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What is a chiropractic adjustment? How does it work?

A chiropractors main method of treatment is called a chiropractic adjustment. This involves a small rapid thrust to a joint that isn’t functioning to its full capacity. If done successfully it will allow the joint to move with more ease, which is usually felt immediately by the patient. An audible click called a cavitation which accompanies the thrust is usually heard but not always, (you can read about what causes the clicks on our other blog by clicking here).

So, how does it work and what’s going on?

There are three main areas where an adjustment has a positive effect;

1) Resetting the nervous system - We all have receptors in our joints which are constantly feeding back to our brain, letting the brain know what the joint is doing and that everything is functioning correctly. This is the reason we are able to perform things like, touching our nose whilst our eyes are closed, (you just tried that didn’t you!).

When a joint becomes restricted our brain will send a message to the muscles in the area telling them to contract/tighten up, in order to try and get it to move again. If the muscle is unsuccessful in producing this joint movement, the brain will keep on sending the message to the muscle and the muscle will keep on getting tighter and/or recruit more/larger muscles, to try and create joint movement, eventually causing discomfort, stiffness and pain.

An example of this is if you were travelling in your car, after a while you'd feel the need to move position/fidget, this movement is the brain trying to get some feedback from the receptors in your back, hips, knees etc…the movement lets the brain know everything is okay and you can sit in your new position for a little while longer. After some more time driving, these small movements aren’t enough to satisfy the brain that everything is okay and inevitably you’ll feel the need to pull over into the services and have a walk around to “stretch your legs”. Once you have done this the joint receptors provide feedback to the brain to show that everything is okay, then you are able to get back in the car and continue for another 1-3 hours or so.

Research by Orthopedic Surgeon WH Kirkaldy-Willis, MD, was clearly able to show that Chiropractic spinal adjusting was capable of decreasing both muscle spasm and pain (2). Dr. Kirkaldy-Willis used 283 patients with chronic, severe, treatment resistant low back pain and documented that Chiropractic spinal adjusting was able to fix the condition in 81% of the patients. Dr. Kirkaldy-Willis’ explanation for the observed improvement in clinical status was the firing of facet capsule mechanoreceptors, which decreases muscle spasm and closes the pain gate.

So in summary, an adjustment to a restricted joint/area allows the brain to feel movement in that joint again which resets the nervous system, allowing the local muscles to relax and normal function to return, this is why most patients feel an almost immediate relief or improvement in pain/function.

2) Physical adhesions - When joints are restricted for long enough (4-12 weeks) they can form fibrotic adhesions which further restrict the joint (1), at this point you may find stretching or massage alone doesn't help. This restriction again leads to the nervous system tightening up the muscles around it as discussed above. We know that adjustments create a gap between the joints which may break up these adhesions preventing the nervous system getting involved, causing you to feel reduced function/tightness or pain.

3) Facet irritation (usually a meniscus impingement) - Sometimes we can feel more of a sharp pain often described as a ‘pinched nerve’ by patients. Often this isn’t a nerve being pinched but an irritation of a facet joint, likely due to a meniscal impingement shown below.

Diagram A shows a normal joint with the meniscus circled in black sitting between the 2 joint surfaces, creating a wedge for support. B shows the meniscus being pinched, C shows the separation of the 2 joint surfaces during an adjustment, therefore freeing the impinged meniscus.

By separating the 2 joint surfaces via an adjustment it can help release this impingement and patients normally feel an instant improvement in function which usually provides pain reduction within 24-48 hours once chemical inflammation has reduced.

We hope this makes sense and helps with your understanding of how visiting your chiropractor helps, but if you have any further questions please don't hesitate to email us and we will be sure to get back to you asap!

1) Journal of Chiropractic Humanities. 2011 Dec; 18(1): 74’85

2) Kirkaldy-Willis WH; Cassidy JD; Spinal Manipulation in the Treatment of Low back Pain; Canadian Family Physician; March 1985, Vol. 31, pp. 535-540.


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