Your Spine Isn’t “Out of Place”: The Truth Behind Spinal Misalignment and Effective Treatment.

evddawix
Jan 14
3 min read

For years, people have been told that their spine can “shift out,” and that a physiotherapist or chiropractor needs to “put it back in” to fix it. When your back feels stiff, locked, or painful, it’s understandable to think that treatment is literally realigning something to create relief.

But the truth is, our spines are incredibly strong, stable, and well-designed. Bones aren’t popping in and out of place during everyday life — and adjustments aren’t “realigning” your spine the way many people imagine. That doesn’t make spinal manipulation useless; it means it works for different reasons than most people have been taught.

Where Did the “Spine Misalignment” Idea Come From?

A lot of this belief comes from how we picture the spine: like a stack of blocks where one might slip out of line. When someone receives an adjustment and hears a “pop,” it feels like proof something was corrected.

In reality, that sound isn’t a bone snapping back into place. It’s simply gas releasing inside the joint as pressure changes — the same thing that happens when you crack your knuckles. The relief you feel afterward is real, but it’s not because something was repositioned. It’s because joint manipulation influences how your nervous system processes movement and pain.

The “out of alignment” idea has stuck around largely because it’s simple and easy to explain. Saying “your pelvis was out” is quick, straightforward, and feels like a satisfying answer. The real explanation, however, is more complex. It involves the brain, nervous system, stress, sleep, and lifestyle factors — all of which take more time to communicate clearly. Because of this, many practitioners still default to the easier, more familiar message: “your joint was out.”

What’s Really Changing in the Body?

Spinal manipulation doesn’t realign bones — it influences the nervous system. This is important to understand because it explains why a joint manipulation can feel good and be effective.

When a joint is moved quickly through a small range, receptors in the joint send different signals to the brain. This can reduce pain sensitivity and help muscles relax, which is why people often feel looser and more comfortable afterward.

Meanwhile, the spine itself is extremely stable. Ligaments, discs, and deep supporting muscles keep each vertebra secure. If a bone truly moved “out of place” — it would be a serious injury requiring an emergency room visit.

Most common back or neck pain comes from:

irritated joints
tight or overprotective muscles
a sensitive nervous system responding to stress, load, or fatigue

A Manipulation can help calm these systems and restore normal movement — not by “putting things back,” but by helping the body feel more relaxed, returning to it's baseline state.

About The “Crack” Sound

The popping sound during an adjustment (called cavitation) is simply a pressure change in the joint fluid. It doesn’t mean anything was realigned, it doesn’t need to happen for treatment to be effective and it’s harmless.

There are rare medical conditions where true instability exists, like spondylolisthesis or Ehlers-Danlos Syndrome, — but for the average person with everyday back or neck pain, the spine is structurally stable. The problem is usually functional, not structural.

Why Moving Away From Fear Matters

The “your spine is out” message can sometimes do more harm than good. If people believe their body is fragile or easily “out of place,” they may become scared of movement or dependent on someone to “fix” them.

Pain does not automatically mean damage. Often it’s the nervous system asking for support, load management, or movement variety. When people understand the body is strong, adaptable, and capable of recovery, they often feel better, move better, and recover faster.

Does Spinal Manipulation Still Help?

Absolutely — when used appropriately by a trained clinician, it can:

reduce pain and muscle guarding
temporarily improve movement
build confidence in moving again
support progress when paired with exercise and education

Manipulation is often effective when used alongside movement retraining, strengthening, and patient education.

The Big Picture: Your Spine Is Strong

Your spine isn’t slipping out. But it can become irritated, stiff, or sensitive — and that’s treatable. At Royal City Physio, our physiotherapists use evidence-based manual therapy — including spinal manipulation when appropriate — alongside exercise, education, and movement retraining. Our goal is to help you understand your pain, move with confidence, and trust your body’s resilience.

If your back or neck has been feeling sore or we’re here to help you feel better, understand what’s really happening, and get back to doing the things you love.