Neck pain remains one of the most common and disabling musculoskeletal complaints globally, with a lifetime prevalence of up to 70%. Neck pain is often treated using high-velocity low-amplitude (HVLA) cervical spine manipulation, which has proven to be an effective treatment modality, although the optimal dosage of manipulation as an intervention remains unknown.
The biological mechanisms of spinal manipulation are also currently unknown. Several theories suggesting biomechanical, psychological and/or neurophysiologic mechanisms have been proffered, although the inability to accurately measure the intervertebral kinematics of the spine during manipulation act as barriers to full understanding and optimization of treatments.
The objectives of this study were therefore to characterize the intervertebral kinematics (i.e. facet joint gapping) and manual forces at play in the cervical spine during spinal manipulation. The hypothesis was that patient-reported pain would decrease and the intervertebral range of motion (ROM) would increase following manipulation…LOG IN OR SUBSCRIBE TO READ THE FULL REVIEW!
Neck biomechanics
THIS WEEK'S RESEARCH REVIEW: “Intervertebral Kinematics of the Cervical Spine Before, During and After HVLA SMT”
This paper was published in The Spine Journal (2018) and this Review is posted in Recent Reviews, Cervical Spine - Manipulation / Mobilization, Spinal Manipulation - Mechanism of Effect and the 2019 Archive.
These authors demonstrated the ability to measure clinician-applied force and facet gapping during cervical spinal manipulation.  In fact, this study is the first to measure facet gapping during cervical manipulation on live humans! They also demonstrated changes in intervertebral motion following manipulation in both target and adjacent motion segments, as well as increased intervertebral ROM in all planes after manipulation.

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