According to the American Chiropractic Association (ACA), back pain prevents millions of Americans from engaging in everyday activities. It is also the single leading cause of disability worldwide. People battling acute and chronic pain usually turn to a medical doctor for help. Traditional first-line treatment for pain revolves around the use of various pharmaceutical drugs.
Drugs such as over-the-counter painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) are first-line pain relief medicines. In cases of severe pain, doctors may prescribe narcotics or opioids such as codeine or hydrocodone. The problem with these drugs is they are habit-forming and produce unwanted side effects both on a short-term and long-term basis.
Over the years, more patients are turning to chiropractic care and other alternative ways to alleviate pain. The reason for this is linked to the science behind chiropractic care. Chiropractic is really an attempt to treat pain by identifying the underlying condition instead of treating the symptoms. Chiropractor adjustment is the primary tool used by chiropractors to relieve back pain and pain caused by joint dysfunction.
What Exactly is a Chiropractic Adjustment?
Chiropractic adjustment is a skilled technique Doctors of Chiropractic use to realign the joints, bones, discs, and soft tissue of the spine in particular. Spinal adjustment, also known as spinal manipulation, is reserved for realigning the spine as the name suggests. It is typically done to correct a subluxation that usually results in lower or upper back pain of varying intensity and length of time. A subluxation is essentially where a portion of the spine shifts out of alignment.
Chiropractors also adjust other body joints such as the shoulder, elbow, wrist, and knee, also called extremity adjustment. There are different techniques or methods they can use to correct joint misalignment. It all depends on the needs of a particular patient. Common techniques they utilize include:
- Diversified Technique
- Gonstead Technique
- Activator Method
- Thompson (drop table) Technique
- Flexion-Distraction Technique
Who Performs the Adjustment?
Doctors of Chiropractic, or chiropractors, perform adjustments to alleviate back pain and other symptoms related to back injury, trauma, or degenerative disc diseases. Pain commonly stems from spinal injuries from an accident and age-related deterioration of the spinal joints or intervertebral discs.
For example, a herniated disc also called a slipped disc or ruptured disc.A disc or joint may slip out of its normal position and press on a nearby nerve causing back pain,numbness, or tingling.
A common pinched nerve condition is sciatica where a herniated disc compresses the sciatic nerve, causing lower back pain and leg pain. Other common back pain conditions treated with chiropractor adjustment include:
- Spinal stenosis
- Spinal osteoarthritis
- Bulging disc
- Vertebral fracture
- Muscle or ligament strain
Adjustment is also used and is safe for neck pain, whiplash, headaches, and migraines. Some chiropractic clinics even offer gentle and safe adjustment to pregnant women with conditions such as sciatica or sacroiliac joint pain. Adjustment is also safe for infants and pediatric patients and is done to promote good nervous system development as well as structural balance as they grow.
That being said, in order for an individual to become a licensed chiropractic physician, he or she must successfully complete at least 3 years of undergraduate studies at an accredited college. This is followed by 4 years in a Doctor of Chiropractic program where they receive specialized training. A 1-year internship stint at a clinic is also required at some point.
Some chiropractors do an additional 2 to 3 years of residency after completing the program. To practice, they need to get certified by the National Board of Chiropractic Examiners and the State Board of Examiners in the state they intend to practice. Others take additional courses to master their techniques or as part of continuing education to maintain their license and stay up-to-date with advanced techniques.
Why the Need to Adjust the Spine?
Chiropractic physicians are what you can call “trained specialists” in the science of pain relief by addressing problems linked to the musculoskeletal and nervous systems. There is irrefutable scientific evidence that concludes chronic back pain is linked to imbalances somewhere in the central nervous system (CNS).
So, the objective becomes to identify the imbalance or dysfunction and address it at its source.
This is in contrast with the traditional medical approach of treating pain as a symptom instead of seeking to correct the reason for the pain. In addition, spinal adjustment is considered the most effective way to correct dysfunctions or nervous system interference caused by vertebral subluxation and relieve chronic back pain.
You see, the brain and the spinal cord (a bundle of nerves) in the spinal column make up the nervous system. One main function of the nervous system is to regulate sensory information between the brain and spine. It sends signals or messages to the spine and other parts of the body and influences how the body responds to sensations such as pain. The CNS also plays an important role in body motion or movement.
When back pain develops and lasts for more than 12 weeks, doctors consider the pain as chronic and usually prescribe medication. Chiropractic doctors usually suspect that pain lasting this long or longer is a sign that something is “off” with nervous system functions. Once they do a detailed evaluation and confirm this is the case, they may recommend spinal adjustments to restore function and improve range of motion.
Realigning the vertebrae helps to relieve back pain since it takes the pressure off the disc, nerve, and soft tissue. It also helps stimulate the flow of vital nutrients to spine, which assists in reducing inflammation and healing of the disc and tissue.
How is the Adjustment Done?
Spinal manipulation is a non-invasive, painless, drug-free way to improve spinal motion and improve your body’s physical function. The manner in which the adjustment is done will depend on the technique used.
In general, a chiropractic adjustment is done by hands (manually) or using a small instrument. In the case of spinal adjustment, the goal is to apply gentle pressure to the segment of the spine where the subluxation or misalignment is present.
To be more specific, here is how an adjustment is done and what it seeks to achieve using these 5 common techniques:
- Diversified Technique: The Diversified Chiropractic Technique, or DCT, is the traditional and most widely used adjustment method. It involves applying short (low-amplitude), quick (high-velocity) thrusts to the restricted joints to realign the spine, correct joint dysfunction, and increase range of motion. For that reason, it is also called the Direct Thrust Technique.
- Gonstead Technique: Precise thrusts are applied to the exact parts of the vertebrae that are out of alignment (the subluxation). The techniques help to restore normal alignment and motion and correct nerve interferences resulting from the subluxation.
- Activator Method: A handheld instrument helps to deliver gentle impulses that feel like a thumping sensation to the targeted segment of the spine or the extremity joint. This method is effective in treating low back pain, headaches, and migraines. The procedure is painless and safe for almost anyone who chooses chiropractic care for back pain or pain in the extremities.
- Thompson (drop table) Technique: Good for spinal and extremity adjustments. The patient lays flat on a specially-designed table with sections that can be lifted up or down. The table drops slightly each time the chiropractor applies pressure (thrust) to carry out the adjustment. This helps make the adjustment session comfortable for the patient.
- Flexion-Distraction: A type of decompression manipulation also known as the Cox Technique. Many chiropractic clinics use the non-surgical technique for resolving disc herniations, disc bulges, sciatica, and for increasing spinal flexibility, particularly in the lumbar or lower back spine. The technique is performed on a special adjusting table. During the treatment session, the patient usually feels a gentle stretching motion as the physician performs the procedure to take pressure off the lumbar spine and surrounding structures.
Other Applications of Chiropractic Adjustment (other tools used in chiropractic)
Chiropractors also use adjunct therapies to enhance the results of chiropractic adjustments and maximize pain relief. Some common therapies that may be recommended or included in your chiropractic care plan are:
- Manipulation therapies: Used to mobilize muscles and other soft tissue as a way of reducing swelling, inflammation, and myofascial pain. A popular technique is the Graston Technique where an instrument is used to break up scar tissue and release fascia (soft tissue) restrictions.
- Massage therapies: It is common to combine chiropractic adjustment with massage therapy prior to or following the adjustment. Doing so helps to relax the muscles, relieve soreness, reduce pain, increase blood circulation, and accelerate healing.
- Heat/cold therapies: Chiropractors use hot and cold therapies to help patients treat back pain and extremity pain. Therapy can start with a heating pad or heat wrap to stimulate blood flow to the treatment area for about 10 to 15 minutes. An ice pack is then used to numb the back for 10 to 15 minutes. Treatment can continue by alternating between applying the heat pad and cold pack.
- Other soft-tissue therapies: Laser therapy, electric stimulation, and ultrasound therapy are commonly used in chiropractic care for pretty much the same reasons as massage therapy. These chiropractic therapies help to reduce pain and inflammation and aid soft tissue healing and repair
- Corrective exercises: Patients are usually encouraged to do special corrective exercises at home. They may receive instructions on how to perform the exercises as well as therapeutic stretches. Corrective exercises are like a do-it-yourself form of physical therapy for back pain that helps to strengthen the back and increase flexibility.
- Lifestyle and nutritional counseling: Chiropractic care takes treatment a bit further to include nourishing the body to build an immune defense against inflammation and pain. Your Doctor of Chiropractic may recommend foods that can help you achieve this. He or she may also recommend dietary supplements to boost overall wellness and restore balance. In addition, your physician may advise you to avoid certain activities or posture to prevent re-injury and back pain.
First Steps to Treatment
There are different stages in getting a chiropractic adjustment. The process usually begins with your initial consultation at the chiropractor’s clinic. Here’s what you can expect at your first visit:
- A detailed physical exam and medical evaluation
- Start of the first chiropractic treatment session (possible)
- A consultation that lasts approximately 30 minutes. Longer if treatment begins.
A thorough physical exam will be done. Depending upon the findings in the initial exam, further diagnostic tests may be ordered to complete the evaluation. Other tests may be done, such as:
- Assessing the range of motion of your back or other affected body part
- Checking your muscle strength and tone
- Analyzing your posture and gait to identify any structural imbalances
Patient History and Symptoms
At your first visit to the chiropractic clinic, you will need to fill out medical forms to provide information about symptoms and any other health condition you have. This will help in making an initial diagnosis in determining your care.
There may be a questionnaire to fill out on things like the nature and location of your pain, when it started, and whether you were recently injured, or if you are receiving any treatment or taking any medication currently.
An X-Ray, CT scan, or MRI may be necessary when soft tissue or musculoskeletal injury is suspected.For example, in cases of muscle tear, herniated disc, or nerve compression. Neurological tests may also be performed to assess the function of the nervous system. The results of the exam and tests will help with exploring whether chiropractic adjustment or other treatment options are right for you and to reach a more concise diagnosis for patient care.
After The Procedure
There may be discomfort if the muscles surrounding the area are in spasm, but this discomfort is short-lived. You may experience minor, short-lived discomforts in the days following the session such as fatigue, headaches, or pain in the treated areas. Be sure to follow up with your practitioner if these symptoms persist. They may offer alternative techniques such as physical therapy, acupuncture, massage, or electrical stimulation to help the process.
Chiropractic adjustment is an effective treatment particularly for the lower back, but it is important to note that, like all established and regulated treatments, it is not a “miracle cure”. Steady alleviation of pain has been reported in many studies, with more still suggesting that the practice is also effective in the treatments of spinal conditions, headaches, and injury-related subluxation. It is frequently complimentary to other forms of treatment, and, as always, other avenues of alleviation are often explored in congruence with chiropractic adjustments.
Severe complications resulting from a chiropractic adjustment are rare, and, as is the case with all healthcare, chiropractic practice is safe only when administered by a trained and licensed professional. Rare complications include herniated disks, nerve compression, or a particular type of stroke which results from an interruption of blood flow in the neck. A 2009 estimate of the risk of this type of stroke following chiropractic adjustment was roughly one in 10,000,000. For context, that percentage is 100 thousand times higher (aka 100 thousand times less likely) than the surgical mortality death rate of 1%.
What About After My Appointment?
Your practitioner will probably suggest some at-home exercises, such as stretching or light yoga; they may discuss nutrition as well. Certain foods such as dairy, sugar, refined carbs, certain vegetable oils, and red meat have a known inflammatory effect on the body. Frequent ingestion of these inflammatory foods can exacerbate your already painful condition. Therefore it may be suggested that you reduce your intake of these foods, or other foods to which you may have a personal intolerance or allergy. Even if you have a relatively mild intolerance or allergy, intake can have a cumulative inflammatory effect and cause chronic inflammation or even histamine overload. This will increase general body inflammation, which will exacerbate whatever existing conditions you suffer from. Other methods of combating inflammation could be through intake of turmeric, garlic, green tea, or ginger; all of which have solid and proven anti-inflammatory effects.
Payment and Insurance Coverage
Depending on your insurance and the wide variety of coverage, chiropractors will work with you and your particular plan to find the best coverage. However, there are certain exceptions to some insurance policies in this regard. For example, Medicare Part B is willing to cover manual manipulation of the spine if the procedure is medically necessary to correct a subluxation when provided by a chiropractic physician or other qualified provider.
Insurance plans, including Medicare Part B, are more likely to cover chiropractic services to correct a spinal subluxation following an auto accident. Private insurance plans may also provide similar coverage. Note that co-pay and deductibles may apply.
It’s probably best to talk with your insurance provider upfront to find out if you have coverage for a chiropractic adjustment. Of course, those who can afford to pay out-of-pocket for chiropractic adjustments and other related services need not worry, most chiropractors will offer a cash discount for services provided. Read more about what it costs to visit a chiropractor.
The Ultimate Choice is Yours
Chiropractors generally work hand in hand with other specialists to give the patient the best treatment for relieving back pain. However, chiropractors are trained and specialized in non-invasive adjustments of the spine to relieve back pain and other symptoms due to an injury or degenerative condition. This is a unique technique that western medicine does not offer.
If you’re looking to avoid chemicals or prescription medicine or avoid surgery, then try chiropractic care. Furthermore, by combining other therapies, the patient not only has an opportunity to experience lasting pain relief but also to enjoy overall wellness. If you would like to try chiropractic for yourself, call us to schedule a consultation today.
Doctor Ferguson has advanced training with neurological, musculoskeletal, and all areas of sports medicine and injuries to the spine and the extremities such as shoulders, knees, and ankles etc. with specialization in musculoskeletal injections to the spinal regions as well as the upper and lower extremities both acute and chronic. Dr. Ferguson is an advanced Integrative medicine and rehabilitation specialist.
- American Chiropractic Association (ACA): Back Pain Facts and Statistics: https://www.acatoday.org/Patients/What-is-Chiropractic/Back-Pain-Facts-and-Statistics
- Harvard Health Publishing: Chiropractic Care for Pain Relief: https://www.health.harvard.edu/pain/chiropractic-care-for-pain-relief
- Medicare.Gov: Is My Test, Item, or Service Covered?: https://www.medicare.gov/coverage/chiropractic-services
- National Institutes of Health (NIH): Evidence-Based Practice and Chiropractic Care: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716373/
- Spine Health:What to Expect at the First Chiropractic Consultation:https://www.spine-health.com/treatment/chiropractic/what-expect-first-chiropractic-consultation
- Spine Health:Chiropractic Services Beyond Adjustments: https://www.spine-health.com/treatment/chiropractic/chiropractic-services-beyond-adjustments