“My bone is out of place & I need it to be put back”.
This is a common statement that people make. If a bone is “out of place”, you should not be going into the chiropractor’s office. Subluxation is a word that was used in previous years by Chiropractors. Recently the shift in the chiropractic schools and clinics is to not use this word. According to Merriam-Webster, subluxation means a partial dislocation. The chiropractic subluxation and the medical subluxation have different meanings which can be very confusing!
Let’s clarify a couple concepts that chiropractic patients might be unaware of.
1. Chiropractors do not put your bones back in place through a chiropractic adjustment.
Adjustments are used to improve segmental motion. When you are being evaluated for a restricted spinal segment, the chiropractor will press on your spine to determine if a segment is not moving as well as it could be. There is a chance that it could cause an increase in pain when they press on it but it could also not present with pain. Ultimately, an adjustment is changing the sensory receptors around the joint to “reset” the position. It does not actual move anything, but by providing the impulse it can reduced pain in that area, increase segmental motion of that vertebra and influence neurological activity.
2. If Chiropractors don’t put bones back in place, why does the spine crack when its being adjusted?
The sound that happens during a chiropractic adjustment is called Cavitation. Cavitation comes from gas released from the joints when the joint angle is changed or pushed into the physiological range of motion. Depending on the author, the gas release is made up of either nitrogen or carbon dioxide.
Even though the audible noise is great to hear, not only as the Chiropractor and the patient, the noise is not needed when you are improving the segment’s motion. Mobilization of the joint occurs when using low grade velocity to improve motion of the segment. Often this can be used in conjunction with chiropractic adjustments. Chiropractic adjustments are high-velocity, low-amplitude (HLVA). The Chiropractor will bring the joint to the end of passive range of motion to create a change. Mobilizations and HVLA adjustments can both be used to improve segmental range of motion.
3. How do I know if a Chiropractic adjustment is better or I need mobilization?
Ultimately, it is what you feel comfortable with and what your body responds best to. I have had patients tell me they don’t like specific adjustments, so we try to find another way to do it. Most often that is through a lighter approach with mobilizations, the table, or a tool. It is super important to talk to your Chiropractor about what feels good and what does not. Most would be willing to reassess and do it a different way that may better suit you and your body.
