Immediate Benefits of Chiropractic Adjustments Visible on MRI

It's well known that chiropractic is effective for low-back pain, but scientists are still discovering exactly what makes chiropractic work.

Recent research has revealed some of the key biological processes involved in chiropractic adjustments, from boosting your body's response to inflammation to reducing over-sensitization of the central nervous system. A new study helps to further uncover the underlying mechanisms behind the beneficial effects of chiropractic adjustments.

Gregory Cramer, DC, PhD, of the National University of Health Sciences, started his most recent study by outlining a fundamental hypothesis explaining the beneficial effects of chiropractic adjustments. People with low-back pain have decreased mobility in the joints of the lumbar spine. This limited mobility may result in degenerative changes and fibrous adhesions within and between the joints. It's believed that chiropractic spinal manipulative therapy (SMT) promotes gapping of the constricted joints, breaking up the adhesions and allowing the joints to move freely. This improved mobility is thought to decrease disability and pain.

To test this theory, Cramer and colleagues recently conducted a study of the effects of SMT on spinal gapping in 112 patients with low-back pain. Rather than evaluating the efficacy of SMT which has already been established in low-back pain patients, Cramer and colleagues sought to specifically study the spinal joint gapping immediately after SMT. Patients received two MRI tests and two weeks of chiropractic treatment between the tests. At each MRI test, the patients were randomly assigned to one of four treatment protocol: SMT, side-posture positioning (SPP), SPP control, or SMT control. The researchers scanned the patients' lower backs before and immediately after the treatment.

While all patients improved after two weeks of chiropractic treatment, by the end of the study, the ones treated with SMT immediately before the MRI had the most significant spinal joint gapping. Those treated with a combination of SMT and SPP had the greatest improvement in pain immediately after treatment. The researchers suggested that lumbar side-posture enhanced the therapeutic effects of spinal adjustments.

These findings demonstrate how chiropractic can improve spinal health to reduce pain and restore mobility in patients with low-back pain.


Cramer GD, et al. Magnetic resonance imaging zygaphosphyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding. Journal of Manipulative and Physiological Therapeutics 2013; pii: S0161-4754(13)00055-9. doi: 10.1016/j.jmpt.2013.04.003. [Epub ahead of print].