How do chiropractic adjustments work: Understanding what a chiropractic adjustment does and why.

Chiropractic is a common approach to health care that has been around for more than 100 years, and has been shown to be effective for a wide range of health complaints.

There are many types of chiropractors and chiropractic specialties, but the one commonality among all of them is the primary use of the chiropractic adjustment or spinal manipulation in patient treatment and care.

Chiropractor performing a spinal adjustment on a patient, demonstrating chiropractic technique.
Chiropractor applying a spinal adjustment to explain the mechanics of chiropractic treatment.

What is a chiropractic adjustment?

A chiropractic adjustment is a spinal manipulation or joint manipulation administered by a chiropractor (spinal specialist) to realign or restore proper joint motion in the body, most commonly in the spine.

Classically done by hand, although sometimes also with a small instrument called an activator, a high velocity low amplitude controlled force or thrust is applied to the misaligned or stuck vertebra to improve spinal motion, joint alignment, and to decrease nerve irritation and associated pain.

Techniques of joint manipulation have evolved over time to include not only adjustments in the neck, back, or spine of the patient, but to also include misaligned extremity joints as well.

What is a Spinal Misalignment and what causes it?

A spinal misalignment is a condition in which one or more vertebrae are out of place. This may be the result of an injury, chronic tension, or other issue.

Spinal misalignment can be caused by a number of factors, including: injury such as from a car accident or fall; muscle contractions from chronic tension that pull your joints out of alignment; poor posture (either while awake or while sleeping); and repetitive motions.

When the spine is misaligned or stuck, this can create inflammation and irritate spinal nerves, causing pain and other problems. Chiropractic adjustments or spinal manipulation are a chiropractic treatment used to correct spinal misalignments.

Chiropractor pointing to a spinal model showing misalignment, explaining its causes.
Expert chiropractor illustrating spinal misalignment using a model and discussing its causes.

How do chiropractic adjustments work?

A chiropractic adjustment works by a chiropractor applying a high velocity, low amplitude thrust to a stuck or misaligned spinal joint or vertebra, sometimes referred to as a vertebral subluxation.

This restores spinal motion and function to the restricted joint, decreasing localized inflammation and nerve irritation, decreasing pain and associated local muscle spasm.

The adjustment or spinal manipulation is often accompanied by a popping sound, termed a joint cavitation, which is caused by a pressure change in the joint capsule and the release of nitrogen gas.

This release of joint pressure with the adjustment will often also be accompanied by an immediate feeling of pain relief and an immediate improvement in the spinal movement and overall mobility in the area of the adjustment.

There are a number of different approaches or techniques of adjustments. Some of the most common chiropractic adjustment techniques are Gonstead, Diversified, Thompson, Activator and Chiropractic Biophysics.

In our Toronto chiropractic clinic Transform Chiropractic, we utilize all of these techniques, depending on the specific needs of the patient.

Almost all adjustments have the goal to correct spinal and vertebral misalignment and to restore movement. Because each individual patient is unique, each chiropractor adjustment will be customized to the particular patient.

Chiropractic manipulation has been demonstrated to decrease pain, decrease inflammation, restore joint biomechanics, and to decrease localized muscle spasm. When combined with other chiropractic treatments, it has also been shown to improve overall global spinal movement and improve posture.

How do chiropractors know where to adjust?

Chiropractors use a variety of techniques to determine where to adjust a patient’s spine. This includes, but is not limited to, taking a patient’s medical history, discussing their symptoms, and examining the patient.

They may also use diagnostic tests such as palpation, posture analysis, range of motion, leg length measurement and analysis, gait, and advanced imaging tests like x-rays and MRIs to help them better understand the condition of the spine and identify any areas that may need adjusting.

Chiropractor conducting a spinal assessment on a patient to identify adjustment areas
Chiropractor performing a detailed assessment to determine precise adjustment points.

A chiropractor will use palpation to test for any stiff or misaligned trouble spots. By applying gentle pressure along the spine, the chiropractor can look for restricted or misaligned vertebra.

This information is used to create a treatment plan that will help to restore normal motion and realign the spine to decrease pain and improve the patient’s health over time.

How does a chiropractor perform a chiropractic adjustment?

Originally done exclusively by hand, although sometimes more recently with a small instrument called an activator, a chiropractic adjustment is classically a high velocity low amplitude controlled force or thrust to a misaligned or stuck vertebra (often termed a vertebral subluxation).

This spinal manipulation thrust is designed to improve spinal motion, joint alignment, and to decrease nerve irritation, inflammation and associated pain.

The chiropractor applies a quick, short force to the joint, which will then release the muscle tension and allow the joint to go back into its proper place. The chiropractor is able to do this by understanding how each of your muscles attach to certain bones and joints.

Chiropractors are able to adjust the spine without producing a sound and still provide significant therapeutic benefits. The audible pop that is sometimes heard during an adjustment (termed a joint cavitation) is not necessary for the chiropractic manipulation to be effective.

Many people report feeling better after just one adjustment, regardless of whether or not there was an audible pop.

There are numerous chiropractic adjusting approaches or techniques, although most will have a similar outcome or goal. To restore movement in stuck spinal joints (or in some cases extremity joints), restore proper alignment, allowing the spine and nervous system to function better, resulting in less pain and improved health for the chiropractic patient.

Do chiropractors actually adjust anything?

Yes, chiropractors do adjust spinal joints (and in some cases extremity joints in other areas of the body). The term “adjust” is defined as “to alter or move something slightly in order to achieve the desired result”.

Chiropractic adjustments have been demonstrated on both x-ray and fluoroscopy (a medical procedure that shows real-time movement in the body) to achieve specific movement in restricted spinal joints with a thrust to the misaligned vertebra, as per the definition of “adjust”.

How do I keep my chiropractic adjustment in place?

After you begin chiropractic care and starting receiving chiropractic adjustments, your body at first may not be used to it’s new aligned posture and movement patterns. Some of your postural habits and muscle adaptation has likely been present for years, and it will take time to form new postural and movement habits.

During this early stage of chiropractic treatment, while your body is in a transitional stage, your spinal muscles and nervous system are not used to this new posture, and may start to slowly pull and return the misalignment vertebrae back into their old position.

To help your chiropractic adjustment to stay in place and “hold” better, we recommend patients walk after every chiropractic adjustment for five to ten minutes, in order to reinforce some of the new movement patterns.

At our chiropractic clinic in Toronto, we also provide specific stabilization exercises to patients, to help strengthen their spine, which will help to keep their adjustments in place for longer. Addressing chronic postural problems is critical for this. If poor posture is left unaddressed, this will pull the adjustments out of place faster.

Patient performing recommended exercises after a chiropractic adjustment to maintain alignment.
Engaging in specific exercises to maintain the benefits of a chiropractic adjustment.

As per the Chiropractic Biophysics technique, we also provide specific corrective postural exercises and stretches, along with spinal traction devices (Denneroll spinal orthotic), customized to the x-ray results of the patient.

These take home exercises and traction devices help to change the patient’s soft tissues (muscles, tendons, ligaments) over time, allowing for the structural changes from the chiropractic adjustments to stay in place for longer, and for the patient to achieve better and more long lasting symptomatic improvements.

How do chiropractors adjust themselves?

Chiropractors are not able to adjust themselves. In order to have their spine properly assessed and adjusted, they would need a proper chiropractic examination (posture analysis, leg length/gait analysis, palpation, range of motion, special imaging) and another chiropractor to perform the chiropractic adjustment.

Who can benefit from a chiropractic adjustment?

Chiropractic adjustments have been shown in multiple research studies to be beneficial for patients experiencing a number of conditions: lower back pain, neck pain, sciatica, arthritis, disc herniations, chronic pain, bad posture and headaches.

Chiropractic treatment can benefit a wide number of patients as the adjustment has been shown to decrease pain, increase movement and flexibility, decrease inflammation, minimize joint and muscle injuries and improve posture.

Is spinal manipulation and chiropractic care an effective form of treatment for back pain, neck pain and joint pain?

Spinal manipulation and chiropractic care are considered effective forms of treatment for low back pain, neck pain, joint pain and overall musculoskeletal pain. Chiropractors use spinal manipulation or a specific adjusting technique to restore proper spinal alignment to relieve pressure on a given nerve or soft tissue, help to restore normal movement, provide pain relief and improve overall function.

If you have any questions, or we can help in any other way, please feel free to contact us at our Toronto chiropractor clinic.  

Dr. Byron Mackay

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