When are chiropractic adjustments better than exercise?

As a chiropractor, chronic pain sufferers expect me to adjust their spine. This is because many people assume seeing a chiropractor equals chiropractic adjustments. However, this is not true. Evidence-based chiropractors are trained in a variety of techniques including spinal manipulation, soft tissue therapy, ultrasound, dry needling, physical therapy, and of course rehabilitative exercises!

What is a chiropractic adjustment?

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Chiropractor Jesse Cai used to offer chiropractic adjustments. However, results were extremely slow and our clients have to keep coming back. With our new recovery programmes, over 80% of our clients will achieve their recovery goals without needing to always come back. No more endless chiropractic packages!

A chiropractic adjustment is a procedure that chiropractors use to treat musculoskeletal conditions. It is often performed by hand where a gentle thrust is applied to parts of the spine or other joints in your body. The goal of spinal manipulation is to restore normal joint function as well as to increase range of motion. Besides using the hands, adjustments can also be done by adjusting tool such as an Activator or Impulse IQ.

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Chiropractors like to brand their adjustments as being special and just exactly what you do. However, research doesn’t support that adjustments can be that specific.

During an adjustment, your chiropractor will position your body in a way so force can be applied to a specific joint. For example, if the chiropractor is adjusting your upper back, you may lie face down on a chiropractic table. The chiropractor will then use their hands or an adjusting tool to apply a controlled force to your thoracic facet joint.

Adjustments are usually painless and may produce a feeling of relief or relaxation. Some people may experience minor side effects, such as soreness or achiness, after an adjustment, but these symptoms typically resolve quickly.

What is exercise therapy?

While exercise therapy is considered synonymous with physiotherapy, it is definitely not the case. Exercise as a modality is utilised by a range of healthcare professionals from chiropractors to clinical exercise physiologists (AEP). Outside of clinical setting, exercise is also used by personal trainers to help their clients achieve peak physical well-being.

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Exercise has been part of chiropractic for over a hundred years!

This comes as a shock to a lot of people but exercise has been part of chiropractic since it’s founding days. B. J. Palmer has a chiropractic clinic that is fully equipped with exercise equipment from a punching bag to a cable machine!

At Square One Active Recovery, we use exercise as a big part of our treatment because research has shown that it is superior to other treatments. In fact, all clinical guidelines around the world agree that exercise is the first-line treatment for chronic pain!

Is exercise enough for me?

low back pain clinical guideline, lancet low back pain

Surprisingly, no. Exercise alone is inferior to exercise plus education. This is also well documented in research. When we dig into clinical guidelines, such as the one published by Lancet for low back pain, exercise PLUS education is superior to exercise alone. This is why it is advisable to seek treatments from practitioners with clinical training over those without.

As part of your treatment with us, we will share with you the latest research and also how to apply that to your own recovery. For example, a lot of people like to blame their slouched posture for their aches and soreness. Did you know this is actually not supported by latest research?

Being able to separate hard facts from junk science is very important in your path to pain-free living. It will allow you to stop doing what is useless. It will also allow you to channel your resources to what actually will help you in the long run.

Education can also include lifestyle coaching. This means learning tricks and strategies to help yourself get started with exercise. If you are a weekend athlete, we can also partner you to design an exercise programme that will ultimately benefit you recovery.

Understand that pain is not just pain

One of the reasons that people get very poor results with their pain treatment is that they think pain is just pain. Unfortunately, that is not the case. Pain is a complex human experience.

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This is why there is a huge push for using a biopsychosocial approach. In other words, psychosocial factors such as mental health state, work situation, and even family relationships can make a big difference.

In the above diagram from Lancet’s paper on chronic pain, we can see that pain is separated from nociception. Nociception refers to the processing of threat stimulus (e.g., tissue damage). While pain refers to any unpleasant and undesired experiences you have. In other words, you can experience tissue damage WITHOUT pain. Isn’t the human body and brain amazing? To learn more about this, check out our pain science article.

When are chiropractic adjustments better than exercise?

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Exercises may seem scary when you are experiencing pain. However, when done correctly, exercise has better results than passive treatments (e.g., manipulation, dry needling, ultrasound therapy, etc.)

To be honest, never. There are no occasions where chiropractic adjustments can be a better option when compared to exercise.

Let’s start with discussing when spinal manipulations are never a better option. If your aches, soreness, stiffness have been more than 12 weeks in duration, you should definitely not consider adjustments. For symptoms more than 12 weeks, we consider it to be persistent or chronic. What this means is that the nature of your symptoms is unlikely to be only physical in nature. You may refer to the Lancet flow chart above for perspective.

We are not saying that you won’t feel better after spinal adjustments. We are saying that it’s not going to be a long-term solution. There is no way a gentle thrust into your spine will be sufficient enough to change anything beyond placebo. In fact, there are studies published by chiropractors to ascertain that adjustments do not work better than placebo!

Having saind that, there are some occasions where spinal manipulations can be an acceptable treatment. When we say acceptable, we don’t mean superior. We mean acceptable.

How to find long term success for your persistent pain?

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Most of us can identify with this. We think medication is the short-term solution and that it is not sustainable. How is chiropractic adjustments any different? It too is unsustainable.

Instead of trying to make your problem go away. The better solution may be to work on your physical body’s robustness and resilience so you no longer experience pain.

Sure, surgery and drugs or even chiropractic adjustments may help you feel better in the short-term. Without working on your own body, however, the relief is unlikely to last.

To find out more about how we can help you help yourself find freedom from, drop us a message via the form below.


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.