Do we need “CRACK” to deem a successful chiropractic adjustment?

Do we need “CRACK” to deem a successful chiropractic adjustment?
 
Many practice members have enquired about the audible sound when a chiropractor performs an adjustment. In our previous blog, we spoke about the mechanism of how the sound or cavitation was being produced. Moving forward leaves us with the question “is the cavitation essential for an adjustment to be deemed as effective and therapeutic?” We have an answer for this common misconception.
 
It is important to note the chiropractic adjustment has an impact on our nervous system.(1) Although more research needs to be done to have a better understanding of the physiological mechanism, there are biomechanical markers we can measure pre and post adjustment, ensuring adjustment is successful. Most chiropractors utilise neurological testing as their objective outcome measures.(2) These including fine touch sensitivity (pain), manual muscle strength and deep tendon reflex testing.(2)
 
Research suggests that the sound of an audible release does not necessarily indicate that the appropriate reflexes are stimulated.(3) It suggests the greatest therapeutic benefit of the cavitation (sound) may not be physiological in nature but rather psychological.(3) The cavitation could have a powerful placebo effect on both the patient and practitioner.(3) Some people expect to hear a “cracking” sound from their treatment and interpret this sound as a sign of a successful adjustment. When the expectation is not fulfilled, it could place a negative effect on the clinical outcome.
 
At Sprouting Health, we perform a thorough examination for each practice member and a reassessment within a certain time frame. This is to make sure we are measuring health and results objectively rather than heavily focusing on joint cavitation. We focus on very gentle means to help you reach your health goals. If you are interested in how chiropractic may benefit you, feel free to have a chat with our friendly staff members anytime.

REFERENCES

1. Wirth B, Gassner A, De Bruin ED, Axén I, Swanenburg J, Humphreys BK, et al. Neurophysiological effects of high velocity and low amplitude spinal manipulation in symptomatic and asymptomatic humans: a systematic literature review. Spine. 2019;44(15):E914-E26.
2. Hinton PM, Randall McLeod D, Broker B, MacLellan CE. Outcome measures and their everyday use in chiropractic practice. The Journal of the Canadian Chiropractic Association. 2010;54(2):118.
3. Bakker M, Miller J. Does an audible release improve the outcome of a chiropractic adjustment? The Journal of the Canadian Chiropractic Association. 2004;48(3):237.