Subluxation | Subluxations
Subluxations and dislocations of the joint both involve the pulling of the joint, that connects two or more bones, from the articular capsule that hold it in place. The articular capsule is a casing around a joint, composed of ligaments, that keep the joint in the joint capsule. With a dislocated joint, the two bones that that are connected by the joint separate from one another, causing a significant separation, and possibly a tearing of the ligaments of the joint capsule. With a subluxation, there is only a partial dislocation of a joint. There is some controversy in the spine community about vertebral subluxation, with doctors trained in manipulations of the spine thinking that a high percentage of cases of lower back pain are due to subluxations of the spine, and medical doctors who don't.
Because subluxations only involve a partial dislocation of the joint, their pathology is not typically easy to diagnose based on medical imaging studies and the physical examination. Typical medical imaging studies (i.e. X-Ray, MRI, CT Scan) are designed to point out pathology such as herniated discs, scoliosis, spinal stenosis. Though a physical examination and medical images may not indicate subluxations or the resulting ligament damage, they may occur, causing both pain and instability in that joint. Chiropractors and Osteopaths are specifically trained in recognizing and treating vertebral subluxations and partial dislocations of other joints. When these joints problems are identified, their treatment involves the same types of movements to "reduce" and angle the bones and joints back into their proper position.
In osteopathic and chiropractic medicine, vertebral subluxations refer to the improper alignment or juxtaposition of vertebrae with the surrounding vertebrae. These vertebral subluxations may be caused by trauma to the spine, pathology to the discs and facet joints, and tears and stretching of the soft tissues such as the ligaments and tendons. Because of weight gain, bad posture, or bad work ergonomics, the ligaments may be constantly pulled on, and stretched to lengths that they were not meant to go for long periods of time. Because of this continuous stretching of the ligaments, they may become loose. Weak or loose ligaments may allow the vertebrae to move out of position. The result may be similar symptoms as you would see in conditions such as herniated discs or sciatica, namely back pain and referred pain. Patients whose lower back pain is caused by subluxations may experience immediate relief through manipulations to correct misalignments of the spine. In the long term, patient will want to make lifestyle changes to prevent the types of postures and movements that caused the stretching and loosening of the ligaments. When getting chiropractic manipulations, the chiropractor uses short, powerful but painless thrusts to pop back joints that were out of place. Typically, a successful chiropractic adjustment produced immediate relief of that joint and part of the body.
For ligaments that remain weak despite chiropractic/osteopathic care, lifestyle modification, and physical therapy, prolotherapy may help patients to make permanent corrections to these ligaments. Prolotherapy is the injection of certain types of irritants near the ligaments of the spine to stimulate healing of these and other damaged tissues.