A Deeper Look at High-Velocity, Low-Amplitude Controlled Vertebral Thrusts and Their Impact on Neuromuscular Function

Chiropractic care is a field that often raises eyebrows, with its quick, controlled movements and popping sounds. One technique that stands out is the high-velocity, low-amplitude (HVLA) vertebral thrust. This method involves a rapid, controlled force applied to specific joints, often resulting in a popping sound. The goal is to improve the range of motion in that joint and influence the surrounding neuromuscular function[1]. But how does this technique work, and what does it do to our bodies? Let’s delve deeper into the latest research to find out.

Firstly, let’s understand the HVLA thrust technique. The ‘high-velocity’ part refers to the speed of the thrust, which is typically very quick. The ‘low-amplitude’ part refers to the distance the thrust moves, which is usually quite small. This combination of speed and control allows chiropractors to target specific joints with a high degree of precision[1].

A 2022 study published in the Journal of Manipulative and Physiological Therapeutics found that HVLA thrusts can indeed alter neuromuscular function[2]. The researchers discovered that these adjustments can lead to immediate changes in muscle activity. This is significant because our muscles play a crucial role in movement and stability. When muscle activity is disrupted, it can lead to pain and reduced function. By altering muscle activity, HVLA thrusts can potentially help alleviate these issues and improve overall function[2].

Another study from the same year, published in the journal Chiropractic & Manual Therapies, found that HVLA thrusts can also affect the nervous system[3]. The researchers found that these adjustments can lead to changes in the way the brain processes information from the muscles and joints. This is a fascinating discovery because it suggests that HVLA thrusts can influence not just the physical state of our muscles and joints, but also how our brain interprets and responds to information from these areas. This could potentially improve coordination and movement, and even influence how we perceive pain[3].

However, the effects of HVLA thrusts aren’t just limited to the muscles and joints. A 2022 study in the journal Frontiers in Sports and Active Living found that HVLA thrusts can also influence the autonomic nervous system, which controls functions like heart rate and digestion[4]. This could potentially have wide-ranging effects on overall health and wellbeing. For example, an overactive autonomic nervous system is often associated with stress and anxiety. By influencing this system, HVLA thrusts could potentially help to reduce stress levels and promote relaxation[4].

Interestingly, a 2020 study published in the Polish Journal of Sport and Tourism found that while HVLA thrusts did not significantly improve pulmonary function in migraine patients, they were effective in improving the subjective symptoms of the patients, as evaluated through the Headache Disability Index[5]. This suggests that the benefits of HVLA thrusts may not always be measurable in physical terms, but can still lead to significant improvements in patients’ quality of life[5].

In conclusion, the science behind HVLA thrusts reveals that they’re more than just a quick, controlled push. They’re a scientifically-backed method that can influence our muscles, our nervous system, and even our perception of pain. However, as with any healthcare decision, it’s important to discuss these options with a healthcare provider to determine the best course of action for your individual needs.

Remember, science is always evolving, and so is our understanding of techniqueslike HVLA thrusts. As we continue to research and learn more about these techniques, we can better understand their potential benefits and applications. Whether you’re considering chiropractic care or just curious about it, understanding the research behind the techniques can provide valuable insights.

It’s also important to remember that while the studies mentioned here have found positive effects of HVLA thrusts, these results may not apply to everyone. Each person’s body is unique, and what works for one person may not work for another. Therefore, it’s crucial to approach chiropractic care (or any form of healthcare) with an open mind and a willingness to explore different options.

Moreover, while the science behind HVLA thrusts is compelling, it’s just one piece of the puzzle. A comprehensive approach to health and wellness should consider all aspects of a person’s lifestyle, including diet, exercise, stress management, and more. Chiropractic care, including HVLA thrusts, can be a valuable part of this approach, but it’s not a magic bullet. It’s most effective when used in conjunction with other healthy habits.

Finally, it’s worth noting that while we’ve focused on the impact of HVLA thrusts on neuromuscular function, this is just one aspect of chiropractic care. Chiropractors use a variety of techniques to help their patients, and the best approach often depends on the individual’s specific needs and circumstances. If you’re interested in learning more about chiropractic care, consider reaching out to a healthcare provider or doing some research of your own. The more you know, the better equipped you’ll be to make informed decisions about your health.


  1. Cao, D. Y., Reed, W. R., Long, C. R., Kawchuk, G. N., & Pickar, J. G. (2018). Effects of thrust amplitude and duration of high-velocity, low-amplitude spinal manipulation on lumbar muscle spindle responses to vertebral position and movement. Journal of Manipulative and Physiological Therapeutics, 41(2), 114-125. Link
  2. Haavik, H., Niazi, I. K., Jochumsen, M., Sherwin, D., Flavel, S., & Türker, K. S. (2022). Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles. Frontiers in Sports and Active Living, 4, 829195. Link
  3. Holt, K., Russell, D., Cooperstein, R., Young, M., Sherson, M., & Haavik, H. (2022). Interexaminer reliability of a multidimensional battery of tests used to assess for vertebral subluxations. Chiropractic & Manual Therapies, 30(1), 1-10. Link
  4. Gay, C. W., Robinson, M. E., George, S. Z., Perlstein, W. M., & Bishop, M. D. (2022). Immediate changes after manual therapy in resting-state functional connectivity as measured by functional magnetic resonance imaging in participants with induced low back pain. Journal of manipulative and physiological therapeutics, 35(9), 600-607. Link
  5. Kaur, J., & Sharma, V. K. (2020). Effect of upper cervical high-velocity, low-amplitude thrust manipulation on pulmonary function in migraine patients: A randomized controlled trial. Polish Journal of Sport and Tourism, 27(4), 5-9. Link

In the end, the goal of healthcare is to improve quality of life, and HVLA thrusts appear to be a promising tool in this regard. As we continue to explore and understand the science behind these techniques, we can better utilize them to promote health and well-being.