Patients often ask:

Does spinal manipulation actually help nerve pain?
Is it safe?
Is it enough on its own?

A 2025 systematic review and meta-analysis published in the Journal of Orthopaedic & Sports Physical Therapy offers the clearest evidence to date.

Below, we unpack what the research shows — and how it applies to real-world care in Brisbane.

What Is Radiculopathy?

Radiculopathy occurs when a spinal nerve root becomes irritated or compressed. Common causes include:

  • Disc bulges or disc herniations
  • Degenerative spinal changes
  • Inflammation around the nerve

Symptoms may include:

  • Sharp or burning pain into the arm or leg
  • Pins and needles or numbness
  • Weakness
  • Reduced tolerance to sitting, lifting, or sport

Effective radiculopathy treatment requires more than rest — it requires restoring confidence, movement, and capacity.

What Is High-Velocity Low-Amplitude Thrust (HVLAT)?

HVLAT is a form of spinal manipulation involving:

  • A quick, controlled movement
  • Through a small joint range
  • Aimed at influencing joint mechanics and the nervous system

When used appropriately by trained clinicians, it can be a useful part of care — but it should never be the only intervention.

Overview of the Research

The 2025 review analysed:

  • 11 randomised controlled trials
  • 991 participants: Cervical and lumbar radiculopathy cases

Outcomes measured:

  • Pain intensity
  • Disability
  • Range of motion
  • Quality of life

HVLAT was compared with:

  • Sham (placebo) manipulation
  • Conventional physiotherapy
  • Spinal mobilisation
  • Other non-recommended treatments

Risk of bias and evidence certainty were also carefully assessed.

Key Findings

Short-Term Pain Relief:

  • HVLAT resulted in clinically meaningful pain reduction when compared with:
  • Sham manipulation
  • Physiotherapy alone
  • Non-recommended interventions

This effect was most consistent in cervical and lumbar radiculopathy, particularly in the early stages of care.

Improvements in Function:

  • Several studies showed reductions in disability, meaning patients were able to:
  • Move more freely
  • Return to daily activities sooner
  • Better tolerate rehabilitation exercises

This supports the idea that pain relief can help unlock active recovery.

No Long-Term Superiority

At longer follow-up periods, spinal manipulation did not outperform other active treatments.

This aligns with modern best practice:

Manual therapy may help early — but long-term recovery depends on rehab.

What This Means for Patients in Brisbane, Bulimba & New Farm

From our clinical perspective at PEAK:

✔ Spinal manipulation can help reduce pain early

✔ It works best as part of a broader plan

✔ Long-term improvement depends on:

  • Progressive strengthening
  • Gradual exposure to movement
  • Nervous system confidence
  • Education and reassurance

Our Approach to Radiculopathy at PEAK

At Peak Sports & Spine Centre, we take an evidence-based, individualised approach to radiculopathy care across Brisbane, Bulimba and New Farm:

  • Thorough assessment
  • Targeted hands-on care when appropriate
  • Early movement and education
  • Progressive rehabilitation to restore capacity

Spinal manipulation isn’t “good” or “bad” — it’s context-dependent. When used wisely, it can support recovery.

Final Thoughts

If you’re experiencing nerve pain, the real question isn’t:

 “Should I get spinal manipulation?”

It’s:

“What combination of care will help me recover fully and stay well?”

The evidence continues to support integrated, personalised care — and that’s where the best outcomes live.

Reference

Giovannico, G., Cioeta, M., Giannotta, G., Bargeri, S., Brindisino, F., & Pellicciari, L. (2025). Efficacy of spine high-velocity low-amplitude thrust manipulations in patients with radiculopathy: A systematic review with meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 55(10), 649–660. https://doi.org/10.2519/jospt.2025.13103

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