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Subluxation is the term used by Chiropractors to describe a joint misalignment in the body that irritates the surrounding nerve tissue. This term was first used in the late 1800's by D.D. Palmer, the founder of Chiropractic. The medical explanation for 'Subluxation' is a movement of a bone from its normal location, prior to dislocation. Palmer's explanation included the existence of nerve irritation when the joint surfaces became misaligned. Joint surfaces can misalign usually in response to trauma, stress and chemical imbalances. These subluxations are often the cause of spinal and joint pain, along with a wide variety of associated symptoms. Chiropractors are trained to detect and correct subluxations of the spine and peripheral joints. At The Spinal Joint, we offer a wide variety of adjuting techniques to specifically locate your subluxation/s. A subluxation is removed from the spine by a specific adjustment done by hand, and it will usually take several adjustments to correct the problem.
Chiropractic will benefit individuals who are suffering symptoms caused by subluxations. The most common cause of sustaining a subluxation is through physical trauma, however, emotional and chemical influences can also cause subluxations to occur. Physical trauma such as whiplash, falls and incorrect lifting techniques can upset the normal biomechanics of your spine resulting in abnormal nerve function and pain. When these subluxations are detected in your spine and are the cause of your problem, a chiropractic adjustment will benefit your symptoms. However, not all subluxations will cause symptoms and or pain, which is why many of our patients will have periodic appointments to assess the health of their spine, similar to dental check ups.
There are small pockets of air in the synovial fluid that surrounds the joint capsule. The chiropractic adjustment causes a stretching of the joint tissues which 'pops' these pockets of air, resulting in the 'cracking sound'. This is a normal part of the Chiropractic adjustment, and helps your doctor know how successful your treatment has been.
The normal response to an adjustment is an immediate improvement in spinal or joint motion. Once the 'sticky' joint is working again, there is usually an associated reduction in muscle spasm, swelling and associated symptoms. Initial improvement may only be temporary until the body has had sufficient time to heal. More chronic cases may require several adjustments before improvements are noted. Once sustained improvement is achieved, the frequency of treatment is gradually reduced until the joint has stabilized. A small percentage of patients do experience some post-treatment soreness that will usually resolve within 24-48 hours. Some patients also report feeling worse before improvements become obvious, particularly when the problem has been long standing. If your Chiropractor is not achieving the improvements they expect, they may refer you for a medical opinion or to a more suitable specialist.
It is impossible to predict the number of visits any one will need. There are many factors that contribute to how rapidly someone heals: length of time of injury, previous damage, degree of damage, general health, lifestyle choices, whether they continue to aggravate the damaged area. At The Spinal Joint, the emphasis on treatment is to return the maximum amount of function and symptomatic relief to the patient in the shortest time their bodies healing capacity will allow.
Specific exercises will be given relating to the involved condition, however, these exercises are not given until a specific and acceptable amount of the joint motion has been restored. These exercises are given on a case by case basis and help to strengthen the muscles in the involved area to better support the structural changes the Chiropractor is trying to make. There are some cases where it is necessary for more specialized evaluation by a therapist or exercise physiologist and Dr. Barry or Dr. Michael will refer you to the appropriate person. Pilates and Yoga are good adjuncts to chiropractic care as they strengthen core stomach and pelvic floor muscles that help to support the spine. You will be advised when this is appropriate for you.
The adjustment is a quick shallow thrust into the spine which generally does not hurt. It is similar to cracking your own knuckles, except the chiropractic adjustment specifically repositions the subluxated or misaligned joint to restore normal biomechanics or movement to the joint. When there are large amounts of swelling associated with a subluxation, we recommend people apply ice pre and post adjustment to reduce this swelling and therefore reduce the possibility of pain experienced during the adjustment.
In short - anyone with a spine!
A child's spine, like an adults, goes through a lot everyday. In fact children are continually subjected to traumas right from the birth process - going through the birth canal, unsupported head and neck movements, frequent falls, learning to walk. This trauma is transmitted as force to the children's spines causing subluxations. All children are advised to have a spinal assessment, but healthy spines will not require any adjustments or treatment. Early detection of problems leads to a much better prognosis. We do not routinely x-ray children unless indicated.
Throughout life we sustain injuries causing subluxations from playing sport, car accidents and falls which need to be corrected. Early detection and correction can prevent years of future problems. As people get older they have normally sustained injuries to their spines or extremities from the many physical, chemical or emotional stresses they have sustained. Chiropractic is safe and effective for older people, the adjustment acting to re-lubricate the joints, similar to a grease and oil change for your car.
Therefore everyone and anyone should have their spine checked to assess for subluxations from birth right up until old age. Our patients range in age from newborns to over 90 years old. Our adjusting techniques can be adapted to suit the age and health concerns of all types of patients.
Not all patients that present to this clinic have a chiropractic problem, and not all patients are suitable for chiropractic care. When a patient presents with a non chiropractic problem Dr. Barry or Dr. Michael will refer them to the appropriate specialist. In some cases the additional care provider will solely look after the patients and therefore take over the case, in other incidences, the patient will need to be co-managed. The Spinal Joint utilizes a great team of allied health care providers to serve individual patients needs.
Chiropractic adjustment of the spine has stood the test of time as one of the most effective and safe treatments for neuro-musculoskeletal conditions. Research shows that Chiropractic care is more effective and economical and also gives longer lasting results than other forms of health care. 1 2 3 However, as with all health care procedures there is a risk of injury or complication. In nearly all cases of injury, the patient had a pre-existing condition. That is, the patient had a pre-existing pathology, such as bone cancer or osteoporosis or a disc prolapse, and the condition was not correctly diagnosed and an inappropriate technique was performed, putting the patient at risk.
A thorough examination and x-ray series, and a very controlled and specific adjustment are necessary to prevent such injuries.
A specific list of the risks involved:
1. 1 in 3 patients experience temporary soreness. This is normal, since the body has to become accustomed to the changes occurring in the spine. 4
2. Strains and sprains to the soft tissues such as ligaments, muscles or tendons are uncommon. 5
3. Injury to the disc between each vertebra is very uncommon. 1:62,000 in low back cases and 1:139,000 in neck cases. 6 In some of these cases nerve compression by the disc can occur, resulting in pain, numbness and muscle weakness.
4. Bone fracture is rare and has occurred only in cases where the patient has had osteoporosis or bone cancer, and the adjustive technique was inappropriate.
5. Stroke due to neck adjustment is exceedingly rare, the most recent estimate being between 1:2,000,000 and 1:5,850,000 (To put it into perspective, the risk of getting struck by lightning in Australia is 1:1,500,000). 7 8 In fact, it is so rare that the latest studies indicate it is most likely coincidence. The force of a neck adjustment upon the arteries supplying the head is about nine times less than the force needed to damage an artery. 9 Furthermore, the forces involved in merely turning your head to check your blind-spot when driving can exceed those of a neck adjustment. However, a rare number of people may have a connective-tissue disorder that can weaken the arteries. Such persons may be at greater risk of injury even when checking blind-spot or washing their hair in a basin, than the normal population. 10
CHIROPRACTIC CARE is considerably safer than usual medical and surgical treatments for benign spinal conditions.
1. Drugs and surgery are the third biggest cause of death second only to cancer and heart disease.11
2. Neck surgery has a risk of complication in 3-4/100 cases, which leads to death in 4-10/1000.12
3. The risk of complication from using non-steroidal anti-inflammatory drugs is 1:25. The risk of death from their use is 1:250 (360 Australians and 3200 Americans die each year due to their use).13 Chiropractic care has been shown to be 250 times safer than the use of anti-inflammatory drugs for the same conditions.14
1. Meade TW, Dyer S, Browne W, Townsend J, Frank AO. (1990) Low Back Pain of Mechanical Origin: Randomised Comparison of Chiropractic and Hospital Outpatient Treatment. The British Medical Journal 300:1431-7.
2. Manga P, Angus D et al (1993) The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain, Pran Manga and Associates, University of Ottawa, Canada.
3. Shekelle PG, Adams AH, Chassin MR et al (1991) The Appropriateness of Spinal Manipulation for Low Back Pain: Indications and Ratings by a Multidisciplinary Panel. RAND Corp, Santa Monica, California.
4. Senstad O, Leboeuf-Yde C, Borchgrevink C. (1996) Predictors of Side Effects of Spinal Manipulative Therapy. J Manipulative Physiol Ther 19(7):441-5.
5. Senstad O, Leboeuf-Yde C, Borchgrevink C. (1997) Frequency and Characteristics of Side Effects of Spinal Manipulative Therapy. Spine 22(4):435-40.
6. Dvorak J, Dvorak V. (1992) Study cited in Haldeman S. (1992) Principles and Practice of Chiropractic. 2nd ed. USA: Appleton and Lange. 121-3 and 250-4.
7. Terrett AG (2001) Current Concepts in Vertebrobasilar Complications Following Spinal Manipulation, NCMIC Group Inc: West Des Moines, Iowa.
8. Haldeman S, Carey P, Townsend M, Papadopoulos C. (2001) Arterial Dissections Following Cervical Manipulation: The Chiropractic Experience. Canadian Medical Association Journal, 165(7):905-906.
9. Symons BP, Leonard T, Herzog W. (2002) Internal Forces Sustained by the Vertebral Artery During Spinal Manipulative Therapy, J Manipulative Physiol Ther 25:504-510.
10. Herzog W, Symons B. (2002) The Mechanics of Neck Manipulation with Special Consideration of the Vertebral Artery, J Can Chiropr Assoc 46(3):134-136.
11. Starfielf B. (2000) Is US Health Really the Best in the World? Journal of the American Medical Association (JAMA) Jul 26, 284(4):483-5.
12. The Cervical Spine Research Society Editorial Committee. (1990) The Cervical Spine. 2nd ed. Philadelphia, PA: Lippincott. 834.
13. Terrett AG (2001) Current Concepts in Vertebrobasilar Complications Following Spinal Manipulation, NCMIC Group Inc: West Des Moines, Iowa.
14. Dabbs V, Lauretti WJ. (1995) A Risk Assessment of Cervical Manipulation vs NSAIDS for the Treatment of Neck Pain. J Manipulative Physiol Ther 18(8):530-6.
Chiropractic care can be extremely beneficial to post-surgical back pain patients. The role of surgery is to remove the symptom-producing structure from the spine when the body is incapable of healing the damage. This often requires cutting a small amount of disc and/or bone from the spine as well as deadening some nerves. Some spinal surgeries also require the area of the spine to be stabilized with titanium rods and screws. It is important to point out that it is NOT the role of surgery to address the original cause of the damage. If the original problem is of a mechanical nature, the mechanical back problem usually remains after surgery and should respond to conservative care if the patient still experiences post-surgical back pain. X-rays and scans are used in these cases to determine how and where Chiropractic may be safely applied to the spine. The specifics of your case are discussed at length before we agree to administer Chiropractic care.
Pain is a protective mechanism our body uses to tell us something is wrong. Pain is known to be an emotional response to a noxious stimulus that is generated in the higher brain centres. That is why individual pain perception differs, as does individual pain thresholds. Our bodies are able to adapt to minor aches and pains, however, if the pain persists, the cause of the problem must be addressed. Symptoms may worsen with time and the body is forced to compensate for any lingering problem. Mechanical compensations in the spine often lead to accelerated wear and tear to that region of the spine. It can also take years for symptoms to manifest after the original injury was sustained. Early detection and correction of problems are the best course of action.
Yes we can adjust osteoporotic patients. We adapt our technique to your age, size and condition. There are many ways for us to adjust your spine, so there are always different alternatives. A bone density scan is usually recommended to those patients who have concerns relating to bone mineral density or osteoporosis,
Unfortunately we are not able to adjust ourselves. An adjustment is a specific thrust and vector delivered to a joint that has been prepositioned from the subluxated position, back to neutral, which repositions the vertebra back on top of the disc. The adjustment is not just the popping noise you hear when you pull on your fingers, these noises as we discussed earlier relate to the release of gas from the synovial fluid. Not even Dr. Barry is able to adjust himself; he receives regular treatment from his chiropractic colleagues.
The birth process is a very dramatic event for mother as well as for the child. The child's spine can be injured during the birth process and subsequently produce a number of symptoms.
Even today's "natural" childbirth methods can affect an infant's spine. Colic, unusual crying, poor appetite or erratic sleeping habits can be signs of spinal distress. Adjustments are gentle. Knowing exactly where to adjust, applying no more pressure than you'd use to test the ripeness of a tomato is involved.
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