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Manipulative therapies: chiropractic, osteopathy and manual medicine

What are they?

Manipulative therapies include chiropractic, osteopathy and manual medicine. They’re used mainly for:

  • musculoskeletal problems, including spine, neck and shoulder disorders
  • joint, posture and muscle problems
  • sciatica
  • sports injuries
  • whiplash
  • repetitive strain injury (RSI).

The best-known technique is the ‘high-velocity thrust’ – a short, sharp movement, usually applied to joints in the spine, which often produces the sound of a joint ‘cracking’ – but many other methods are also used.

These therapies can be carried out by many healthcare professionals including doctors, physiotherapists, osteopaths and chiropractors. All of these groups are legally registered health professionals in the UK. These treatments should include advice on exercise and lifestyle as well as hands-on manipulative therapy.

Are they safe?

You shouldn’t use manipulative therapies if:

  • you have a circulatory problem affecting your spine
  • you have osteoporosis
  • you have malignant or inflammatory spine conditions
  • you have recent fractures or dislocations
  • you’re on anti-clotting or blood-thinning drugs (for example, warfarin, heparin)..

The most serious risks of osteopathy and chiropractic are stroke and spinal cord injury after manipulation of the neck; however, these serious problems are very rare. Slight discomfort at the site of manipulation for a few hours afterwards is quite common.


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