Here's what chiropractors and osteopathic physicians believe. You can take all the anti-inflammatories and physical therapy treatments you want, but no matter what you do, the back pain symptoms are going to endure until you restore the proper alignment of your body. In the event of broken bones and severe nerve root compression, X-Rays and MRIs will pick up on these obvious conditions. In other cases, certain conditions are much more subtle and will not show up on medical images. These cases include conditions known as vertebral subluxations.
Vertebral subluxations are misalignments of the vertebra. These alignment problems may cause pressure on the spinal nerves and the spinal cord itself, though it may not show on X-Rays and MRIs. To detect these types of problems, osteopaths or chiropractors must put their hands on the patients to feel for the problems. Chiropractors will also talk to the patients and observe them as they walk, flex, and extend their spine to get a better picture of the overall health of the spine. Once vertebral subluxations are observed, then manipulation treatment may be done to put the affected elements of the spine back into their correct alignment.
Treatments that are done to bring the spine back into alignment are known as adjustments, spinal manipulations, and manipulation treatment. These treatments are performed to alleviate pressure on the spinal nerves and to align the motion segments to move freely.
During a manipulation treatment, the vertebra that is out of position is freed and moved back to where it is supposed to be to allow for normal comfortable movements of the spine. Once the adjustment has been successfully done, it allows the affected structures to heal and move freely, without inflammation and stiffness.
Chiropractors often use their hands to perform these adjustments, though various chairs, tables, and specialized instruments help to facilitate certain movements. Each patient has a unique set of medical conditions and orthopedic problems that necessitates the need for custom treatment programs.
Each chiropractor may favor one set of techniques over others based on the education/training they have received and through the trial and error history associated with their years of clinical experience. Here are some of the most commonly used adjustment techniques:
Manipulation done under anesthesia (aka twilight sedation): These types of adjustments may be performed when more traditional adjustments have failed to achieve the desired results. Twilight sedation will be done in a clinical outpatient setting.
Release Work: The chiropractors will use their fingertips to apply gentle pressure to the affected structures to separate the vertebrae.
Lumbar roll: For this treatment, the chiropractor will use the table and their own body to generate the power necessary to apply quick, powerful, downward thrusts to the patient's lumbar spine. The chiropractor rolls the patient's body to one side, just to the edge of the chiropractic table. The chiropractor then applied a force to the lumbar spine that jars the misaligned vertebra loose from the improper position that it was in.
Motion palpation: The chiropractor will feel the vertebra along your spine while you are moving and it is on motion. This technique will allow the chiropractor to detect if the vertebrae are moving normally or if there is resistance in one or more of the motion segments.
Toggle Drop: The toggle drop involves short, quick powerful bursts of pressure onto the vertebral joints in order to restore normal mobility. For this action, the chiropractor will cross his or her hands and then perform these quick movements onto one area of the spine.
Instrument adjustments: Not all chiropractic adjustments involve the rapid powerful bursts that produce the audible cracks and pops that the general population is so familiar with. Certain instruments and machines are used to apply more gentle adjustments to the spine, to either increase space between the vertebras or to improve mobility in the vertebral joints. Instrument adjustments involve the patient lying face down on the table while the therapist uses a string-loaded activator to carry out the adjustment.