.

Evidence suggests that spinal mobilizations cause:

  • sympathoexcitation improved muscle function and reduction in spinal stiffness;
  • neurophysiological effects resulting in hypoalgesia (local and/or distal to mobilization site).

Also, it has been demonstrated that the utilization of passive and active movements of the spine (spinal mobilizations) aid nutrition of the cartilage, covering the zygapophyseal joint surfaces as well as intervertebral disc nutrition.



Ion Lascurain-Aguirrebena, et al. (2016), Mechanism of Action of Spinal Mobilizations A Systematic Review.


DOI: 10.1097/BRS.0000000000001151.

Pickar JG.(2002)Neurophysiological effects of spinal manipulation.


DOI: https://doi.org/10.1016/S1529-9430(02)00400-X

J Man Manip Ther. 2018 Jul;26(3):123-135.. Epub 2017 Nov 20.

Roenz D. et al.,(2018), The impact of pragmatic vs. prescriptive study designs on the outcomes of low back and neck pain when using mobilization or manipulation techniques: a systematic review and meta-analysis.


DOI: 10.1080/10669817.2017.1398923

​Self-Adjustments Videos
Neck, Upper Back
and Lower back