How Does Chiropractic Work?
Written by: James Demetrious, DC, DABCO
Why, What, and How?
Why do we adjust patients? What is the elementary purpose to move bones with High Velocity-Low Amplitude Spinal Manipulation (HV-LA SM) or Low Velocity-Low Amplitude techniques (LV-LA)? I am not asking about the effect of those interventions. I am asking HOW chiropractic works?
A fundamental purpose of chiropractic adjustments is to improve segmental mobility, bone to bone. In this regard, I have codified segmental hypo-mobility as intra-articular, extra-articular, and neurogenic causes. Under each of these headings, I have acknowledged quantifiable causes of segmental hypo-mobility.
Recognition of contributory causes affecting respective patients offers insight into patient management, clinical expectations, therapeutic approaches, and dosing:
- Intra-articular causes of hypo-mobility:
- Synovitis/facet joint edema,
- Synovial hypertrophy,
- Meniscoid/plical entrapment,
- Intra-articular debris,
- Intra-articular adhesions.
- Extra-articular causes of hypo-mobility:
- Capsular thickening,
- Extra-articular adhesions, DJD, and discogenic contributors,
- Disuse atrophy,
- Denervation atrophy,
- Myofascial adhesions.
- Neurogenic causes of hypo-mobility:
- Neurogenic hypertonicity,
- Trigger points,
- Pain – fear avoidance,
- Psychosocial issues,
- Iatragenic denervation.
Clinical Utility
These headings are interrelated and represent a practical clinical tool. All of these factors are quantifiable, objective, and observable. Highly skilled chiropractic spinal adjustments positively affect these causative factors in a manner that is reflected by the overwhelming safety and efficacy reported in the literature.
I discuss each of these topics in my continuing education coursework available at: PostGradDC.com.
PostGradDC offers advanced post-graduate chiropractic continuing education. Our founder, Dr. James Demetrious, is a nationally distinguished board-certified chiropractic orthopedist, educator, author, and editor. For current, evidence-based, and clinically intuitive CE Coursework, attain your advanced training at PostGradDC.com.