Activator Method Efficacy and Risks

The Activator Method is usually considered safe and is used by chiropractors to treat neck and back pain of spinal origin, as well as pain in the extremities.

Activator Adjustment Instrument Research

When compared to the use of high-velocity, low-amplitude manual manipulation (Diversified technique), the benefits of the Activator adjusting instrument were not proven to be better or worse.1

In a low back pain study, 3 treatment methods were compared2:

  • Manual-thrust manipulation using high-velocity low amplitude thrust
  • Mechanical-assisted manipulation using the Activator instrument
  • Usual medical care consisting of over-the-counter analgesic and NSAID medications and advice

At 4-weeks post-treatment, the study found a statistically significant advantage of manual-thrust manipulation for reducing pain and disability compared to either mechanical-assisted manipulation or usual medical care. At 3 and 6 months, however, none of these treatment groups were found superior to the others.


While the Activator Method is a widely researched chiropractic technique, most of the research has been funded by the method's developer. Additionally, most of the studies were conducted in small groups of patients with a relatively brief follow-up period and lack of control groups. Independent studies with large patient groups are needed to determine efficacy with any significance.

When the Activator Method May Not be Used

As with any spinal manipulation or mobilization treatment, a careful clinical examination is required to ensure that the Activator method is not performed on a person who has pain being caused by:

  • Infection
  • Cancer
  • Fracture in the treatment area
  • Open wound in the treatment area
  • Serious neurological disorder

These conditions and other problems could potentially be worsened by using the Activator Method.

Activator Method Risks

When performed by a qualified medical professional on an appropriately selected patient, the Activator Method is relatively safe. Some people may experience an increase in discomfort or stiffness after the initial treatment. This feeling is typically similar to what is felt after receiving thrust manipulation or exercising, and it typically tends to subside within a day.


While there is at least one documented case in the literature of a person experiencing a cerebral hemorrhage after receiving an Activator method treatment at the top of the neck, this risk is currently thought to be exceedingly rare.3 For anyone concerned about having the Activator Method or other spinal manipulation performed on the neck (where more neural tissues and critical arteries are located closer to the surface), it is reasonable to request that this treatment not be performed in the cervical spine region.

See Gentle Chiropractic Techniques for Neck Pain

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.


  • 1.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.
  • 2.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.
  • 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