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The Activator Method chiropractic technique is a type of manual manipulation treatment used by chiropractors to treat various types of back and neck pain, as well as extremity complaints. This treatment method uses the Activator adjusting instrument, which is an alternative to traditional manipulation utilizing a high velocity, low amplitude (HVLA) thrust, such as the Diversified technique.

Some chiropractors use a small, hand-held instrument called the Activator Adjusting Instrument to deliver a quick, low-force impulse to spinal joints with the goal of restoring motion to the targeted joint.

Next to the Diversified technique, the Activator adjusting instrument is reported to be one of the more common therapeutic interventions used by chiropractors. According to the National Board of Chiropractic Examiners, about half of full-time American chiropractors have used the Activator Method in their practices.¹ The Activator Method is also commonly used in Canada, Australia, and New Zealand.²

Activator Method Treatment

The Activator Method chiropractic technique uses a spring-loaded, hand-held mechanical instrument called the Activator adjusting instrument. This instrument allows chiropractors to provide a quick, low-force impulse at specific points.

There are two theoretical advantages of an Activator instrument-assisted treatment:

High speed. The instrument is so quick that the body's muscles are less likely to tense in response, and resist the treatment. The lack of muscle resistance may facilitate the treatment’s effectiveness.
Controlled force. The applied force is localized and does not put the joint in any compromised positions, such as bending or twisting.

Newer Activator adjusting instruments are also on the market that work similarly to the older models. Newer models are cordless and powered electronically rather than being spring-loaded.

Leg Length Evaluation in the Activator Method

An evaluation of apparent leg length may be performed as part of the Activator Method treatment. This evaluation is based on the theory that apparent differences in leg length may indicate the location of spinal and/or pelvic misalignments. However, this form of evaluation is controversial as there is a lack of clinical evidence to support this assessment approach.

Activator Method treatment providers may or may not use the apparent leg length evaluation method as many rely on routine physical examination approaches such as static and motion palpation of the spine to determine the location to apply the Activator adjustment.

Activator Method Risks

When performed by a qualified health professional for back or neck pain, the Activator Method is a relatively safe treatment. While there is at least one documented case of cerebral hemorrhage following an Activator Method treatment applied at the top of the neck, this type of complication is believed to be extremely rare.³ Moreover, cerebral hemorrhage more commonly occurs spontaneously in the absence of any type of treatment.

Efficacy of the Activator Method Treatment

It is important to note that the Activator Method may not always help relieve neck or back pain and more research is needed regarding its clinical effectiveness.

Before agreeing to have the Activator Method treatment, it is important to discuss the potential benefits and risks with the chiropractor or other qualified health care professional.

References

1.National Board of Chiropractic Examiners. Job Analysis of Chiropractic 2005: A project report, survey analysis, and summary of the practice of chiropractic within the United States. Greeley, CO. January 2005.
2.Huggins T, Boras AL, Gleberzon BJ, et al. Clinical effectiveness of the activator adjusting instrument in the management of musculoskeletal disorders: a systematic review of the literature. Journal of the Canadian Chiropractic Association 2012;56(1):49-57.
3.Cerebral hemorrhage following chiropractic activator treatment—case report and review of literature. J Neurol Surg Rep. 2016; 77(4): e162-e167. doi: 10.1055/s-0036-1597626

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