Published Sep 12, 2017
Yulia S. Suvarova Ronald Conger


The exact mechanisms involved in the sounds produced by manipulation of synovial joints have not been unequivocally elucidated but a number of explanations have been put forward. We have reviewed experiments designed to explain these sounds, with results that were quite unexpected. We have also considered the composition of synovial fluid and how its pH may potentially change locally after the release of CO2 by physical manipulation. The insights gained provide a rational explanation for the sounds generated by joint manipulation and the beneficial effects of manipulation on patients with joint disorders and pain. We recommend that joint manipulation should be prescribed as first-line therapy before drug therapy and expensive surgery is considered. (Chiropr J Australia 2017;45:203-216)
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Cavitation, Osteopathic Manipulative Treatment, Synovial Joints

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