The Chiropractic Adjustment: What Chiropractors Really Do
Whether you have been seeing a chiropractor for years, or you have never seen been to one before, there is no doubt that it can be very difficult to explain chiropractic care, what you experience when treated, and why it works.
With an understanding of what really happens during a visit to a chiropractor, you can see how chiropractic fits in with other spinal specialties to provide an integrated approach to treating back pain.
To do this, it is helpful to build a mental picture of how a chiropractor looks at the spine. The ‘living spine’ and how it functions in the body will help you to better understand chiropractic and what the chiropractic experience is all about.
The chiropractor sees the spine as a series of motor units; each called a spinal joint complex. Each joint complex is composed of sets of two bony vertebra, the disc between, and the ligaments, muscles, tendons, fascia, blood vessels, and nerves. It is important to emphasize that the spinal joint complex is an intricate and powerful link between the brain and the whole body. Chiropractors view the spinal joint complex as its central diagnostic and treatment area. The next step is to understand how a chiropractor examines the spine. Palpation is the process of examining by means of touch, but. Palpation is not the only way a chiropractor determines where and how to adjust or manipulate the spine. It is however, the chiropractor’s central diagnostic technique. With experience, a chiropractor can gain vital information through direct touch. Normal motion is compared with the feel of the joint being examined as it is moved through its range of motion.
Spinal Joint Subluxation
Standing behind the patient and using both hands in a series of gentle motions, the chiropractor examines the low back joints one by one, taking each joint through its five ranges of motion to determine if any joint has become locked or fixated. Specific lack of spinal joint motion is one important aspect of what chiropractors call a subluxation.
A subluxation is a disturbance in the spinal joint’s function. The term subluxation describes a set of abnormal spinal joint inter-relationships that is not yet fully understood. These inter-relationships include the structural, mechanical, chemical, neurological, hormonal, and circulatory spinal joint components. While not an identifiable ‘thing’ like a fracture or a wound, it is a useful organizing principle for chiropractic research and clinical practice.
The chiropractor’s primary goal is to return motion to the fixated low back joint. The chiropractor may apply ice (i.e. ice pack) if the muscle inflammation is acute, or use some type of physiotherapy instrument, or muscle therapy to reduce muscle spasm. As long as the patient is not too acute, and no contraindications are found on examination, the chiropractor will turn to the central and primary therapeutic tool of chiropractic — the chiropractic adjustment.
Chiropractic: Adjusting or Manipulation of the Spine
Chiropractors use the terms adjusting and manipulation almost interchangeably. The term adjusting is used more commonly because it implies a specific correction to the spine that distinguishes the chiropractic approach. Chiropractors use a wide range of techniques that include specific adjustments, general manipulation, low force and non-force maneuvers, and an array of eclectic procedures tailored to the individual patient.
The Specific Adjustment
The main chiropractic technique remains the specific adjustment of a joint in the spine. Specific adjustment (also called osseous adjustment) is the technique the chiropractor will use to treat a locked or fixated joint. The adjustment will begin to return normal motion to that joint.
Chiropractors may talk about ‘putting a bone back in place’ to help a patient understand the purpose of the adjustment. However, spinal bones (vertebrae) do not go out of place. The spine’s architecture includes incredibly strong sets of ligaments, tendons, and muscles governed by an always attentive nervous system that works together to hold the vertebrae in place.
Therefore, the chiropractor is not putting a bone back into place or cracking the spine. Instead, the purpose of the spinal adjustment is to return motion to an abnormally locked (fixated) spinal joint that causes biomechanical disturbance (i.e. pain).