Spinal Manipulation Therapy (SMT) in Holland Park, Brisbane
If you are researching manual therapy options for musculoskeletal conditions in Holland Park or the surrounding Brisbane suburbs, you may encounter the term Spinal Manipulation Therapy, often abbreviated as SMT. SMT is a specific type of manual therapy utilised by various trained healthcare professionals, including chiropractors. At Silky Oak Chiropractic, SMT is a key technique employed by Dr. Jan Jones within a comprehensive approach to care. It involves the application of controlled forces to joints of the spine with the aim of improving movement, function, and managing related musculoskeletal symptoms. This page provides further information on SMT as offered within our chiropractic practice.
Understanding Spinal Manipulation Therapy (SMT): Characteristics and Approach
Spinal Manipulation Therapy involves specific procedures designed to affect spinal joint mechanics. Understanding its key characteristics is helpful when considering chiropractic care.
1. Aiming to Restore Spinal Joint Motion: A primary objective of SMT is to address joints in the spine that exhibit restricted movement (hypomobility). When spinal joints do not move correctly, it can impact overall spinal function and potentially contribute to symptoms. SMT procedures are designed to introduce movement into these restricted joints, aiming to restore more normal biomechanics.
2. Application of a Controlled Thrust: SMT often involves the application of a controlled, specific force, commonly delivered as a High-Velocity, Low-Amplitude (HVLA) thrust. This technique uses a quick but shallow impulse directed at a specific spinal joint. The intention is to move the joint surfaces briefly, often near or at the end of the joint’s passive range of motion. While HVLA thrusts are common, SMT can also encompass other manual techniques with different force applications. The chiropractor selects the most appropriate technique based on the patient’s condition and assessment findings.
3. The Audible Release (Cavitation or ‘Pop’): An audible ‘pop’ or ‘crack’ sometimes accompanies an HVLA SMT procedure. This phenomenon, known as cavitation, is thought to be caused by the release of gas bubbles (like nitrogen) from the joint’s synovial fluid due to rapid pressure changes during the thrust. It is comparable to cracking one’s knuckles. It is important to understand that this sound is not indicative of bones cracking or damaging structures, and its presence or absence does not necessarily determine the effectiveness of the SMT procedure in improving joint function.
4. Role in Managing Musculoskeletal Pain Conditions: SMT is recognised as a treatment option for several common musculoskeletal conditions, particularly those affecting the spine. Clinical practice guidelines and systematic reviews frequently include SMT as a recommended intervention for non-specific low back pain (both acute and chronic) and certain types of neck pain and related headaches (like cervicogenic headaches). Evidence generally suggests that for these conditions, SMT can provide short-term improvements in pain and function, often comparable in effect size to other recommended conservative treatments such as exercise or certain types of medication (Reference 1, 2, 3). SMT is typically used as part of a multimodal care plan.
5. Potential Influence on Surrounding Tissues: By addressing joint restrictions and potentially modulating pain signals, SMT may also influence the function of surrounding muscles and soft tissues. For instance, it may help in reducing protective muscle guarding or spasm associated with joint dysfunction. Ongoing research continues to investigate the specific biomechanical and neurophysiological effects of SMT on the musculoskeletal system (Reference 4, 5).
6. Focus on Musculoskeletal Health: The application of SMT within chiropractic care is primarily focused on the assessment, diagnosis, and management of disorders related to the musculoskeletal system – the bones, joints, muscles, ligaments, and associated nerves – and their impact on physical function and quality of life.
7. Integration within a Broader Care Strategy: SMT is not typically provided as a standalone treatment. At Silky Oak Chiropractic, it is integrated into a comprehensive patient management approach. This includes a thorough assessment, consideration of contributing factors, and often combines SMT with patient education, advice on posture and ergonomics, targeted exercises and stretches, and potentially other manual therapy techniques (e.g., soft tissue work, joint mobilisation) as appropriate for the individual.
Our Process: Spinal Manipulation Therapy (SMT) at Silky Oak Chiropractic
Providing SMT involves a careful and systematic process focused on safety and effectiveness:
1. Thorough Patient Assessment: Before SMT is considered, a comprehensive assessment is essential. This involves taking a detailed health history, discussing your symptoms and functional limitations, and performing a physical examination. The examination includes relevant orthopaedic, neurological, and musculoskeletal tests, including specific assessment of spinal joint mobility through palpation and movement analysis. This process helps determine the suitability of SMT for your condition and screens for any contraindications (factors that would make SMT inappropriate or unsafe).
2. Identification of Spinal Segments for SMT: Based on the assessment findings, specific spinal joints exhibiting dysfunction relevant to your presentation are identified as potential targets for SMT.
3. Informed Consent Discussion: Dr. Jan Jones will discuss the assessment findings and proposed management plan with you. If SMT is recommended, the procedure, its potential effects, and any relevant considerations will be explained, allowing you to provide informed consent before proceeding.
4. Performing the SMT Procedure: You will be positioned comfortably and securely on a chiropractic table. The chiropractor will use specific hand contacts and body positioning to isolate the targeted spinal joint. A controlled, quick thrust will then be applied. You will likely feel the movement, and may or may not hear the cavitation sound. The procedure itself is generally brief.
5. Re-Assessment: Following the SMT, Dr. Jones may re-assess certain aspects of your spinal mobility or function to evaluate the immediate response to the therapy.
6. Post-SMT Advice and Management: After the procedure, you will usually receive advice on self-care measures. This is a critical part of the process and typically includes guidance on specific exercises or stretches, postural awareness, activity modifications, or the application of heat or cold, as appropriate, to support your recovery and help maintain improvements.
7. Safety and Professional Training: Registered chiropractors in Australia complete extensive university education that includes comprehensive training in diagnostic procedures and the safe application of various manual therapies, including Spinal Manipulation Therapy. Training emphasizes proper technique, patient selection, and identification of contraindications.
References:
(Note: These references point to higher-level evidence regarding spinal manipulative therapy (SMT) for common conditions, consistent with AHPRA requirements.)
- Low Back Pain: Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA. 2017;317(14):1451–1460. (Supports SMT as a treatment option for acute LBP).
- Chronic Low Back Pain: Rubinstein SM, de Zoete A, van Middelkoop M, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:l689. (Supports SMT for chronic LBP, often with moderate certainty evidence for small to moderate effects).
- Neck Pain & Headache: Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther. 2014;37(1):42-63. (Includes recommendations for SMT for certain types of neck pain and headache).
- Neurophysiological Effects (Review): Pickar JG. Neurophysiological effects of spinal manipulation. Spine J. 2002;2(5):357-371. (Discusses potential mechanisms influencing the nervous system).
- Sensorimotor Function (Review): Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyogr Kinesiol. 2012;22(5):768-776. (Explores potential impacts on sensorimotor function).
Disclaimer: The information provided on this page is for general informational purposes only and does not constitute medical or chiropractic advice. It is essential to consult with a qualified healthcare professional, such as a registered chiropractor, for a thorough assessment, diagnosis, and discussion of appropriate treatment options based on your individual circumstances and health status. Do not disregard professional advice or delay seeking it because of something you have read on this website. Spinal Manipulation Therapy, like any healthcare intervention, carries potential risks and benefits. Treatment outcomes can vary between individuals.
