What Is a Chiropractic Adjustment and What Happens During It?

Q. How do chiropractors know where to adjust?

This question has far too many answers to limit to just one article, but I will summarize some of the more popular methods chiropractors use to locate vertebral misalignments (also called subluxations).

1) Static palpation – Palpation refers to the Doctor of Chiropractic using his or her hands to feel for signs suggesting the presence of subluxation. These signs can include muscle tension or spasm, areas of hot or cold on the skin, or feeling the bones of the spine actually being out of alignment by running a hand down the spine and noting which bones do not line up with the bones above and below. Sometimes, the location needing adjustment is tender, or may refer pain, numbness or tingling to another part of the body when touched.

2) Motion palpation – this type of palpation involves movement, such as when the Doctor of Chiropractic uses his or her hands to rock he spinal bones back and forth to note if some are “stuck together” or simply not moving at all. When bones are stuck together the process of moving one bone will cause the other to move with it. Sometimes moving a vertebral bone will cause pain at the location of the bone, or will send pain, numbness or tingling, or shooting pain down an arm or leg or other part of the body.

3) Leg check – the leg check is a method many chiropractors use to analyze for lumbar or pelvic subluxations. This can be performed with the patient lying face up or face down. Since the legs insert into the hips the legs may be used as a proxy to measure problems above them. Increased muscle tension in one side of the low back or hip muscles can cause that side of the low back or hips to pull a leg upwards. Normally, everyone has either equal length legs or nearly equal length legs. By analyzing leg length and observing the reaction of the legs to various physical tests, the chiropractor can discover where a problem lies. Sometimes the Doctor or Chiropractic will perform additional testing on the legs, such as bending the legs at the knee, palpating low back or hips muscles, or performing muscle tests. Quite often, testing the leg lengths after an adjustment will show the legs to no longer appear to be different lengths.

4) Many other methods – there are numerous additional methods and techniques used by chiropractors. Listing and describing them is beyond the scope of this article. You are encouraged to contact a local chiropractor, or ask your current Doctor of Chiropractic, and ask him or her about this if you would like to learn more.

Q. What happens during a chiropractic adjustment?

When a chiropractor adjusts a spinal bone there are a number of things happening. I will describe the anatomical and biological processes involved in as simple a manner as possible without “dumbing it down”.

The importance of the set-up – In order to adjust a subluxation the joint in question must first be brought to a point of tension. A proper and safe adjustment requires the spinal joint to be first maximally stretched so that the adjustment need only involve a minimal amount of force. This way, the joint is gently pushed beyond it’s limit with a final nudge. Imagine rolling a ball up a hill. If we try to roll it straight up from the bottom we need to use a lot of force all at once. If we roll the ball all the way near the top first, then all we need to do is give it a gentle push to get it over the top of the hill. Many times the person who needs an adjustment has tenderness in the area of the subluxation, so the proper way to adjust it in order to minimize discomfort to the patient is to perform a proper set-up by bringing the joint to tension, and then to apply a gentle additional force to complete the adjustment. This method reduces pain and discomfort and makes the procedure much safer. Many Physical Therapists that perform spinal adjustments (called “spinal manipulations” by PT’s) use the less comfortable method involving more force, and using a “long lever” to move the bones. When being adjusted, be sure to pay attention to them “setting you up” properly and not causing undue pain. Adjustments can occasionally cause brief pain, especially if the area already hurts, but proper technique can minimize this.

That popping noise

That noise is actually gases “escaping” the joint capsule. When the joint is taken beyond it’s normal range the capsule experiences brief negative pressure inside it which pulls nitrogen and other gases through the membrane, causing a popping noise in each joint adjusted. You can verify to yourself that this noise is not bones hitting each other by simply pulling your fingers and hearing them pop. Clearly, the bones are separating, not colliding.

Why it feel so good

While the adjustment does some obvious things like re-align your neck or back, it also causes some other things to happen as well. By relieving pressure on the nerve roots at the spine, the muscles those nerves feed will relax, and the pain from those injured nerves may disappear within a very short time. Any organs or tissues that those nerves feed will begin to function more optimally with the inflammation and physical pressure reduced at the location of a nerve root or disc lesion.

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