Design: A qualitative semi-structured interview study.
Setting: Interviews were carried out on a one to one basis at the Anglo-European College of Chiropractic (AECC).
Subjects: Eight patients were recruited from the AECC clinic reception. Patients were invited to participate in the study if they had been suffering from a long-standing problem treated with manipulative chiropractic care and had attended the AECC clinic for a minimum of 4 months. Students from the AECC were excluded.
Methods: Signed informed consent was gained. Interviews were recorded and transcribed verbatim. The eight transcripts were then analysed through a process of thematic analysis.
Results: Patients perceived the audible release as resulting from bones being moved, or the sound to a release of gas bubbles from the joint space. Patients showed a divergence of opinion as to whether the audible release guaranteed a successful adjustment.
Conclusion: Patients do not need to have a deep understanding of the mechanisms for the sound they hear. The majority of the patients associate the crack with a physical feeling of release; therefore they assume that the sound is proof of a well-achieved adjustment. Nevertheless, patients do not discard the therapeutic benefit of an adjustment that did not achieve the audible release. This appears to be due to their past experiences and their trust in the chiropractor.
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