• shoulder adjustment | 34
    Adjusting the shoulder
  • occiput exercise | 34
    Exercise for the upper neck
  • exercise teaching | 34
    Michael coached me through my exercises
  • car seat advice | 34
    Michael helped me improve my car seat position
  • shoulder exercise with band | 34
    Exercising the shoulder with a band
  • resisted neck exercise | 34
    Learning a resisted neck exercise
  • pillow advice | 34
    Now I know how my pillow should support my neck at night
  • Teaching the Piriformis Stretch  | 34
    Teaching the Piriformis Stretch exercise
  • breathing exercises | 34
    learning to breath more fully
  • Low back massage | 34
    Massaging the low back
  • Soft tissue therapy to the shoulder | 34
    Deep soft tissue therapy to the shoulder
  • thoracic massage | 34
    Remedial massage to the upper back
  • Thoracic adjustment | 34
    Adjusting the thoracic spine
  • TMJ adjustment | 34
    Adjusting the temperomandibular joint
  • low back toggle | 34
    A toggle adjustment to the low back
  • using cold gel | 34
    Using a cold gel on the forearm
  • Thoracic adjustment | 34
    Adjusting the thoracic spine
  • Applying a neck roll  | 34
    Applying a neck roll to the pillow
  • Soft tissue therapy to the shoulder | 34
    Soft tissue therapy to the front of the shoulder
  • patella adjustment | 34
    Michael prepares to adjust the patella
  • neck toggle | 34
    A "toggle" adjustment to the neck
  • Activator adjustment | 34
    Activator neck adjustment in a 93 year old patient
  • blocks | 34
    Using "blocks" to adjust the pelvis
  • Acupuncture for shoulder pain | 34
    Kate applies needles for migraine and headaches
  • low back mobilisation in a child | 34
    Low back mobilisation in a child
  • massage to the upper back | 34
    Remedial massage to the upper back
  • elbow adjustment | 34
    Elbow soft tissue therapy on an older patient
  • tennis elbow adjustment | 34
    Adjustment to help reduce tennis elbow pain
  • taping the leg | 34
    Kate applies tape to the leg and ankle
  • Applying ice to the knee | 34
    Using ice therapy for the knee
  • Low back adjustment | 34
    Adjusting the low back
  • knee soft tissue therapy | 34
    Soft tissue therapy to the knee
  • seat wedge | 34
    Learning to use a seat wedge
  • Applying needles for back pain | 34
    Michael applies needles to relieve back pain

A typical Chiropractic treatment

 Once you fully understand the report of findings and have given your consent, your chiropractor will make the necessary adjustments (manipulations) to your spinal or other joints. Some adjustments may make a popping sound, due to gas bubbles released when a stiff joint is freed up, but treatment is usually not painful and often brings considerable immediate relief.

Adjustments may be augmented with manual or massage therapy to muscles, ligaments and other soft tissues, ice and heat or physical therapy such as ultrasound. Acupuncture “Dry Needling” therapy may applied for pain relief. Sometimes "strapping" of a joint can be helpful or advice given on shoe inserts or "orthotics".

You will usually be given exercises designed to help "hold" the adjustment and advice may be given on sleeping, adjusting your pillow or adjusting your seating to reduce pain. At work you may need to adjust your workstation and if you drive for your living advice can be given to optimise the car seat and steering wheel positions.

Use these links to fast forward to sections on this page:

Typical low back adjustments

Typical middle back adjustments

Typical Cervical Adjustments

Extremity Adjustments

Soft Tissue Therapy and Massage

Acupuncture Dry Needling


Advice on daily living, sporting activities and working positions


Typical low back adjustments:

lumbar rolltoggle

The "lumbar roll", one of the most common low back adjustments, is shown on the left.     

The "toggle drop" on the right shows the patient lying face down on a special couch that drops away a few centimetres when a fast downward adjustment is made over the joint. It is used when the patient finds difficulty lying on the side.    



Specially designed wedges, known as "blocks" are sometimes used. Placed under points on the pelvis they use gravity to gently move one side of the pelvis against the other, as shown on the left.

child low back


On the right a child is adjusted using a gentle rocking movement through the hip





Typical middle back adjustments

cross bilateralmcp








anterior thoracic




Kate is shown using typical prone thoracic adjustment techniques, above, whilst Michael uses an "anterior thoracic" adjustment, left.





Typical Cervical Adjustments

neck adjustmentsitting neck


Using a very specific contact on just one joint the aim of any adjustment is to open, or "gap" the fixed joint, enabling it to move again.

On the left is a "supine" adjustment - on the right a "sitting" one.




A joint can also be freed using a "toggle drop" method. The headpiece is raised on a set spring and the neck positioned so the"contact" lies over the joint. A very light, fast "thrust" overcomes the spring and the headpiece drops. The recoil frees the joint with the minimum of force, as shown below, to the left.

cervical toggle The "activator" uses a similar spring method. The instrument is placed against the locked joint and the trigger releases a light measured impulse that restores motion. These "non-force" adjustments are used when standard manual adjustments are unsuitable, as shown here on a 93 year old patient.












Extremity Adjustments

Chiropractors are also trained to manipulate other joints, in addition to the spinal adjustments they are famed for. Here we show a selection of adjustments to the upper and lower limbs, as well as an adjustment to the temperomandibular joint (jaw). There are many different types of adjustment that can be applied to any one joint.





Shoulder (Left)




wrist/hand (Right)








Elbow (Left)




knee/patella (Right)








Ankle (Left)


TMJ (temporomandibular joint) adjustment, below











Soft Tissue Therapy and Massage

A wide variety of "soft tissue" and massage techniques can be used and a small selection are shown here.

low back massmid back forearm mass









upper trap massthoracic mass









scalenescapular lift









Hot/Cold packs or  Cooling gel can be used

 ice kneecooling gel









Acupuncture Dry Needling

There is stong research evidence to show that Acupuncture "dry needling" is valuable in the treatment of neck, low back, shoulder and knee pain. Kate also uses acupuncture for a number of stress related conditions, including migraines, and she has a special interest in women's health.

dry needling shoulder

dry needling low back









Click Acupuncture to go the the Acupuncture page for more detailed information



Specific exercises can play a valuable role in maintaining the effects of the chiropractic adjustment. The following pictures show patients being instructed in exercises to do at home.

S/I stretchgym ball 















resisted neck

occiput ex














door stretchshoulder band


















Advice on daily living, sporting activities and working positions

Advice may be given on a wide range of daily living activities such as diet, fluid intake, relaxed breathing and physical exercise. If you are a sports person we will want to know what pre and post exercise "warming up" and "cooling down" routines you may following. At work you may need to review your work surfaces and lifting habits if you have a physical job, to adjust your workstation if you are desk bound and to optimise the car seat and steering wheel positions if you drive for your living. Sometimes using an angled seat wedge can take tension away from the low back. At home we may review and give you advice on your mattress, adjusting your pillow or altering your seating position to reduce pain. Learning to use an ice pack can rapidly reduce inflammation and we will teach you how to apply one at home.

These pictures illustrate advice on car seating, adapting a pillow, positioning a seat wedge, applying a hot/cold pack and coordinating shoulder and diaphragm movements to enhance relaxed breathing.

car advicepillow advice








 pillow advice









seat wedgeice position 














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