The Chiropractic Adjustment

It is estimated that there are more than 100 named methods of spinal manipulation treatment (SMT)  techniques or methods.  Several  high quality research studies have demonstrated that SMT is an effective non-invasive conservative treatment for  mechanical spinal related disorders. SMT is dated back to ancient China. Modern methods were introduced in the late 19th and 20th century by Chiropractic and Osteopathic professions.

 The following represents a short list and not all inclusive of  popular SMT methods.

SMT  also commonly referred to as the CHIROPRACTIC ADJUSTMENT (CA) is  designed to apply forces to vertebral or non-spinal joints. CA is the delivery of high velocity, short lever forces to the targeted vertebra. Often,  but  not always, a pop or clicking sound is made. It is postulated to be a release of joint fluid/gases. The audible click sound it s called cavitation. The physiologic mechanics  also releases the  “subluxated”  or sprained  joint. The desired goal is to help improve joint function, relieve nerve-end pressure,  help in improving muscle tone and to relieve pain.

Diversified  Chiropractic methods: It is the  most commonly taught and most utilized Chiropractic method.   It  is a non-specific High Velocity Low Amplitude ( HVLA) method. The provider applies a quick ( High velocity),  short ( low amplitude)  force. Basically this method is a hands-on approach to a spinal region with one arm/hand used as a stabilizer while the other or contact hand applies a quick directional force towards the spine. 

Gonstead:   Originated by  Clarence Gonstead DC of Wisconsin. This method  applies a comprehensive spinal assessment coupled with an x-ray analysis. The purpose is to find the spinal vertebral lesion(s) and to be able to apply more specificity and accuracy to the problem causing  vertebral motor unit. Gonstead  providers have developed specialized chairs and tables ( e.g. knee chest) to  position the patient for SMT. 

The quote ,  “Find the subluxation, accept it where you find it, correct it and leave it alone.”  is attributed to – C.S. Gonstead DC

Thompson’s Terminal Point: This type of SMT involved specialized treatment tables with sectional pieces which give was or DROP as the HVLA manipulation is applied. The concept is the drop of the table section helps in moving the targeted vertebral joint. There are several types of tables which  have been designed over the years.

 Sacro-Occipital Technique: A method attributed to Dr. Major Bertrand  De Jarnette. The SMT method applies a  set wedges or blocks to the patient lying either supine or prone. It also involves a specialized light force method to treat the head and skull via the Cranio-Sacral analysis.

Graston:  Strictly speaking this is NOT a joint manipulation method but is an instrument method to treat muscles and related soft tissues. There several different  and specially  shaped metalic instruments. The instruments are  rubbed and pulled over localized  muscles and related tendons. Graton practitioners are trained and  must be licensed by Graston Technique.

Nucca:  ( National Upper Cervical Chiropractic Association):  is a   hands  on CA procedure applying  a light force, non-invasive, and light  touch  triceps pull technique. It relies on  x-ray analysis of the upper cervical vertebra or by postural analysis using a ANATOMETER. The procedure was an outgrowth of the Atlas only ( HIO) by Dr. J G Palmer, and later the collaboration of  Dr. John  Grostic and Dr. Ralph Gregory.

Instrument Adjustment:  Activator Technique: This hand held device method, applies “lighter” force to the vertebral segment via  spring loaded or electric mechanical device. The force is quicker than that of the human hand but can deliver multiple adjustment in rapid order.  Activator method relies on specialized exam methods often relying on leg measurement methods to determine location of vertebra which  is to receive the CA. It is also helpful for those patients e.g. seniors who may prefer light force method.

Spinal Decompression:  Spinal decompression  apply  the  principle of spinal traction. Distraction methods via  mechanical forces  pull or separate the spinal motor units, including disc, facets and related ligaments and muscles. Inversion traction devices are now sold directly to the public.

COX: This mechanical table use a combination of hands-on manipulation to traction and mobilize the spinal segments. The method is directed to treat and manage disc protrusions or herniations as well as facet joint dysfunction. The goal is to change intra-  and inter vertebral joint structures and to restore mechanical function. It is also commonly called flexion/distraction method.

Each of the above  method has both professional and patient population followers. The number of sessions to achieve maximum results or outcomes  vary depending on  the severity and type  of condition, and  age of the patient. The consumer should note that some methods are  mores scientifically sound with supportive outcome data and studies when compared to others. 

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Author: Moses Jacob, DC