The E3 Rehab Podcast 193. Spinal Manipulation: What's Actually Happening? w/ Casper Nim
13 snips
Mar 25, 2025 
Chris Hughen talks with Casper Nim, a chiropractor and senior researcher from Denmark, about the intricacies of spinal manipulation. They debunk common myths associated with spinal manipulative therapy and emphasize the importance of patient preferences in treatment. Casper shares insights on the mechanics of joint popping and the psychological effects of these sounds. The discussion also highlights the need for transforming manual therapy education, focusing on psycho-motor skills and patient narratives, to better inform future practices in spinal pain management.
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Defining Spinal Manipulative Therapy
- Spinal manipulative therapy (SMT) aims to improve spinal movement through applied force, often resulting in a "popping" sound.
- It's considered a mobilization grade five in the Maitland classification system.
SMT Effectiveness and Specificity
- A recent systematic review found that SMT's effectiveness in treating spinal pain doesn't depend on specific application procedures.
- This suggests various SMT techniques yield similar results, echoing findings in exercise research where diverse approaches prove beneficial.
Uncertain Mechanisms of SMT
- The mechanisms behind SMT's effectiveness remain largely unknown, likely involving a mix of biomechanical, neurophysiological, and contextual factors.
- This uncertainty mirrors exercise research, where the exact reasons for pain relief are still unclear.