Adjustment / Manipulation
The adjustment is what comes to mind when people think of Chiropractic and for good reason. The adjustment is a skilled application of force to the spine or other joints in order to correct misalignment or restricted joint mobility. Chiropractic is by far the most extensively trained profession in the delivery of this incredibly powerful form of care. Spinal manipulation appears to be as old as human history. Hippocrates, the father of medicine believed manipulation of the joints to be as important as surgery and drug therapy. It was, in fact practiced by a Who's Who of early medicine. The medical profession later lost sight of and denied the benefits of this form of treatment. Only with research conducted in the past 25-30 years is it's real value becoming widely known.
The beginning of Chiropractic in 1895 focused on spinal adjustments, the application of specific force in order to realign spinal bones (vertebra) that were determined to be misaligned or subluxated, causing nerve compression that was thought to be capable of causing disease.
Early chiropractors weren't interested in treating pain. They believed in the human body's ability to heal itself when free of interference. This ability was attributed to an innate intelligence, the same intelligence responsible for creating the body. And they believed that the primary interference with that ability to heal oneself was misaligned or subluxated vertebra. They believed these could only be corrected with spinal adjustments.
These beliefs were considered totally at odds with medical science, leading to a long history of animosity between chiropractic and medicine.
While many chiropractor's philosophy has remained largely unchanged, the majority of chiropractors now focus primarily on the treatment of musculoskeletal and many neurologic conditions.
The terms subluxation is still used by many but not all chiropractors. It and the term segmental dysfunction are now generally considered to involve misalignment or alterations of the mobility of vertebrae. It often includes signs of localized inflammation, alterations in local blood flow and complex alterations in nerve function even though the nerves usually are not actually pinched. This condition usually also involves disturbance of the function of local muscles to varying degrees.
Past allegations that chiropractic was unscientific are no longer valid with regard to many musculoskeletal conditions. Over the past few decades, research has increasingly investigated and supported the effects of spinal adjustment/manipulation for many such conditions.
- Manipulation has repeatedly been shown to be one of, if not the most effective treatment for low back pain, particularly of recent onset.
- Manipulation in combination with therapeutic exercise has been shown to be the most effective treatment of longstanding or recurrent (chronic) back pain
- Chiropractic care has been shown to be the most effective treatment of chronic whiplash injury.
- Manipulation, especially in combination with soft tissue therapies has been shown very effective in the treatment of tension headaches and migraine headaches.
- Manipulation has been shown to be helpful for shoulder pain, knee pain, carpal tunnel syndrome, sciatica and thoracic outlet syndrome.
Though far less research has been conducted regarding adjustment/manipulation for non-musculoskeletal conditions, most of what has been done has shown positive results. Please see the sub-tab for non-musculoskeletal conditions.
Pathology Versus Function
Modern medicine usually looks for pathology or disease states to explain mankind's ills. In most cases treatment of these conditions is extremely helpful, often curing the disease. Many of these conditions are what the medical profession excels in treating. However with the musculo-skeletal system, this explanation is often lacking.
Chiropractors regularly see patients who have lost hope of ever finding relief because they have been diagnosed with arthritis or disc injury. Many of these often elderly patients deny a significant prior history of back pain until some recent, often trivial incident. Their X-rays show arthritis that is often advanced. Arthritis doesn't develop overnight, so if it alone is the cause of their pain, shouldn't we expect that they would have been in pain for the several years.
Numerous studies have actually shown that there is no statistically significant relationship between spinal arthritis or even disk herniations and back pain. That doesn't mean there aren't many cases where they are related. There are so many people with neither arthritis or disk disease despite a serious history of back pain. There are also so many people with one or both of these conditions, but no significant history of pain that there is no clear relationship. In fact, research shows that on average, the older we get, the more arthritis we develop however, research shows that on average people have decreasing back pain after age 50.
So, if not pathology, what is responsible for all of this suffering. The key appears to be function.
Every week in our office, we have new patients in severe pain who are convinced they have a pinched nerve. How else could such severe pain be explained? Careful neurologic and orthopedic examination however shows no sign of a pinched nerve. Chiropractic evaluation shows that specific joints have become stuck or locked up, sometimes with misalignment and usually with some degree of increased muscle tension or spasm.
Treatment including adjustment/manipulation, ART, massage and exercise therapy, directed at correcting these disturbances of normal function, generally gives the patient considerable relief, even in the presence of significant pathology such as arthritis or disk herniation. Although most of these conditions respond well to such conservative care, our staff is well trained and experienced in recognizing when the care of specialists is needed and promptly refer to the best specialists in the region when necessary.