WHO defines chiropractic as “a health care profession concerned with the diagnosis, treatment, and prevention of disorders of the neuromusculoskeletal system, and the effects of these disorders on general health.” (1)
Chiropractors focus their treatment on manual procedures that aid in joint adjustment and manipulation but most of their focus is on subluxation.
Subluxation is defined as the slight misalignment of the vertebrae. Chiropractors believe that many of the health problems that occur in the human body may be caused by subluxation.
Chiropractors aid in the improvement of the overall health of patients through manual techniques to the musculoskeletal system and the spine (especially in the nervous system).
Founded by Daniel David Palmer in 1895 in the United States, the practice of chiropractic care has now spread in different countries with chiropractors helping people relieve pain in a fast and economic way.
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The Problem with Pain
Pain is one problem that has affected millions of people from all walks of life. In the United States alone in 2016, the CDC estimates that 20.4% of adults (around 50 million) had chronic pain, with a higher prevalence in patients with advanced age. (2)
Chiropractic care aims to relieve pain— both acute and chronic.
Acute pain is a type of pain that occurs in a shorter amount of time, typically less than 3 to 6 months, in any part of the body, but most especially on the muscle, tendon, or joint. Acute pain is commonly caused by trauma or an underlying disease but typically resolves once the trauma has healed or the disease is cured.
Chronic pain is more complex and difficult to treat. It is a complicated disease that involves not only the physical but more often, the mental and emotional health of patients.
Patients suffering from chronic pain have been suffering this pain for a long time, some even decades. Examples of chronic pain are those with fibromyalgia, arthritis, migraines, and nerve damage. Most patients with chronic pain have an underlying illness that is hard to treat and have become debilitating that it has affected their activities of normal living.
Tension-type headache (TTH) is very common and affects about 30% to 70% of the population. Patients coming in to see chiropractors with complaints of tension-type headache occupies about 5% to 8% of cases. (3)
Tension headaches can develop at any age and women often suffer more than men. It can last from 30 minutes to several days and constantly affects both sides of the head. Tension headaches is caused by a number of triggers such as stress and anxiety, poor posture, dehydration, lack of physical activity, noise, and even sunlight. It is known as a primary headache together with cluster headaches and migraines.
Chiropractors help patients with tension-type headaches through spinal manipulative therapy by upper cervical manipulation, improvement of their body posture or postural exercises, trigger point therapy, neck stretching exercises, and soft tissue therapy in general.
All these procedures are holistic structural approaches that help improve pain by manipulation, mobilization, and exercises.
Acute Neck Pain
One example of acute pain that can be improved by chiropractors is Acute Neck Pain (ANP). It is defined as a sudden onset of neck pain present in less than 1 month. This is usually caused by traumas like that seen in a traffic-related whiplash injury or poor posture or even those seen in patients who strain their neck while lifting heavy objects. This condition may progress to worsen and become subacute or chronic in nature.
To treat acute neck pain, chiropractors use manipulation of the neck and spine, massage or physiotherapy, exercise, proper posture, and nutritional counseling to help with the pain.
In a study done by Haneline et al. (4), in 2009, they noted that the use of chiropractic treatment in patients with acute neck pain was successful in improving the pain of patients from baseline to final evaluation outcomes.
Shoulder pain is a common reason for patients to seek out help from a chiropractor. In one study, they have analyzed that about 8.6% of patients coming in for chiropractic consults are due to pain in the upper extremity, specifically the shoulder area. (5)
The shoulder is a complex area where a lot of muscles, joints, tendons, and nerves are present. It carries the head, which is one of the heaviest parts of the body and the shoulder performs multifaceted tasks daily which is why it is not a surprise that pain in the area is common.
Chiropractors use cryotherapy, the manipulation of the soft tissue, and tendons in these areas. One method is known as Pennel’s technique or trigger point therapy. This is done by applying pressure on the trigger points that may be causing shoulder pain (usually located in the muscles of the supraspinatus, deltoid, infraspinatus, or the teres minor).
The pressure is applied to these areas between 5 to 15 seconds, it may begin with a light, firm pressure that gradually increases. The duration of the pressure will depend on the number of trigger points. This is done repeatedly and may need a number of visits for the pain to eventually disappear.
About 80% of the population will experience back pain at some point in their life and the majority of patients coming in the clinics of chiropractors are because of it. The most common type of back pain is one that is located on the lower back.
Most low back pain can be the result of an injury through muscle strain or sprain, poor body mechanics while lifting heavy objects, poor posturing, or even because of devastating illnesses like cancer of the spinal cord, sciatica, arthritis, or herniated discs.
Back pain can be acute or chronic in nature. They are common in patients aged 30 years old and above and mostly this is because of aging. As you grow older, the fluid present between the vertebrae of the spine also decreases. This fluid aids the spine in moving smoothly and a decrease in this fluid means that the spine experiences irritation more easily causing the pain.
This area also loses muscle tone as we age, making the back more prone to injuries which is why chiropractors help with low back pain through stretching, spinal mobilization, improved posturing, and exercises that can ease low back pain.
The pain will not go away with just one visit and may require multiple techniques but the majority of patients with low back pain have experienced relief from chiropractic techniques than pharmacological interventions because the root of the pain is addressed.
Back Related Leg Pain
Back related leg pain (BRLP) is a variation of low back pain that has a 40% lifetime prevalence. It can be so painful that it sometimes causes disturbance in the daily activities of patients.
BRLP is defined as a group of symptoms that affect either one or both lower extremities. This is usually from pain radiated by the lumbar (lower back) region. It typically affects the nerve especially the lumbar nerve.
Chiropractors treat back-related leg pain, the same as they treat low back pain, with spinal manipulative therapy, exercises, improvement of posture done in a number of sessions.
How is Chiropractic Care is Done?
Research made on chiropractic therapy is mostly focused on spinal manipulation especially designed for low back pain. Spinal manipulation is the process of the therapeutic movement of the spine. It mostly encompasses a quick and strong pressure on a joint between two parts of the vertebrae of the spine.
Chiropractors do not only help in relieving pain in the back but other parts of the body such as the neck, upper extremity, muscle and ligament, joint injuries, and the head as discussed above.
When arriving in the clinic for the first time, our chiropractor will assess and do a physical examination to help understand your condition better. Management of pain is done over multiple visits especially when chronic pain is involved.
There are over a hundred spinal manipulation techniques used by chiropractors. Chiropractic care techniques vary and are used in different areas of the spine, or used depending on your need as chiropractors see fit.
Here are some of the most common chiropractic techniques that are used:
- Diversified or Direct Thrust Technique
The direct thrust technique is one of the most common techniques used by chiropractors. It is also one of the oldest. To do this, chiropractors use their hands and apply a quick and high-velocity thrust to align the spine. This is usually done on a part of your spine (either the cervical, thoracic or lumbar area) and then they move it to one side for repositioning.
- Spinal Mobilization
The spinal mobilization technique is almost the same as the direct thrust technique but only uses gentle thrusts and involves more stretching. It is used to restore and improve joint function. The majority of chiropractors use this technique because it is safer.
- Gonstead Adjustment
This technique involves the realignment of the spine to reduce pain and inflammation in the affected areas of the body. This is done to address areas with a restricted range of motion and nerve pressure using a hands-on technique.
This technique was established in 1932 by Clarence Selmer Gonstead. He had a background in mechanical engineering which allowed him to develop this technique. It uses digital and motion palpation, postural observation, and x-ray assessment, this way, the safety of the treatment are guaranteed.
- Flexion- Distraction
The flexion-distraction technique is also called the Cox technique. It is less commonly used and involves the adjustment of the skull and stretching of the back to align the spine into its normal position.
It is used for low back pain, sciatica, arthritis, scoliosis, and even in lumbar disc injuries. The goal of this technique is to increase spinal motion and treat disc herniations. It is gentle, non-forceful, and aims to improve symptoms of a herniated disc (to avoid surgery) and reduce the pressure of the spinal nerves.
- Activator Method Chiropractic Technique (AMCT)
In this method, the chiropractor uses a spring-loaded, hand-held mechanical instrument called the Activator Adjusting Instrument. It is used to help deliver a gentle impulse on the spine.
This technique is used to help neck pain, back pain, and even headaches.
- Drop Technique
The drop technique is also called the Thompson Terminal Point. It involves the use of special treatment tables that come with a drop mechanism to help mobilize the joint. It is often used together with a traditional manipulative adjustment method to provide high velocity, low amplitude, and low force adjustment.
- Logan Technique
The Logan Technique uses pressure on a leverage spot on the sacral bone. This gentle pressure helps in treating the muscles of the back and pelvis. It helps realign the bones in the spine and improves headaches (tension and migraine) and back pain.
The technique requires the chiropractor to hold pressure for a few minutes while the back muscle is also manipulated to release tension. This action causes the spine to move toward a more balanced position. The Logan Technique is very gentle yet effective in improving pain.
- Soft Tissue Therapy
The soft tissue technique uses complex soft tissue massages that focus on the muscles, connective tissue, ligaments, tendons, and joints. It helps improve blood flow and circulation of patients.
Soft tissue therapy is often used for sports injuries, chronic pain, and occupational stress. It helps increase patients get relief from stress or tension, increases the mobility of the muscles, and decreases pain.
This technique is often used together with other techniques and is generally safe and provides fast relief from pain.
Chiropractors not only help in relieving pain through spinal manipulation but also intends to improve the overall health of patients. They will discuss other risk factors and lifestyle changes that you may need to work on to avoid further worsening or recurring pain.
Let’s recap our article pertaining to chiropractic care:
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If you want to review what we have talked about in this article you may jump right through their section:
If you think you can improve your overall health, decrease your pain, or be tension free thru chiropractic care and treatment, you may schedule a consultation online!
- World Health Organization. World Health Guidelines on basic training and safety in Chiropractic. Switzerland: WHO Press; 2005.
- Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., Debar, L., . . . Helmick, C. (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — the United States, 2016. MMWR. Morbidity and Mortality Weekly Report, 67(36), 1001-1006. doi:10.15585/mmwr.mm6736a2
- Vernon, H., & McDermaid, C. (1998 dec). Chiropractic management of episodic tension-type headache: A survey of clinical specialists. 209-215.
- Haneline, M. T., & Cooperstein, R. (2009). Chiropractic care for patients with acute neck pain: Results of a pragmatic practice-based feasibility study. Journal of Chiropractic Medicine, 8(4), 143-155. doi:10.1016/j.jcm.2009.08.003
- Hains, G., Descarreaux, M., & Hains, F. (2010). Chronic Shoulder Pain of Myofascial Origin: A Randomized Clinical Trial Using Ischemic Compression Therapy. Journal of Manipulative and Physiological Therapeutics, 33(5), 362-369. doi:10.1016/j.jmpt.2010.05.003