I want to explain what a chiropractic adjustment is because it is something I use to help my patients every single day.  And I especially want to talk about it because patients tell me many times that refer their friends and family to me; however, sometimes people get turned off by the thought of having their spine adjusted.

First, here’s a bit on semantics.  A chiropractic “adjustment” is (can be) considered anything that a chiropractor does to treat a patient; whether that be spinal or extremity manipulation of joints, soft tissue techniques, etc..  Whereas a chiropractic “manipulation” is (can be) intended to refer to the act of manipulating joints manually with a quick movement to that joint.  I will use the term “adjustment” in this article, while referring to manipulating joints, for personal reasons.  I don’t manipulate my patients, if you know what I mean.

We all know that when lay people refer to this type of treatment, they often use the word “crack”, because of the sound that it makes.  I don’t expect people to know the technical term, however, you’ll see why this term shouldn’t be used as I explain what a chiropractic adjustment is and what it does.  By the way, the “crack” noise that is heard is best described as nothing more than the release of air bubbles (potentially nitrogen, carbon dioxide, etc.) that are naturally within the synovial (joint) fluid.

Let’s begin with the technical aspects of an adjustment.  First of all, an adjustment doesn’t quite realign a bone that is out of place.  A bone “out of place” might better be referred to as a luxation or dislocation.  Essentially, a chiropractic adjustment restores spinal and extremity joints to allow for their full range of motion.  Lack of full motion is due to aberrant muscle function.  Remember, muscles move bones and joints.  An adjustment is used to restore proper joint (and muscle) motion.  This is what causes the fantastic therapeutic results afterward.  What are the results of normal joint range motion?  Let’s find out.

The joints in your body are all lined with cartilage which allows for a smooth gliding surface.  Unfortunately, cartilage has a very poor blood supply, which makes it more difficult to get nutrients in, and waste products out.  Instead of a large vascular network, cartilage uses a process called imbibition (to imbibe or “drink”) to maintain its integrity.  This is done through joint movement which basically squeezes waste products out during compression and allows nutrient to flow in during relaxation.  This is why continuous full joint range of motion is so important.  If this doesn’t occur, the joint will gradually degenerate because the cartilage continues to wear away, without regenerating properly.  A scenario like this is what can leads to pain and eventually osteoarthritis, possibly resulting in a permanent loss of full range of motion.  Remember the old adage: “move/use it or lose it”, well this is why.  If your joints (don’t forget spinal joints) don’t have full motion they will deteriorate.  And remember, the purpose of a chiropractic adjustment is to restore normal joint range of motion.

How will an adjustment stop my neck, low back, or knee from hurting?  Let’s continue.  Normal joint range of motion allows for the stimulation of sensory receptors on the joint surfaces, called mechanoreceptors.  So, as the joint moves it is contacting, therefore stimulating, these mechanoreceptors.  These receptors pick up mechanical forces and then transmit that information to the brain.  The sensations of light pressure/touch, stretch, vibration, joint position, and more are what gets transmitted.  It is important for me to note that PAIN does not get transmitted through mechanoreceptors.  Pain is transmitted to the brain via nerve endings called nociceptors.  OK, here’s the point.  If a nociceptor is stimulated, you feel pain – bottom line.  However, you can block the transmission of nociceptors (to the brain) by stimulating mechanoreceptors.  How are mechanoreceptors stimulated – through proper, full joint range of motion.  Additionally, mechanoreceptors travel to the brain (literally) faster than nociceptors.  As a result, you will get the message of the mechanorecptor (e.g. vibration, light touch, etc.) first, and experience those sensations instead of pain.  By the way, that’s one reason why you intuitively rub your knee after banging it on the coffee table; or ask someone to rub your back (you are stimulating nerve endings that pick up vibration AND literally blocking the pain nerve endings).  Don’t get me wrong now, you may need a little more than rubbing to get all pain to go away, but it helps initially.

I’ll leave it at that for pain and joint degeneration.  Now, let’s talk specifically about spinal nerves.  Aside from stimulating nerve ending that directly affect the joints, a chiropractic spinal adjustment will stimulate nerve endings that go directly to your organs.  Again, use it or lose it.  If the nerves that go to your organs are stimulating properly, that organ will function better.  That’s why many patients realize that they have better digestion when their low back gets adjusted; or their asthma clears up when their upper back gets adjusted.  You may need more help for conditions like those, but don’t you want all the help you can get?  A chiropractic adjustment can provide you with additional relief you wouldn’t get elsewhere.

One last thing on the structural front.  Adjustments are meant to be quick, because a quick stretch to the muscles attached to that joint will help relieve a muscle spasm that may be causing the limited range of motion to begin with.

OK, you don’t like the quick adjustment style that traditional chiropractic employs.  That’s fine when you are on my table.  I respect any decision my patient’s make.  I have much more than a hammer (therefore everything doesn’t look like a nail) when confronting my patients problems.  I can get your joints back to their normal range of motion through many gentle techniques, that have NEVER been opposed by my patients.  And lastly, the use of my specialty, applied kinesiology, is of prime importance in normal joint range motion.  That is because I ALWAYS work to restore muscles to their normal function.  Remember, muscles move bones and joints.  Who is to say that a your normal joint range of motion won’t restore it’s abnormal range of motion by the time you walk out the door — IF you don’t “fix” the muscles?

In conclusion, I don’t “crack” my patient’s spine or extremities; I restore their normal joint range of motion.  AND don’t forget, joints need proper nutritional support to function (or rebuild) optimally.

One more thing – the World Health Organization” (WHO) states that when “employed skillfully and appropriately, chiropractic care is safe and effective for the prevention and management of a number of health problems”.

By the way, there are other documented, physiological benefits of a chiropractic adjustment. I simply chose to discuss the major ones.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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