No, your spine is not out of place…

‘I’ve put my back out’ or ‘my spine is out of alignment’ are common phrases I hear from patients with any form of back pain, and it’s usually followed by, ‘can you crack it back into place?’. 

When it comes to back pain, people tend to fixate on structural factors as the trigger for their pain, eg. ‘my bones are out of place’. This belief can be further exacerbated by their peers, health professionals and the internet gurus, which can result in fear and dependency in passive therapy; good for business, not so good for health. 

I thought I’d start this blog off by saying simply: if your spine was out of place, you would most likely be paralysed.

The truth is, your alignment is influenced by many things including bone structure, muscle imbalances, work environment, activities/hobbies, even emotions have an influence on your body’s alignment. The structural factor (i.e. bone) has most likely been there since birth, and a single manipulation or ‘crack’ is unlikely to change this. That is not to say it won’t help with someone’s back pain, it can, but it definitely won’t alter the spine’s structure in one go. 

This is why in order to understand someone’s back pain it’s important to look at the person as a whole. Physically, reasons for someone’s back pain may stretch beyond just alignment, it could be due to neurology, systemic conditions, referred pain etc.. Along with the physical, the cognitive, emotional and environmental factors can also influence back pain. 

Your back pain may not have the same root cause as the stranger standing next to you on the MTR. And for that reason, what helped them may not apply to your case. There are a many possible reasons for back pain, and it’s a matter of addressing the individual case and not generalising back pain or narrowing it down to ‘everyone with back pain has a structural deformity’.

So to wrap it up, for most people it takes a lot of force (suddenly or over time) to dislocate or move your spine ‘out of place’. Here are a few questions to consider asking someone when they mention your spine is out of alignment:

  • Why do they think you’re out of alignment?

  • How does the alignment relate to your pain?

  • How will manipulations/cracks prevent the misalignment reoccurring if it’s due to an ongoing activity (eg one sided-sport such as tennis, work environment, chronic condition)?