With regards to this article, and according to the United States Centers for Medicare & Medicaid Services, the terms “Segmental and Somatic Dysfunction” (a medical/osteopathic term) and “Subluxation” (a chiropractic term) are synonymous. They will be used interchangeably throughout the article.
What does "Segmental and Somatic Dysfunction" and "Subluxation" actually mean?
Starting with terminology (as it relates to this topic), the term “segmental” refers to the joints and the term “Somatic” refers to the body’s framework of skeleton, muscles, vasculature, lymphatics, and nerves.
With regards to the term “subluxation”, there are two categories of “subluxation”: medical subluxation and chiropractic subluxation. (Yes, I know this is already getting confusing. Just stick with it).
A medical subluxation refers to a joint that is “partially” dislocated. Usually caused by trauma, this type of injury is characterized by significant joint instability, anatomical damage (to the ligaments, tendons, joints and surrounding tissues) and possibly severe pain. It can also be caused by diseases (and medications) that damage joint tissue and ligaments, leading to significant joint instability. You will commonly see the term “subluxation” on an x-ray report from a medical radiologist. This is NOT what chiropractors mean when they use the term “subluxation”.
A chiropractic subluxation (also called a vertebral subluxation or vertebral subluxation complex when referring to the spine) and segmental and somatic dysfunction pertain to a FUNCTIONAL problem involving the bones/joints, associated musculature, and nervous system (the neuro-musculoskeletal system). The dysfunction occurs in all three systems (bones/joints, muscles, nerves) at the same time and are interdependent on each other. Subluxations (segmental and somatic dysfunction) can affect both tissues/structures local to the subluxation as well as associated systems and tissues throughout the body.
Subluxations can occur in any individual at any age.
What are the signs and symptoms of a subluxation (segmental and somatic dysfunction)?
Symptoms of a subluxation may include (but are not limited to) pain, numbness, tingling, burning, weakness, tightness, and soreness.
Other indications that a subluxation may be present are changes in tissue tone (local or associated soft tissues: including skin, fascia, muscle, and ligament), asymmetry/misalignment (e.g. postural, muscular, skeletal, strength, neural integrity), range of motion abnormalities (changes in active, passive, and/or accessory joint movements resulting in an increase or a decrease of sectional or segmental mobility) and tenderness to palpation.
It is important to understand that these signs and symptoms can occur independently or in any combination with multiple signs and symptoms occurring at the same time. It is equally important to recognize that a subluxation can be present without any overt subjective complaints. You DO NOT have to be in pain to be diagnosed with a subluxation or segmental and somatic dysfunction.
Can subluxations (segmental and somatic dysfunction) cause or contribute to other problems in the body?
Yes. In fact, it is very common to have at least one other (if not multiple) problems related to the subluxation. Any time there is a loss of normal neuro-musculoskeletal function (particularly in the spine and weight bearing joints) there can be a cascade of secondary and tertiary effects both local and distant to the subluxation. The severity and chronicity of the dysfunction will play a role in the presentation of these effects (i.e. the more severe the dysfunction and/or the longer you have had the subluxation the more likely the secondary and tertiary problems will be significant).
Common conditions caused by subluxations or conditions where subluxations may contribute to or exacerbate the presentation of the condition include (but are not limited to): Degenerative Joint Disease (e.g. osteoarthritis), Degenerative Disc Disease (e.g. disc bulge and herniation), Cervical Radiculopathy, Thoracic Radiculopathy, Lumbar and Lumbosacral Radiculopathy, Sciatica, Sacro-Iliac (SI) Joint Pain and Dysfunction, Facet Syndrome, Double Crush Syndrome, Headache and Migraine.
What causes Subluxations (Segmental and Somatic Dysfunction)?
A subluxation can be caused by anything that directly or indirectly affects normal function of a joint (and its associated muscles and nerves) to the extent that restoration of normal function does not occur. Some of the more common causes of subluxations include (but are not limited to) poor posture, falls, motor vehicle accident and whiplash, lifting/mechanical injury, repetitive motion, jobs and sports that involve repetitive one sided movement (e.g. golf swing, line work, dentistry, etc.), inflammation, tight and/or asymmetrical muscle tone, mental/emotional stress (which causes the muscles around the joint to tighten and/or increased sensitivity to pain perception), and prolonged sitting.
How do you correct a Subluxation?
The most common and effective way to correct a subluxation is with a chiropractic adjustment. Medications and physical therapy modalities can also be used in conjunction with chiropractic adjustments to achieve complete correction of the neuro-musculoskeletal dysfunction and to address other downstream effects of the subluxation (segmental and somatic dysfunction). For more information about chiropractic adjustments, how long it takes to correct a subluxation, and what to expect following a chiropractic adjustment (click here).
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