Subluxation and Treatment - A Chiropractic Perspective

A chiropractor adjusts a woman's back.
A chiropractor adjusts a woman's back. BanksPhotos/E+/Getty Images

Definition:

In a pain free spine, the 24 vertebrae plus the sacrum and coccyx bone normally stack on top of one another in a centered alignment.

But life experiences of all kinds tend to impose forces of movement that can take one or more vertebrae out of an ideal, centered alignment.

In chiropractic parlance, this misalignment of one vertebrae in relation to the next is referred to as a subluxation.

Subluxation - A Partial Dislocation

But in the conventional medical world, the word subluxation refers to a partial dislocation.

 Dislocation is a very serious injury most often caused by a traumatic event such as a car accident.  Like a dislocation, the full on medical version of “subluxation” can result in injury your spinal cord; unlike a dislocation, it tends not to result in torn ligaments, facet joint jumping and locking, or paralysis (or death.)

Subluxation from the Chiropractic Perspective

According to Charles Henderson in his article entitled “The basis for spinal manipulation: Chiropractic perspective of indications and theory,” which was published in 2012 in the Journal of Electromyography and Kinesiology, a vertebral subluxation is a mechanical disturbance in the normal way the spinal structure is arranged – such that it disrupts the functioning of your nervous system.

So if a chiropractor has ever said to you something like, “all disease comes from misaligned vertebrae,” Henderson’s statement may shed some light as to why.

Henderson’s statement may also explain why, in the chiropractic world, at least, a subluxation is the most important reason for an assessment of your intervertebral joint motion.  Historically - though many chiropractors do branch out to offer physical therapy and nutritional services to their patients - a chiropractor’s entire job has been based around finding and realigning subluxations.

Finding Your Subluxations:  The Chiropractic Exam

A chiropractic exam to identify subluxations generally consists of palpation and radiography - i.e., a manual exam and a set of x-rays. Not all chiropractors use x-rays in their diagnostic process, though.  In the manual exam, the chiropractor checks the alignment of your pelvis and other key joints to help her determine what's going on in your spine.  She also checks the spine itself.  And she may include muscle testing as part of the exam.

Henderson says that subluxation in the chiropractic sense tends to have very subtle features - as opposed to the more gross findings that medical doctors identify in their diagnoses.  

A subluxed spinal joint diagnosed by a chiropractor is characterized not by hypermobility (too much movement) as many believe,  but by hypomobility (decreased or restricted motion,) Henderson clarifies.  

In other words, correcting excessive motion at the spinal joint is likely not the main goal of your chiropractic treatment.

But because it can develop secondarily in nearby joints that are hypomobile, your chiropractor may treat the hypermobility anyway.   She may do so by addressing the more restricted nearby joints, and/or prescribing an exercise program to strengthen your core

The above is an important distinction for some people to make.  If you have a lot of stiffness and immovability, chiropractic may help you.  But if you tend toward lax ligaments, too much flexibility or you have a connective tissue disease, it could make matters worse rather than better.

Who is Licensed to Treat Subluxations and Who Is Not?

Chiropractors, physical therapists some osteopathic physicians and some physical therapists are trained to treat subluxations, while massage therapists, personal trainers and other types of holistic practitioners generally are not.  That said, if you have serious symptoms, you may need to consult with a non-chiropractic physician (i.e. an M.D. or D.O.  Remember a subluxation is a "partial dislocation.") Unless your chiropractor is knowledgeable, it take a non-chiropractic physician to discern between a subluxation of the chiropractic type and one that needs medical attention.

Non-chiropractic physicians generally use physical therapy, medicine, surgery and other invasive procedures to treat spinal misalignments.

Henderson, Charles, N.R. The basis for spinal manipulation: Chiropractic perspective of indications and theory. Journal of Electromyography and Kinesiology. 2012.

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