Sciatica is an umbrella term for leg symptoms, pain, numbness, or tingling, caused by irritation or compression of a nerve root as it exits the spine. Most cases resolve with conservative care, and in our Boulder and Lafayette clinics, that usually means a combination of focused exercise, dry needling, and manual therapy. Spinal manipulation is...
If your physical therapist tells you a segment in your low back or neck is stiff, it is fair to ask whether the manipulation has to land on that exact segment. Clinicians were long taught to find the restricted joint and aim straight at it. Two systematic reviews and one randomized trial have since tested...
Spinal manipulation has a solid evidence base for musculoskeletal pain: our articles on manipulation for low back pain and the best treatments for low back pain cover that research directly. The evidence looks very different once you move outside pain and mobility conditions and into the theory that manipulating the spine can influence internal organs...
Spinal manipulation dates back to Hippocrates and ancient Egyptian medicine, but the explanation for why it helps has changed more recently than the treatment itself. Patients often describe it the same way: “my spine was out of place, and the manipulation put it back.” Research has disproven that theory. Imaging taken before and after a...
By Jeff Ryg, PT, DPT, OCS, FAAOMPT If you came in for shoulder pain and your physical therapist started working on your upper back, there’s a reason. The thoracic spine takes part in every overhead movement you make, and thoracic manipulation is one of the quickest ways to reduce shoulder pain in the first few...
If your shoulder pinches when you press overhead, reach for a high hold, or roll onto it at night, there’s a good chance someone has called it impingement. It’s the most common diagnosis behind shoulder pain, and it is also one of the most treatable without surgery. The research points to a consistent plan: specific...
Spinal manipulation has real but limited support for cervicogenic headache, the type that starts in the joints and muscles of the upper neck. Manipulation aimed at the neck gives a small short-term edge over other hands-on treatment, manipulation of the mid-back alone doesn’t ease the headache itself, and neither holds up without exercise behind it....
Spinal manipulation is one of the most researched treatments in physical therapy for low back pain, and the evidence base has grown enough to say something specific: it works differently, and slightly better, depending on whether your pain is new or long-standing. What Spinal Manipulation Actually Does Spinal manipulation is a quick, targeted thrust applied...
A stiff neck can turn ordinary movements into a problem: checking a blind spot, reaching for the overhead bin, even rolling over in bed. The right treatment depends on what’s driving it. A neck that seized up after an awkward night’s sleep often clears on its own in a day or two. Neck pain that...
For most people with low back pain, the treatments with the strongest support are hands-on joint mobilization or manipulation to calm pain early, followed by progressive exercise to build capacity and keep it from coming back. That is the core finding of the current clinical practice guideline for physical therapists, published by George and colleagues...
