How it works

Human back with a visible pain

Chiropractic is a well established form of physical therapy that aims to improve physical mobility and decrease pain.  It aims to treat a wide range of physical ailments that affect any and all parts of the body.

Chiropractors use joint manipulation, massage techniques, muscle stretching and strengthening exercises, and various other treatment modalities to alleviate pain and improve flexibility.

Chiropractors commonly treat osteoarthritic conditions, lower back pain, neck pain, headaches, shoulder injuries, hip and knee injuries, shoulder blade pain as well as wrist, ankle and elbow injuries. In short, chiropractors have treatment options for pain conditions anywhere in the body.

There are many tissue types in the body that can be a source of pain.  In the musculoskeletal system, these include joints, muscles, tendons, ligaments, bones, discs, and bursa.  When injured these tissues become inflamed and painful.  The job of the chiropractor is to accurately identify which tissues are inflamed and determine ways to restore these tissues to normal functioning.

Stiffness in a tissue is one of the leading mechanisms of non-traumatic injury. When a joint or muscle is too stiff it is more susceptible to being over-strained.  When a joint or muscle is flexible it has increased capacity to absorb forces applied to them.  Chiropractors spend a lot of time loosening joint tension by way of manipulation, and stretching muscles, to improve overall mobility.  This often leads to a reduction in pain.

Muscle weakness is also a contributor to pain as poor muscle tone or capacity is more easily overloaded than normal strong muscle tissue.  Muscle weakness can also lead to abnormal joint mechanics making them more susceptible to injury.  Muscles can become weak because of long standing injury, inactivity and localised inflammatory conditions.

Joint Pain

Throughout the body and especially the spinal column, joints are a significant source of pain. Joints typically become stiff and inflamed.  Small joints are particularly susceptible to stiffening.

Most non-traumatic back pain is the result of stiff and inflamed spinal (facet) joints. When a facet joint is inflamed, the swelling and pain impede normal joint movement. When inflammation is prolonged or recurs frequently, the inflammation can further restrict normal movement as excessive collagen can be deposited in and around the joints making them progressively stiffer.

Chiropractors identify these joint restrictions by finding vertebral segments that are stiff, inflamed and painful. The chiropractic adjustment endeavors to restore normal joint movement by freeing up joint restriction and improving the ability of the joint to lubricate itself. This allows the joint to work more normally. Swelling subsides from the joints as the body recognises that joint mobility has improved.


An animation of vertebral joint stiffness and inflammation.
In this animation, the facet joint between the bottom two vertebra on the right is inflamed. This is impeding normal spinal movement. The top two vertebrae are moving normally. A chiropractic adjustment is a short specific thrust which can improve mobility in a restricted vertebral joint. This results in a reduction in joint stiffness, and may decrease swelling and pain.

Joints can become injured in numerous ways:

  • Trauma can result in sprains, strains, fractures and dislocations resulting in joint damage, inflammation and pain;
  • Inactivity or immobilisation can result in stiffness in a joint which is then easily strained;
  • Staying in an asymmetrical position for long periods can over-extend a joint and make it difficult to return to normal movement;
  • Overloading a joint can strain the tissues resulting in inflammation, stiffness and pain;
  • Preexisting osteoarthritis makes the joint more susceptible to being over-strained;
  • Inflammatory conditions, autoimmune conditions, and other medical conditions can lead to joint stiffness and potential injury.

How does inflammation affect joints?

Surrounding the inner surface of a joint is the synovial membrane, which produces and contains the synovial fluid (a lubricating fluid that helps reduce friction between the joint surfaces and provides nutrients to the cartilage).  When the synovial membrane becomes inflamed it can produce excessive amounts of synovial fluid which accumulates in the joint space resulting in swelling, pain, warmth and stiffness in and around the affected joint.

Over time, inflammation leads to changes in the composition of the synovial fluid causing it to become less viscous and containing higher levels of inflammatory cells, cytokines and enzymes that can degrade cartilage and other joint structures.  The altered composition and reduced viscosity of the synovial fluid can impair joint lubrication, leading to friction, pain and reduced mobility.

It is important to discover the cause of the joint inflammation to ensure a quick recovery to normal functioning, otherwise long term derangement and damage can occur.

An injured joint becomes inflamed, painful and stiff. Overtime the joint becomes increasingly damaged.


As stiffness and inflammation persist in a joint for a long time, the joint becomes progressively more deranged.  Osteoarthritic changes develop as the inflammation breaks down the cartilage within the joint causing it to wear away resulting in further pain, joint stiffness and deformity.

In the early stages of osteoarthritis, chiropractors can help to alleviate pain and stiffness by manipulating these joints.  As the osteoarthritic joints become more degenerated they often become very stiff and less inflamed as the joint space decreases in size.  As a result there are often more inflamed and painful joints nearby that can be treated to provide relief for older patients.  For this reason, it is important to follow the symptoms of pain that a patient is experiencing rather than just following the x-ray evidence of osteoarthritis.

It is essential for good joint health to keep moving regularly because movement is necessary to stimulate the release of synovial fluid to lubricate the joints.  Exercise also does wonders for your bones, muscles, heart, blood vessels and brain.

In Summary...

Joint stiffness is a very common occurrence in people of all ages and it is particularly present in the small joints of the spine.  These facet joints often become stiff and inflamed and cause a myriad of pain conditions.  Chiropractors identify these stiff and inflamed joints and by way of spinal manipulation attempt to restore normal movement to alleviate pain.