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Chiropractic Adjustment

Chiropractic adjustments are a safe and effective way of treating many different painful conditions and neuromusculoskeletal disorders.


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What is a Chiropractic Adjustment?

A chiropractic adjustment (also called Chiropractic Manipulative Treatment or Manual Manipulation) is a treatment provided by a chiropractor to correct segmental and somatic dysfunction (i.e. subluxation or vertebral subluxation). The goal of the treatment is to optimize joint health/function and neurophysiological function.


A chiropractic adjustment can be performed using the chiropractor's hands, handheld tools, and other chiropractic technique devices.


Chiropractic adjustments are commonly performed on the spine, but can also be performed on other joints in the body (i.e. shoulders, wrists, knees, ankles, hips, etc.).


Chiropractors are the only healthcare provider licensed to administer a chiropractic adjustment. Chiropractors receive extensive training in manual manipulation far above all other healthcare professionals (including physical therapists, osteopathic physicians, naturopathic physicians, and medical doctors). If you receive manual manipulation (including spinal manipulation) from anyone other than a chiropractor, the treatment CANNOT be considered as a chiropractic adjustment.


Is Spinal Manipulation the same as a Chiropractic Adjustment?


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When spinal manipulation is performed by a chiropractor, it is considered a type of chiropractic adjustment. Spinal manipulation (also referred to as a High Velocity Low Amplitude Thrust or Dynamic Thrust) is the most common type of chiropractic adjustment performed by chiropractors around the world. Chiropractor's categorize these types of adjustments, as well as manual manipulation of other joints (i.e. shoulders, wrists, knees, ankles, hips, etc.) as Diversified Chiropractic Technique.


How do Chiropractic Adjustments work?

The exact mechanisms of how chiropractic adjustments actually work are still unclear. Currently, there are several theories involving plastic changes in the brain and interplay between the nervous system (central, peripheral, autonomic), musculoskeletal system, immune system and endocrine system. As more good quality scientific research is done on this subject, we should have a much better understanding of this very complex process.


What we do know, from thousands of scientific studies and millions of satisfied chiropractic patients, is that chiropractic adjustment are able to relieve pain (and other subjective complaints), improve function, enhance tissue repair and aid in the healing process of the entire body.


Do Chiropractic Adjustments hurt?

Most of the time, chiropractic adjustments do not hurt. In fact, many patients experience a release with some level of instant relief immediately following the adjustment.


If the area to be adjusted is inflamed, very tender to the touch, and/or the muscles around the joint are very tight, the patient can experience some pain when the adjustment is delivered. In these instances, the pain can be significant but usually only lasts a minute or two.


What should I expect after a Chiropractic Adjustment?

There are lots of ways you can feel (that night and/or the next few days) after a chiropractic treatment. Some patients feel significantly better after their first adjustment. Some patients report slight improvement, usually saying "It's a little better", "I feel a little looser" or "the pain got better but then came back". And, some patients experience soreness or discomfort. In fact, the most common side effect of manual manipulation is soreness. All of these results are totally normal and can be attributed to several factors, including (but not limited to) how long they have had the problem, how irritated or inflamed the area was prior to treatment, how receptive the patient was at the exact time of treatment, and/or how successful or encompassing the treatment that was delivered.


Do you have to be in pain to get a Chiropractic Adjustment?


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No. You do not have to be in pain to require and receive a chiropractic adjustment.


Chiropractic adjustments look to normalize/optimize the function of the joints, muscles, nerves, and associated systems and tissues.


Pain is only one of the symptoms of segmental and somatic dysfunction (subluxation or vertebral subluxation). Subjective complaints (pain, numbness, burning, soreness, etc.) may or may not be present in order to require a chiropractic adjustment. Other indications of segmental and somatic dysfunction (subluxation or vertebral subluxation) are changes in tissue tone (local or associated soft tissues: including skin, fascia, muscle, tendon and ligament), asymmetry/misalignment (e.g. postural, muscular, skeletal, strength, neural integrity), range of motion abnormalities (changes in active, passive, and/or accessory joint movement resulting in an increase or a decrease of sectional or segmental mobility), and tenderness to palpation.


How many Chiropractic Adjustments do I need?

The honest answer is "until the segmental and somatic dysfunction (subluxation or vertebral subluxation) is corrected or minimized to the point of optimal health for that individual".


Because chiropractic adjustments are trying to correct a functional problem, there are many factors that play into the amount of care necessary to correct the dysfunction. Things such as level of pain, chronicity of the problem, current inflammatory state, amount of neurological maladaptation and compensatory change, level of muscular dysfunction and asymmetry (weakness, hypertonicity, fatty infiltration, etc.), amount of fibrotic and degenerative change to the local and surrounding tissues, unaddressed and/or perpetuating external stimuli (poor ergonomics, continued use of the affected area, poor education regarding health status and condition management, etc.) and more.


Are there situations/conditions when I should not get a Chiropractic Adjustment? (Contraindications to a Chiropractic Adjustment)

There are two types of contraindications: relative contraindications and absolute contraindications.


A relative contraindication is a condition that adds risk of injury to the patient but does not rule out the use of chiropractic care (including dynamic thrust). In this case the doctor would assess the level of risk and discuss the risk with the patient to determine if the treatment is warranted and should (or should not) be performed. Examples of relative contraindications to a dynamic thrust type of chiropractic adjustment include (but are not limited to): Joint hypermobility and/or instability, severe demineralization of bone (e.g. osteopenia/osteoporosis), benign bone tumors at the site of manipulation, bleeding disorders and anticoagulant therapy, and radiculopathy with progressive neurological signs.


Absolute contraindications are conditions where chiropractic adjustments (dynamic thrust in particular) should not be performed. Examples of absolute contraindications to chiropractic adjustments include (but are not limited to): Acute inflammatory arthropathies characterized by acute inflammation and ligamentous laxity and anatomical subluxation or dislocation (including active/acute rheumatoid arthritis and ankylosing spondylitis), acute fractures and dislocations or healed fractures and dislocations with signs of instability, malignancy in the area to be treated, infection in the area to be treated, signs and symptoms of myelopathy or cauda equina syndrome, for the cervical spine: vertebrobasilar insufficiency syndrome or unstable os odontoideum, and artery aneurysm near area to be adjusted.


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Wishing you good health.


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DR. JASON HAGMAN

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