Joint mobilization/manipulation is a treatment in which the physical therapist passively moves a joint in order to improve mobility and decrease pain. These techniques can be applied to any joint in the body and may be applied at varying speed and intensity. The term spinal manipulation has traditionally been used to described a quick, small movement (thrust) of the spine that produces a pop. However, we know from research that thrust and non-thrust manipulation are equally effective, and that when using thrust manipulation, the effect is the same whether or not a pop is produced. This is likely because the primary effects of spinal or extremity joint manipulation are neruophysiological, meaning they trigger a response in the patient's nervous system to alleviate pain and alter muscle tone, rather then mechanical (moving joints that are "out" back into place).
Dr. Dave Candy is a fellowship-trained orthopaedic manual physical therapist who has extensive training in both thrust and non-thrust manipulation, and he uses both in his treatments depending on the individual patient's unique needs and preferences. He also recognizes that joint mobilization/manipulation is just one part of a comprehensive treatment package and should be used in combination with other treatments to have the best effect.