Chiropractic Adjustment: Manual Adjustment and Drop Table

Given the likelihood that 84% of the population will experience back pain in their lifetimes, there is a high demand for treatments to address this condition [1]. Due to its ability to assuage back pain, along with neck pain and headaches, chiropractic adjustment is one such option [2]. Generally, adjustment procedures on the back consist of a doctor of chiropractic applying a controlled force to the patient’s spinal joints, either with their hands or an instrument [2]. If successful, the patient will experience diminished or eliminated stiffness and soreness [2]. There are many methods for performing a chiropractic adjustment, including manual adjustment and drop table [2].

Manual adjustment involves chiropractors using their hands to apply quick, low-amplitude thrusts on the patient’s spinal joints [3]. It is one of the most common forms of chiropractic adjustment, owing both to the general population’s familiarity with the technique and doctors’ tendency to be comfortable administering the method [3]. Manual adjustment is often successful when treating joint soreness, pain, or stiffness [3]. More specifically, it may be an ideal technique to use when other methods, such as laser or infrared technology, have failed to relieve patient’s conditions [3].

There is no single ideal candidate for manual chiropractic adjustment: anyone who suffers from back, neck, or other joint pain, stiffness, or soreness can benefit from this form of treatment [3]. It can relieve subluxations caused by toxins, trauma, or mental difficulties [3]. Overall, manual adjustment is a highly versatile chiropractic technique.

An alternate form of chiropractic adjustment is the drop table method. For drop table adjustments, the chiropractor uses the force of gravity, administered via a controlled drop in a segment of the treatment table, to settle the patient’s spine into place [4]. It requires considerably less applied force than other chiropractic adjustment techniques [1]. Drop table has proven successful in treating many joint conditions, perhaps most notably sciatica, without subjecting neither the patient nor the chiropractor to particularly forceful treatment sessions [1, 4].

Drop table can be especially beneficial for patients who are pregnant, weigh more, or experience difficulty moving around [1, 4]. Because patients lie on the table during the treatment, they do not need to expend much effort [1]. To best cater to patients’ conditions, chiropractors should carefully choose a table constructed by a reputable manufacturer with easily accessible tension knobs, so as not to hit the patient’s knees [4]. By choosing the right table, chiropractors can render the drop table technique an appropriate treatment option for the greatest number of patients [4].

When choosing between the two techniques, there are several considerations to keep in mind. For one, manual adjustment requires no expenditure on instruments, while the drop table can be an expensive piece of technology [5]. Conversely, the drop table requires minimum energy expenditure from practitioners, while manual adjustment can lead to chiropractors experiencing soreness over time [5]. In terms of efficacy, instrument-assisted techniques, such as drop table, appear to be at least as effective as manual adjustments [5]. However, drop table may be best for sensitive patients because it avoids placing them in the uncomfortable twisting positions associated with manual adjustment [6].

Ultimately, chiropractors should consider each procedure’s effects on the physician, ability to meet the patient’s needs, and economic impact to choose between manual or drop table chiropractic adjustment. 


[1] C. DeBusk, “Drop table treatments found to provide relief for patients with sciatica,” Chiropractic Economics, Updated January 15, 2015. [Online]. Available:

[2] Mayo Clinic, “Chiropractic adjustment,” Mayo Clinic, Updated November 26, 2020. [Online]. Available:

[3] Premier Chiropractic & Wellness, “Manual Adjustments from Chiropractors: What Are They?,” Premier Chiropractic & Wellness, Updated August 1, 2020. [Online]. Available:

[4] C. DeBusk, “Are chiropractic drop tables safe?,” Chiropractic Economics, Updated July 13, 2018. [Online]. Available:

[5] T. Beyshok, “Chiropractic Adjustments: Pros and cons of manual vs. Instrument-assisted,” Chiropractic Economics, Updated June 2, 2016. [Online]. Available:

[6] R. Grassi, “Chiropractic Subluxations and Adjustments,” Spine Universe, Updated November 11, 2019. [Online]. Available: