Adjustments

Be ready to provide your medical history, which will be essential for preparing a course of treatment for you. Medical records, such as diagnostic test results, or imaging results, such as X-rays and MRIs, also will provide important information about your condition.

Certain things in your health history are particularly vital to a chiropractor. This information could provide important clues that will allow your chiropractor to properly diagnose your problem. Such clues include whether you have or have had:

Bone disorders, such as osteoporosis
Circulatory problems (poor circulation could be a sign that you have a subluxation, for example)
Dizziness or blurred vision
Heart conditions such as hypertension or high blood pressure
Infections, especially those affecting your spine
Injuries, such as bone fractures, muscle sprains, or disc injuries
Joint disorders such as arthritis
Sleep apnea
Be prepared to answer such questions as:

Did the onset of your pain immediately follow an injury?
Is there anything you do that improves or worsens the pain?
When and how did your pain start?
Where is the pain centered?
The physical exam
Here's what to expect:

The first order of business is checking your vital signs, reflexes, and blood pressure.

Sometimes measurements will be taken to determine arm and leg length. Next, you will be asked to do a series of simple and easy activities or exercises. These exercises will provide information about your motor skills, balance, and gait, among others. These tests also help determine your range of motion, muscle tone and strength, and integrity of your nervous system. Any abnormalities could provide clues about a condition. You may be asked to:

Bend forward, sideways, or backwards - Misaligned spinal vertebrae can sometimes be detected during this exercise.
Flex and extend your leg - This is a test for signs of sprain and helps determine the integrity of your joints (also called the "Yeoman's Test").
Grip something such as a rubber ball - Your grip strength is vital for showing signs of muscular or nerve damage.
Lie down and raise one leg - This is often referred to as the "Thomas Test," in which the chiropractor gently pushes on your raised leg to check for hip joint mobility.
Stand and raise one leg - This test can sometimes show whether you have sciatica, a nerve disorder in your lower back. Another test may involve pushing on your raised leg to determine whether you have pain, inflammation, or imbalance in the joints between your spinal vertebrae. (This is also called the "Psoas Muscle Test.")
Stand or sit - Posture can sometimes show whether you have misalignments in your spine.
Walk a straight line - This test measures your gait, and helps to determine if you have a normal walking pattern.
Walk in Place - Abnormalities in the way your pelvis and spine coordinate can be seen during this test.
Next, a short physical exam by the chiropractor will involve palpation, or use of the hands, to explore the alignment of your spine and other structures, as well as provide information on any stimuli that may cause pain. Depending on your condition, a series of diagnostic tests may follow. These tests may include MRIs, CT scans, X-rays, blood work, and other laboratory tests.

The chiropractor may also consult with you about making important lifestyle changes, such as exercise, nutrition, and smoking cessation to improve your chances of healing faster or preventing further injury.

Adjustments

Chiropractic adjustments have been shown to be a safe and effective alternative treatment for pain and injury.

Chiropractors perform 95 percent of all adjustments in the world to correct the subluxations, or misalignments, of the vertebrae in the spine. Chiropractic adjustments are performed by applying gentle, yet firm pressure to a bone. The goal of any adjustment is to restore the bone to its natural, or original, position. The important thing to remember is the act the adjustment frees-not forces-a vertebra to allow it to find its natural position. This is accomplished by the body's innate intelligence.

Chiropractic adjustments are performed to treat a wide variety of conditions, including (but not limited to):

  • Arthritis
  • Bursitis
  • Carpal tunnel syndrome and other repetitive strain disorders
  • Chronic muscle pain and stiffness
  • Headaches
  • Most musculoskeletal and sports-related injuries
  • Nerve disorders
  • Pain and stiffness in the back, chest, abdomen, neck, hips and shoulders, as well as extremities, such as arms, legs, and feet
  • Sciatica pain
  • Scoliosis
  • Tendonitis
  • Whiplash and other traumatic injuries

Adjustments can be performed while sitting, standing, or lying down. Some adjustments involve special instruments or tables.

Some common adjustment techniques include:

  • Instrument adjustments, which involve a spring-loaded device.
  • Lumbar roll, in which the chiropractor applies a firm, yet quick thrust to a misaligned vertebra while the patient lies on his or her side.
  • Motion palpation, a hand technique the chiropractor uses to determine if your vertebrae are properly aligned.
  • Release work, in which the chiropractor uses gentle pressure with the fingers to separate the vertebrae.
  • Table adjustments, which entail lying on a specially designed table that drops when pressure is applied to a specific area. The dropping motion allows more gentle adjustments than some manual adjustments do.
  • Toggle drop, which entails firm pressure applied on a specific area of the spine by using crossed hands.

Chiropractors take many factors-including size, weight, and muscle structure-into consideration when deciding on which adjustment to make. Sometimes, ice, electrical stimulation, or massage therapy (including traction massage) are used prior to a spinal manipulation in order to relax the muscles.

In some cases, it may necessary to perform an adjustment while you are sedated.

Spinal manipulation under anesthesia, which is considered a very safe procedure, is usually reserved for patients with conditions such as chronic neck, back, and joint pain, muscle spasm, shortened muscles, and fibrous adhesions.

Another form of adjustment called craniosacral therapy, or "CST," involves exerting very mild pressure to the body's craniosacral system, which is comprised of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord. This includes cranium-which is composed of the skull, face and mouth, and the "sacrum," or tailbone.

CST has been shown to provide relief from chronic neck and back pain, scoliosis, brain and spinal cord injuries, migraines, chronic fatigue, nervous system disorders, jaw joint problems, and stress disorders. (Conditions such as aneurysm and intracranial hemorrhage prohibit this kind of therapy.)

Adjustments almost always do not involve any pain or discomfort. The important thing for a patient to keep in mind is to remain relaxed, because stiffening up may impede the adjustment process. Popping sounds are sometimes heard during adjustments; these are usually pockets of air being released behind a joint or other bony structure.

Adjustments can leave you with a greater sense of well-being, calm, and most importantly, on the road to a life without pain. Following an adjustment, some patients experience mild aching or soreness in their spinal joints or muscles, which can usually be relieved by an ice or heat pack.

Adjustments have been shown to:

  • Increase blood flow
  • Increase pain tolerance levels
  • Increase range of motion
  • Increase the body's secretion of "good" chemicals, such as melatonin and endorphins
  • Reduce blood pressure
  • Reduce tension and muscle pressure