What is an Adjustment and Why Might I Need One?

A quick search of chiropractors in online videos will bring up a list of pops, cracks, and snaps. These videos rarely go into depth about what is happening and can even be misleading. What exactly are these doctors doing and why?

The primary means of treatment for chiropractors is the adjustment (known medically as manipulation). An adjustment consists of a quick, low force thrust applied to a joint that is fixated, poorly positioned, or moving dysfunctionally. That specific complex of symptoms was historically described by the term subluxation but is now sometimes described as segmental dysfunction.

Just as there are many types of medicines, there are also many types of adjustments.

Manual Adjustments

The original and most common type of adjustment is done entirely by hand without the use of any devices, instruments, or special table mechanisms. Though there are various techniques, most are applied either in the face down position (prone), the face up position (supine), or side laying. A few select kinds of adjustments are done with the person seated. A properly applied hand adjustment is swift and gentle, using very little force.

Manual adjustments (done entirely by hand without any instruments or tools) tend to produce the characteristic “crack” associated with chiropractic. This noise is created when the space between joints is increased briefly, releasing small nitrogen bubbles that result in a popping noise. The technical term is tribonucleation, and most of us experience it regularly in the form of cracking the knuckles or suddenly stretching a joint.

Contrary to popular belief, the “crack” has almost nothing to do with an effective treatment. Specific, precision movement of the joint in question is the key element of an adjustment, and not all adjustments will result in an audible sound.

Table Assisted Adjustments

Another common type of adjustment involves the use of a specialty table to aid the doctor in moving the desired joint. These adjustments typically use a dropping mechanism, where a part of the table is lifted into position then dropped to its original position when the chiropractor applies the adjustive thrust to a specific joint.

The dropping mechanism is relatively noisy and as a result, cracks are rarely heard using this type of treatment. Drop adjustments are very gentle because the table absorbs some of the thrusting force, resulting in a smoother treatment. Table assisted adjustments work great on sensitive or fragile patients. They may be useful for smaller doctors without the proper reach to treat patients larger than themselves.

Instrument Based Adjustments

Many chiropractors utilize hand or computer operated tools to apply their adjustments. These handy tools have the advantage of being extremely consistent and can be used to treat hard to reach areas of excessively tender spots. They usually apply less force and are excellent for patients with reduced bone density or high sensitivity to touch.

Instrument based adjustments do not produce a tribonucleation “crack.” They generally do not separate the joint enough to release nitrogen bubbles and don’t require the patient to be in a special position. Just like an adjustment done only by hand, instrument-based adjustments still require the doctor to manually locate the problem areas.

Because there is no twisting or sound associated with instrument adjustments, patients will sometimes not notice immediate changes. Instrument adjustments produce more subtle changes but are just as effective as adjustments done by hand.

But what symptoms are adjustments effective in treating?

Common Symptoms Relieved by Chiropractic Adjustments

While there are many different problems, or symptoms, adjustments are used to address, the most common include:

• Neck pain
• Low back pain
• Headaches
• Stiffness or loss of range of motion
• Extremity pain, such as in the shoulders, hips, or knees
• Carpal tunnel syndrome and other wrist problems
• Ankle pain and imbalances of the foot
• General wellness of the spine

Most choose to get adjusted because they are experiencing pain or have difficulty moving properly. An adjustment can help with a variety of painful conditions by helping to improve movement, reduce tension by correcting alignment, increase function of the nervous system, and relieving muscle tension in the locally attached muscles.

Distortions in the posture and joints may take more than an adjustment to correct: many chiropractors will also offer advice on exercises and lifestyle habits that can help reduce the need for adjustments and improve overall quality of life.

Should I Get Adjusted?

Whether or not you should be adjusted depends a lot on your health goals and if you are experiencing any symptoms. Only a qualified chiropractor can determine if your concerns may be alleviated with an adjustment. If you have concern over any of the symptoms listed above, it’s worth getting checked out by a doctor.

Most of the symptoms discussed in this article can be dramatically improved or even eliminated without ever needing to use any medications or surgeries. Your chiropractor can help put together a plan to get your health back to its fullest.

If you or someone you know is experiencing any of the above symptoms, we may be able to help! Give our offices a call today.

About the Author

Dr. Brandon Orsino is a chiropractic physician specializing in treating injuries related to automobile accidents. Along with the other chiropractors at Dynamic Medical & Rehabilitation, he uses chiropractic techniques and physiotherapies to get patients feeling better and back to living their best lives.