Mobilization Techniques: Effective, Relaxing and Safe.

How do people change? Gradually, most of the time. Experience percolates through us slowly. How does the body change? Most of the time, also gradually. Healing, physical conditioning and skill learning all take time.

Having come to appreciate this has influenced the techniques I use to treat painful musculoskeletal problems, including back and neck pain. For example, conventional chiropractic treatment usually includes a fast, thrusting adjustment of joints in the neck and/or back. However, over the years my own treatment methods have evolved to include slower, non-thrusting, low-force “mobilization” techniques.

In general, the same pain problems that can be addressed with faster adjusting are also amenable to slower techniques. I even find slower, gentle techniques sometimes address problems with a thoroughness and depth that’s simply harder to match using more conventional “cracking” techniques.

Over the years, and as I’ve deepened my mobilization skills, I’ve also noted other benefits to patients:

Assurance that I’m delivering an effective treatment, in the right way. By using a rapid cycle of assessment, treatment and reassessment, I can test the effect of my treatment methods before committing too heavily to them. For example, suppose I plan to restore pain-free range of motion to a spinal joint. After physical assessment of the joint, treatment starts with a series of small corrective movements based on that initial assessment. The patient and I then re-assess the effect of the corrections. If symptoms are becoming more manageable, then I resume those corrections. But if pain is starting to spread over a wider area instead, then I can change strategies, based on that re-assessment. I can zero in on the most effective strategies in a short time.

This assessment-treatment cycle also allows me flexibility to pair the joint mobilization closely with appropriate soft tissue (e.g. muscle) techniques. It’s even possible to combine the mobilization and soft tissue therapies with focused exercises, to augment the effect of the hands-on therapies even more. In this way we can develop a powerful, customized treatment strategy very quickly.

Safety. Notice that this assessment-treatment cycle allows me to determine whether a manual treatment is likely to make a pain problem worse instead of helping. If a technique for low back pain seems to generate mild leg pain as well, for example, then it’s easy to stop using that treatment strategy, and switch to different strategy right away. That “safety valve” might not be available if I’d started with a more rapid or forceful technique.

The low force used for mobilization techniques also makes it safer than faster manipulation for patients with connective tissue disorders, osteoporosis and sensitive joints (e.g. arthritis).

Comfort. Effective musculoskeletal therapy often requires getting tightened muscles to relax; and that’s often easier when the therapy is relaxed as well. It’s the feeling of persuading change, rather than forcing it.

Patient preference. I hear this from new patients pretty much every week: “I thought about visiting a chiropractor for a long time, but I didn’t want anyone cracking my neck!” After receiving my mobilization treatment, these patients often tell me that this was the type of treatment they were hoping for, and that they’d found the treatment quite comfortable.

I’ve also talked with many patients who have become used to receiving faster adjustments, and have become fond of the “cracking” sensation. Faster adjusting is certainly available in my practice. However those same patients usually find that the lower-force treatment delivers the same results, over about the same period of time. And clinical research so far likewise suggests it works just as well.

Effective. Relaxing. Safe. Sound good?