These days it is increasingly common for people who suffer from chronic pain or an injury to seek chiropractic treatment. But what is a chiropractic adjustment, a common technique that chiropractors use, and how do they work?

Doctors who perform chiropractic adjustments

Doctors of chiropractic (DC) are highly trained medical doctors who complete specialized training culminating in a series of four board examinations and completion of requirements to be certified in the state in which they practice.

There are currently approximately 77,000 DCs practicing in the U.S., with another 10,000 chiropractic students working towards degrees in 18 accredited chiropractic schools across the country. Doctors of chiropractic complete a minimum of 4,200 hours of classroom study, laboratory work, and internships. This is the equivalent of the number of hours spent for an allopathic doctor (MD) or an osteopath (DO). Every year, 2,500 graduating students enter the workforce as doctors of chiropractic care, either joining an established practice or starting a practice of their own. Doctors of chiropractic treat an estimated 27 million adults and children annually in the U.S. and are on staff of all 32 teams in the National Football League (NFL).

In Arizona, chiropractors practice a drug-free, hands-on approach to healthcare that includes patient examination, diagnosis and treatment, but excludes prescription medication. Chiropractors have broad diagnostic skills and can have advanced board certifications in physiotherapy rehabilitative exercises and treatment modalities, as well as acupuncture and other alternative modalities. Chiropractors are well trained to provide nutritional, dietary, and lifestyle counseling in relation to symptoms as well.

People feel strongly about conservative chiropractic care – both positively and negatively. As the chiropractic profession has evolved, however, this form of care has been widely accepted in the medical community because of its effectiveness and safety in treating pain. More than ever, patients are coming to chiropractors to seek relief from pain.

The basics of chiropractic care

Chiropractic is a healthcare profession that focuses on disorders of the neuromusculoskeletal system. Modern chiropractors use the best scientific, non-drug related treatments to treat muscles and joints. Chiropractic care is used most commonly to treat low back pain, neck pain, pain in the joints of the shoulders, knees and hips, and headaches.

Treatment is hands-on, drug-free, and complex. Doctors will take a detailed health history, including family history and details of the current injury if applicable. After taking health history and answering any questions the patient might have, doctors may also recommend X-rays or an MRI to confirm that chiropractic care is appropriate. If a patient is experiencing loss of strength or lack of reflexive response, a chiropractor may refer the patient to a spine surgeon to get more information.

Once all of these steps are complete, treatment can begin. This may seem like an arduous process, but doctors of chiropractic are most concerned with the health, well-being, and recovery of their patients. When dealing with the delicate structures of the spine, it is important that special care be taken before beginning.

What is a chiropractic adjustment?

The most common kind of chiropractic care is referred to as spinal manipulation therapy (SMT) or a chiropractic adjustment. The Mayo Clinic defines a chiropractic adjustment as:

“A procedure in which trained specialists (chiropractors) use their hands or a small instrument to apply a controlled, sudden force to a spinal joint. The goal of chiropractic adjustment, also known as spinal manipulation, is to correct structural alignment and improve your body’s physical function.”

In this type of work, doctors apply controlled force in a very specific way to restore mobility in the joints. Sometimes the patient will hear a popping noise as the spine is adjusted, but this is no cause for alarm. This popping is caused by the release of small pockets of air trapped in the joints, similar to what one might hear when cracking the knuckles.

In the following video, our own Dr. Kibler demonstrates how a chiropractic adjustment is performed. This can give you a better idea of what to expect before going into your first appointment, as well as alleviate any concerns you may have.

Benefits of chiropractic adjustment

When vertebrae become misaligned, they can place pressure on the spinal nerves and cause pain. This condition is known as spinal dysfunction, vertebral restriction, or subluxation. This can occur as a result of a tissue injury caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses such as sitting with poor spinal posture for an extended period of time. These type of injuries to the joints and surrounding muscles cause physical and chemical changes that can result in inflammation, pain, and diminished function for the patient. Chiropractic adjustment of the affected joint and tissues restores mobility, thereby alleviating pain and muscle tightness and allowing tissues to heal.

Most patients will feel immediate relief after treatment, but there is the chance of minor soreness in the area of treatment. This soreness should subside quickly after treatment and is not a serious side effect.

Types of chiropractic adjustments

We have a more in-depth article that discusses the common types of chiropractic adjustment. You can read that full article here.

That post covers techniques including:

• Direct thrust technique
• Spinal mobilization
• Articulatory
• Myofascial release
• Muscle energy technique
• Indirect positional technique
• Cervical spine manipulation
• Functional technique

What is a chiropractic neck adjustment?

Medical intervention and drugs aren’t the only treatments for persistent neck pain. If you’ve been feeling the effects of long-term neck problems that not only make you uncomfortable but also affect your quality of life, you may want to consider chiropractic neck adjustments. Many aspects of our daily lives can affect the natural positions of our neck. Simply sitting at a computer for work all day can throw off the balance of our bodies. Chiropractic neck adjustments can readjust and relieve problems in the neck.

Before a chiropractic adjustment for the neck, your chiropractor will ask you several questions regarding the pain that you are experiencing. These include:

• What were you doing when you began to feel the pain?
• How long has this been going on?
• Are you experiencing pain in other parts of your body?
• What have you already tried for reducing the pain?

Chiropractic treatment to help restore normal range of motion and reduce pain in your neck may occur over an extended period of time. Several chiropractic neck adjustments may be necessary before you find yourself back to normal. Your doctor may also recommend ongoing adjustments to prevent any further pain or damage from occurring.

Dr. Strubbe, a chiropractor in Florida, shows how a chiropractic neck adjustment is done in the following video.

Safety of chiropractic adjustment

Chiropractic adjustments are safe, effective, and generally free of side effects. In fact, recent studies have shown that patients with back pain have a higher chance of more serious side effects (including gastrointestinal bleeding) when taking over-the-counter (OTC) non-steroidal anti-inflammatory drugs. According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin, or NSAID painkillers.

Chiropractic adjustment is widely recognized as one of the safest non-invasive therapies available for the treatment of neuro-musculoskeletal complaints. Chiropractic has an excellent safety record, but almost all treatments have the potential for adverse effects. Many patients feel immediate relief following chiropractic treatment, but some may experience mild soreness or aching, just as they do after some forms of exercise. Current research shows if patients experience minor discomfort or soreness following chiropractic adjustment, it typically fades within 24 hours.

There has been some concern over the technique of high-velocity neck manipulation and its connection to a certain type of stroke. Research has since proven that this stroke is more often connected to an activity that occurred prior to the patient seeking chiropractic treatment. Injury to the vertebral artery as a direct result of high-velocity neck manipulation is extraordinarily rare. It occurs in only one case out of every 5.85 million manipulations.

Spine-Health discusses what patients can expect before they even enter the clinic room for a chiropractic adjustment. This video, and all videos on this post, are meant to make you more comfortable with the exact processes that occur during a chiropractic adjustment. However, always remember to ask your doctor if you have any more questions or concerns before undergoing a chiropractic adjustment.

Efficacy of chiropractic care

So chiropractic adjustment is safe, but is it effective? Mounting evidence proves that chiropractic care is one of the most effective treatments for all types of back pain. Here are just a few of the latest research findings regarding the effectiveness of chiropractic adjustment.

• A person who seeks chiropractic treatment after an injury to the lumbar (low back) region of the spine before seeking treatment with an allopathic doctor is much less likely to have spinal surgery.
• In a study published in The Spine Journal, researchers reviewed 699 studies of chiropractic adjustment treatments as compared to other types of treatments that included exercise, medication, mobilization, and sham (placebo) treatments. Researchers found that five to ten sessions of spinal manipulation therapy over two to four weeks was just as effective as other treatments, if not more. Unlike other treatments in the studies, there were no side effects reported for spinal manipulation.
• A large-scale consumer survey carried out by Consumer Reports found that chiropractic adjustment outperformed all other treatments for back pain. This includes outperforming traditional prescription medications in managing pain.
• Researchers from the University of Florida found that patients who received spinal manipulation experienced less pain as a direct result of their treatment. Study participants with low back pain were assigned to one of four groups: SMT, placebo SMT, enhanced placebo SMT (when patients were told they would be receiving either SMT or a placebo), or no treatment. Participants reported on their pain, including any changes in pain sensation during the session. Enhanced placebo SMT was the most effective treatment, and researchers believe these results are directly related to the care itself.

If you’re interested in learning even more about the benefits of chiropractic adjustment, Dr. Axe discusses the top ten chiropractic studies and research on his website.

Final thoughts on chiropractic adjustment

While not directly related to the efficacy of treatment, the cost of care is an important aspect of treatment for back pain, especially when that treatment is long-term for chronic back pain. A claims analysis of all of the fully insured patients with Blue Cross Blue Shield of Tennessee found that patients who initiated care with a doctor of chiropractic rather than an allopathic doctor had 40% lower paid-for costs (the costs that come directly from a patient’s pocket).

Chiropractic care can provide immediate and long-term relief, with fewer known side effects than both pharmaceutical and invasive options for pain care. For more information about chiropractic care and a list of doctors of chiropractic nationally, visit the American Chiropractic Association.

If you’re ready to find relief for your back pain, neck pain, or other chronic pain condition, a chiropractic adjustment can be a very effective and safe alternative to your current chronic pain treatment plan. We recommend looking for a well-respected chiropractor in your community who can help. As we noted in our post on finding a chiropractor:

“One of the most difficult parts of receiving chiropractic care is locating a qualified chiropractor near you. This can be daunting. Simply going online to find a list of names doesn’t help you to know if the chiropractor you choose is going to work for you. There are some easy steps to take, however, when asking ‘how to find a chiropractor near me?'”

That post discusses the steps to take to find a chiropractor near you. For Arizona patients, we definitely recommend reaching out to one of our doctors for a consultation today!

Chiropractic adjustment is safe, effective, and affordable. Have you or someone you love sought treatment with a chiropractor for back pain?

Chiropractic care focuses on making sure the body’s underlying structure, including the skeleton and joints, is properly aligned and functioning. More than 100 different types of chiropractic adjustments are utilized to achieve these goals, but each chiropractor generally has about ten that he or she focuses on and uses in the practice to help patients.

Although most chiropractic techniques involve the spine, they can also be applied to other parts of the body. The ultimate purpose is to promote the body’s natural healing abilities and ensure a healthy range of motion.

Chiropractors operate under the premise that pain results from problems in the nervous and musculoskeletal systems. Headaches, back, neck, and joint pain often result from improper alignment, muscle or joint tightness, inflammation, or other problems that disrupt the body’s natural flow.

Because of this emphasis on health and balance, chiropractors often recommend complementary therapies to patients, such as lifestyle and diet modifications, that support the success of chiropractic adjustments.

Here is an overview of common chiropractic adjustments.

Direct thrust technique

This technique, also referred to as spinal manipulation, focuses on the spine and is perhaps the most well-known chiropractic adjustment. The chiropractor uses a high-velocity, low-amplitude thrust, which is a swift, short movement to encourage proper vertebral alignment because misaligned spinal components may cause restricted motion and resulting pain.

This technique frequently produces the cracking sound that many people have come to associate with chiropractic care. The popping sound is nothing to worry about and is actually the release of gas trapped between joints.

The noise results from the joint’s movement, which causes a change in pressure and the resulting release of gas bubbles. Usually this technique does not involve pain or discomfort.

Chiropractors work with each patient to determine the appropriate amount of pressure and ensure the technique supports health and helps to reduce pain. This procedure may be done with the hands or a small, specially designed instrument to apply the pressure.

Spinal mobilization

For patients with conditions such as osteoporosis who require a gentler approach, spinal mobilization may be used in place of the direct thrust technique, although the goal of proper spinal alignment and optimal joint functioning is the same.

With this form of chiropractic adjustment, slow movements including gentle stretches or firm pressure—as opposed to thrusts—are used to encourage spinal components into their rightful places.

Articulatory

Articulatory chiropractic adjustments target injured joints and help to restore them to their full range of motion. To achieve this goal, the chiropractor slowly moves the arm, leg, or other extremity through its range of motions while applying force.

Moving the joint through the full range of motion helps to remedy stiffness and improve mobility.

Myofascial release

This chiropractic adjustment targets myofascial tissue, which is a layer of membranes that cover, support, and connect the body’s muscles. This type of therapy is also sometimes done in massage. Stress or other causes can lead to stiff areas in myofascial tissue, called trigger points, which lead to pain.

Pain is not always present at the area of the trigger point. Sometimes, the patient will feel it in another area of the body, which can make the points difficult to find. A chiropractor works with patients to uncover these stiff areas and release tension to reduce pain.

In addition to causing stiffness, trigger points may further restrict the movement of joints and muscles, which can cause problems and pain throughout the body.

During myofascial release, the chiropractor finds these stiff areas and applies pressure to loosen them up, free movement, and reduce pain.

Muscle energy technique

This type of chiropractic adjustment is a form of myofascial release, but is active because it requires patient participation. It targets stiff areas of the body that have developed into trigger points and cause pain.

As the patient uses specific muscles, the chiropractor applies counter-pressure. This technique is repeated several times, with each repetition lasting for several seconds followed by a brief period of rest. After each repetition, the chiropractor will shift the position slightly to ensure the technique targets the complete range of motion.

Muscle energy technique strengthens weak areas, promotes mobility, works to release trigger points, and improves blood flow to promote healing and flexibility. The goal is to provide full mobility and reduce pain.

Indirect positional technique

Some people suffer pain from hypertonic muscles, which means they are overly toned. Many times, people think of muscle tone as a good thing, but too much muscle tone, or uneven tone, can lead to tightness and pain.

For example, a mostly sedentary person with a desk job who then lifts weights several times each week may have overly developed pectoral muscles that result in poor posture, with the shoulders rolled forward. In this case, the pectoral muscles would be considered hypertonic.

The indirect positional technique seeks to correct hypertonic muscles and help the surrounding joints regain the full range of motion. This chiropractic adjustment involves the practitioner holding the joint in a neutral position before applying a specific force. Sometimes, the force is used to lengthen the muscle and other times it’s intended only to release tightness and encourage the muscle’s return to health.

Cervical spine manipulation

Problems in the cervical spine, which is the portion in the neck, may lead to headaches, upper back pain, discomfort in the shoulders or arms, or diminished range of motion. Chiropractors manipulating the cervical spine use the same techniques as with direct thrust or the more gentle chiropractic adjustment, spinal mobilization.

Functional technique

Functional technique targets joints to free them from restriction and improve overall mobility. To achieve this goal, chiropractors use a gentle force as they move the joint through its natural range of motion. Once a restriction is detected, the practitioner holds the joint at the point of restriction until it releases.

This technique, like other chiropractic adjustments, is as much an art as it is science and requires an in-depth knowledge of the body’s systems to perform safely and effectively.

Have you ever tried any of these chiropractic adjustments?

Image by Allan Ferguson via Flickr