Chiropractic Techniques - An Explanation

There is a wide variation of techniques used by different chiropractors. Chiropractors focus on dysfunctions that can result from irregularities spinal structure or movement. They rely heavily on hands-on procedures to determine structural and functional problems, and they use manipulation to promote normal bodily function correcting or preventing these structural deviations. The principal procedure used by many chiropractors is a form of manipulation known as adjustment that refers to a variety of manual mechanical interventions. There are about 55 adjustments in a chiropractor's repertoire. Some of them are:

Manipulation is movement of short amplitude and high velocity that moves the joint beyond where patient's muscles could move the joint by themselves but short of ligament rupture.

Mobilization is movements administered by the clinician within physiologic joint space in order to increase overall range of motion.

There are hundreds of ways or techniques to adjust the spine. Each chiropractor becomes highly skilled in a variety of adjustment procedures that are most suitable for your age, body type and condition. Some of the most common chiropractic techniques used today are:

Gonstead Technique:
Detailed analysis of spinal X-rays is used to determine correct adjustments to be administered.

Activator:
Detects and corrects dysfunction using a small tool which delivers a light and measured force to correct misalignments. It is used to gently and painlessly move the vertebrae. Detailed information regarding the Activator Technique can be found {activator} here.

Bio-Energetic Synchronization Technique (BEST):
A non-force technique using subtle, yet precise pressure applied by hand to remove blocked nerve energy, eliminate physiological interference and balance sensory signals to the central nervous system.

Cox Flexion Distraction:
Involves traction or stretching of the spine designed especially to correct lower-back pain.

Applied Kinesiology:
Applied KInesiology deals not only with the placement of bones, but with the muscles that hold them in position. Chiropractors employing applied kinesiology use special techniques to help balance opposing muscles attached to a misaligned bone. Light massage is given to various reflexes and sometimes to acupressure points. This restores normal muscle function, in order to allow the adjustments to be more effective.

Thompson Terminal Point:
A full spine technique using a special drop table.

Palmer Toggle Recoil Technique:
A speed and precision adjustment in which the hands are placed over the subluxation and the elbows snapped to give sudden pressure. There is no joint cracking.

Sacro-Occipital Technique (SOT):
Padded blocks are placed under the patient in the pelvic area to allow the body to adjust itself, since muscle tension at the pelvis affects the neck.

Logan Basic Technique:
A gentle, sustained pressure is exerted at the base of the spine. Correcting the sacrum corrects the rest of the spine.

Nimmo Technique:
Application of simple pressure to tender areas to release muscles from localized spasm.

Orthotics:
Custom-made devices placed in the shoes to treat posture problems, such as uneven leg length, spinal curvature and tilted pelvises.

Motion Palpitation:
Joints felt as they are moved to determine fixations.

In general, an adjustment consists of a sudden, short, controlled thrust against a joint. The chiropractor will move the affected joint to the limit of its range of movement and then make a rapid thrust beyond this point to stretch the joint capsule and surrounding tissues.

While undergoing adjustment, it is important that the patient remain relaxed for this to be effective. A certain speed of the thrust is employed to ensure that the patient's muscles have no time to contract and so restrict the movement. Cracking or popping sound may be heard during the thrust: this is caused by gases in the synovial fluid (the lubricating fluid inside each joint capsule) and is harmless.

Most chiropractors will treat only a joint that they believe is misaligned or subluxated. Some, however, may treat the whole spine or concentrate only on one area.

In 1990, a detailed study on low back pain was published in the British Medical Journal (vol 300, p 1431). It compared chiropractic with hospital outpatient treatment for managing low back pain. It demonstrated that chiropractic was the more effective of the two. A follow-up study in 1995 confirmed this conclusion, reporting a 29 per cent improvement level for chiropractic over hospital treatment (BMJ, vol 311, p 349).

In 1997, at the World Chiropractic Congress in Tokyo, Danish researchers presented results showing that chiropractic reduced the duration of headaches by 69 per cent (compared with 37 per cent for massage) and their intensity by 36 per cent (compared with 17 per cent for massage). It also reduced the number of painkillers needed by 36 per cent. And a Dutch study shows that for shoulder pain arising from disorders of the spine or upper ribs, chiropractic manipulation has very positive effects (BMJ, vol 314, p 1320). But despite such evidence, the case for the profession is confounded by inaccurate use of the term chiropractic. In 1995, Alan Terrett, an Australian professor of health science, reviewed the published research on the complications of chiropractic neck manipulation. On contacting the original authors and patients, he found that many reported incidents were not severe at all and that many of the "chiropractic manipulations" were not performed by chiropractors.

The risks of chiropractic should be put in perspective. The Independent's article said that "chiropractic treatment can result in vascular damage in an unknown number of cases" - so it's not surprising it caused some alarm. Based on published cases and insurance reports, complications from genuine chiropractic manipulation to the neck are, at worst, a problem for 1 in 500,000 patients so treated. That's just 0.0002 per cent. In contrast, a 1995 risk assessment study (Journal of Manipulative and Physiological Therapeutics, vol 18, p 530) reported that nonsteroidal anti inflammatory drugs can carry a 0.4 per cent risk per year of severe stomach ulceration, possibly leading to perforation and death. Would the reluctant patient have chosen painkillers rather than chiropractic had he known?

Consider a statement made by Dr. Pran Manga, Ph.D:

"Chiropractic care is a cost-effective alternative to the management of neuromusculoskeletal conditions. It is also safer, increasingly accepted by the public as reflected in the growing utilization and high patient retention rates and there is much and repeated evidence that patients prefer chiropractic over other forms of care for the more common musculoskeletal conditions. The integration of chiropractic into the health care system should serve to reduce health care costs, improve accessibility to needed care, and improve health outcomes. There is an extensive body of literature demonstrating that chiropractic care for NMS disorders is effective though there (are) studies that question or dispute this finding. Suffice to say that there is not nearly as much nor as convincing evidence for the effectiveness of medical management of these conditions. Additionally, there is a strong and compelling consensus that chiropractic is safer, and patient satisfaction is higher than for other professions."

"The Economic Case for the Integration of Chiropractic Services into the Health Care System", by Pran Manga, Ph.D., University of Ottawa, Ottawa, Ontario, Canada.

If an adjustment is contraindicated for any reason, such as the possibility that it might cause the patient excessive pain or anxiety, a joint can be stretched by placing a roll or wedge in the correct position beneath the spine when the patient is lying down. However, doing this takes time, and the results are not achieved as quickly as those brought about by manipulation. Chiropractors also use a number of soft-tissue techniques (such as massage, heat, ice, and kneading) to relax a patient's muscles before a manipulation, to release trigger points (painful knots of muscle fibers), and to lengthen tendons and muscles.

Is chiropractic effective? Yes! There are many studies supporting the effectiveness of chiropractic. Read these studies here.

Using our ChiroLocator, you can easily find a chiropractor that practices a specific technique or one who employs other adjunctive treatment procedures such as nutrition, physiotherapy, etc. To search, go {find_doctor} here.