Monday 24th April, 2023

What do chiropractic adjustments do- with video

Dr Graeme's comments

Why I wrote this article

My name is Graeme. I’m a retired chiropractor, and today I’m going to share with you what chiropractic adjustments actually do. I’m prompted to do this because most of the descriptions of what adjustments do that I’ve seen over the years are either misleading or just plain wrong. The main problem with that is although adjustments are excellent and exactly what you need for a lot of conditions, if people like you and the heath professionals you rely on don’t know what’s going on, you end up inappropriate treatment and don’t get better.

Video version

Video content

An example of the problem

As an example, adjustments correct issues that cause ongoing damage to your spine. If you don’t know what’s going on, rather than fix the problem the pain gets treated with anti-inflammatory drugs. The damage continues, while these drugs hospitalise or kill thousands of people each year.

We will just describe basic adjustments

Just to clarify things, the adjustments I’ll be talking about are the basic ones that have been the cornerstone of chiropractic since it’s inception. Since then chiropractors have developed a wide range of alternative or add on therapies that are also sometimes also described adjustments. I’m just talking about the basics here.

The problem chiropractic adjustments correct

The best way to share with you what adjustments do is to look at the at the problem adjustment help correct. You’ll sometimes hear these described as bones out of place or miss aligned vertebrae, but to use non technical terms, that’s total BS. Lets show you what’s really going on.

Normal spine
Vertebrae should sit balanced and move evenly

What is normal for a spine

First this is a normal spine. When you stand straight all the vertebrae should sit on top of each other, nicely balanced, and when you bend they should all move about the same amount. That distributes the movement and stresses evenly throughout your spine.

Abnormally functioning spine
Example of a spine with a stiffened joint

Abnormal spine movement

Problems occur when things like injuries or postural problems cause individual joints to stiffen and not move freely. Lets look at an example. In this pic the bottom vertebrae should be able to move freely from side to side, but it’s actually stiffened up and tilted slightly to the right. Standing straight you can see a bit of a kink, but look what happens when you try and bend to the left. The stiffened joint’s still stuck to the right so the joints above are forced to bend way more to compensate.

As we’ll see that sort of thing causes a lot of problems, and what adjustments do is help revert it back to normal. What I’ll do now is quickly go over the problems a having a spine like that causes, then go over how adjustments help fix the problem.

Basic spinal anatomy
Basic spinal anatomy

These problems have a technical name, but I’m going to keep it simple and just call them stiffened joints, and to help you understand whats going on here’s the basics of spinal anatomy. As you can see in this pic your spine has vertebrae sitting on top of the other. Between the vertebrae we have discs, which are like flexible pads. At the back there are small joints that guide the movement of your spine, and between the vertebrae you have nerves coming out. Those levers sticking out the side are for muscles to attach to, to hold your spine up and move it around.

The problems this causes

Consequences of altered spine function

Just standing

Now we’ll use example I just showed you and see the problems it causes. First, because the bottom joint is tilted it’s putting a lot of extra pressure on the small sliding joint bottom right where the bottom red dot is.
Next , with the bottom vertebrae tilted that’s going to lean everything above it that way, You don’t want to fall over so your body has to tilt the part above back the other way to balance. It does that by tightening the muscle on the other side, and of course the joint above has to tilt back the other way. So, just standing up straight this problem has placed lot of extra pressure on two of those small joints, and the muscles on the left are abnormally tight.
Also, check out the gaps between the levers. Looking at the bottom one we’ve now got a big gap on the left and a small one on the right. In your body these gaps are filled with muscles and ligaments and over time these will adapt. To put is simply they’ll shorten in one side and lengthen on the other, and as we’ll see later this is very important when it comes to correction.

Abnormal spine bending

Trying to bend

That’s just standing. Lets look at what happens when you try and bend. That stiffened joint won’t bend, only the freely moving ones do, so what we end up is a situation like this. The joint above ends up being forced to move much more to compensate. It ends up having to move much more than it was ever designed to, and as you can see there’s a lot of extra pressure on the small joint with the red dot.

Your symptoms

Early on

So that’s what happens with your spine. Lets look at what you’re likely to experience with a problem like this. First, your body will be out of balance, with extra pressure on parts of your lower spine, and abnormally tight muscles. Those muscles will not only get tired, they press on blood vessels reducing flow. So, it’s going to take a lot of extra energy just to stand and walk around, which means you’ll get fatigued quickly. With that pressure on your lower spine you might be uncomfortable standing for long periods, and those tight muscles will feel tired, feeling like you need a stretch or a massage, and if you do get a stretch or massage you’ll feel better but they’ll just tighten up again as soon as you stand up.
Next you’ll can get some pain in your low back. You can take your pick for what causes it. It might be the tight muscles. It might be the joint at the bottom suffering from extra pressure, or it may be the compensating joint that’s trying to bend much more than it was ever designed to. You might get some relief from some anti-inflammatory drugs, but they’ll do nothing to stop any of the abnormal stresses so if you keep going it’s on to the next set of consequences.

Long term consequences

Degeneration (arthritic changes) and disc injury

The first is very obvious. This causes long term damage. That will either be arthritic changes you’ll see on an x/ray, disc damage, or both.

Nerve interference

The second consequence is interference to your nervous system. The original chiropractors found that when they adjusted people sometimes certain conditions would improve. They came up with what we call the foot on the hose pipe theory saying that misaligned vertebrae put pressure on nerves and the adjustments relieve the pressure. We now know it’s a hell of a lot more complicated that than that, but whether it’s pressure from a disc or swollen joint, or any one of a number of more complex neurological mechanisms, these issues can either block a nerve or create static.

Autonomic nervous system
The nervous system in the master control system of the body

To relate that to something common, a blockage is where you get numbness, while static can be things like sharp electric shock type pains. The issue here though, is that as well as working your muscles and allowing you to feel things your nerves help control just about every function in your body. Anything that effects you nervous system can potentially have wide reaching and seemingly unrelated effects.

Back in the olden days chiropractors would claim that there adjustments cure diseases. The sensible approach is if you have say condition X there maybe many possible causes and we really have no way of knowing if nerve interference is a factor, other than of cause making an adjustment and see what happens. Therefore, making any promises relating to condition X is a bad thing. On the other hand we know that issues with your spine can cause both blockages and static in the master control system of your body, which can’t be a good thing, and if it’s causing a problem it needs to be corrected.

Inappropriate therapies

Exercises to correct spines

At the start of the video I said that because these issues were not understood other health professionals don’t treat this condition appropriately, so lets look at some of the things they do. We’ve already mentioned things like taking anti-inflammatory drugs which cover symptoms while your spine keeps getting damaged, but they’ve even got a way to speed up the damage, and that’s with exercises. What will happen is you’ll see a professional and he or she will say you’ve got a problem because your backs all stiff. Well, its actually the other way around: you’re backs all stiff because you have a problem. So, these people get things back the front and prescribe exercises.

Trying to correct with exercise

You’ve seen that with these problems every time you bend a certain way it puts a huge extra stress on the compensating joint, making it bend much more then it was ever meant to. The exercises might temporarily relieve a bit of tightness, but I hope you can see that this is just putting more stress on the joints, making it wear faster and heading for a catastrophic failure.

Ruptured discs and arthritic changes

Now, lets look at what happens when you do get severe wear or catastrophic failure. The main catastrophic failure is a ruptured disc that presses on a nerve. The surgeon will do a great job cutting the disc away to relieve the pressure, but usually nothing will be done to correct the issue that caused it and to make matters worse you’ll probably get some exercises to help rehabilitate it. It’s no surprise that once you’ve had a back operation you’re usually very restricted and often end up needing more operations.

Worn vs normal x/ray

Now lets look at what happens with degenerative or arthritic changes. This x-ray is typical. Those white rectangles are the vertebrae, while the dark space between them are the discs. The top joint is completely normal, while in the one below it you can see that the space for the disc is a lot less on the left. You can also see all that whiteness, which is a reaction to the abnormal stress.

As you know now the reason one joint is badly damaged while the others are normal is that there’s a problem causing abnormal stress, and the damage is secondary. What happens though is you’ll be told that arthritic changes are the problem, and you may even be told that it due to your age.

To put this into perspective I’d like to share with you an every day analogy. Just say your car has a wheel alignment problem. One tyre is scrubbing out while the rest are normal. Your tyre person would tell you that you need a wheel alignment, and maybe replace the tyre if you hadn’t caught it in time. The doctors are doing the equivalent of telling you that the worn tyre is the problem, not the wheel alignment, and maybe even that your tyre is worn because of it’s age. The surgeon is doing the equivalent of repairing the tyre but not doing anything about the wheel alignment problem.

The "quick fix"

That’s the medics. Lets have a look at your quick fix adjustment and why I really hate the terms bone out of place and misaligned vertebrae.
As a chiropractor I’ve had my fair share of people coming in in pain, getting adjusted and thinking they were fixed. If they think it’s a bone out of place the logic is that I’ve pushed it back, so they wander off hoping it doesn’t slip back again. The reality is that I’ve just temporarily restored some extra movement in the stiffened joint.
If left there’s a host of reasons why it will just stiffen back up, but the easiest to visualise is what we saw in this previous pic. With the spaces between the levers changed some muscles and ligament shortened while others lengthened. That can’t change instantaneously with an adjustment, so as impressive as they are, your one adjustment fix cannot last.

How adjustments help correct spines

What the adjustment does

That said, lets have a look at what a chiropractic adjustment is and how they can be used to correct these problems.
First, we’ve see that if you just try and bend the spine it will only bend at the freely moving joints, not the stiffened ones. Chiropractic adjustments are a very accurate and specific force that helps restore the movement in the stiffened joints, while not affecting the others. As a bit of background the diagrams I’ve used are pretty simple but actual spines are very complex pieces of machinery that move in many different directions, and as we’ve seen you can have a badly over stressed part right next to a stiffened part, and the last thing you want to do is force an over stressed joint to move even more.
Because of that it takes a huge amount of training, skills and practice to deliver an accurate chiropractic adjustment. Because of this some chiropractors are better than others, but you need to be aware that not all clicks in the spine are adjustments. Any backyarder or lesser trained therapist can put some tension in a spine and make it go snap crackle and pop, but what what’s making the pop is usually the freely moving joints that are often already moving too far. It’s the same sound and basically the same movement, but without the proper analysis and specificity, instead of a good thing we get a very bad thing.
In saying that chiropractors are the main ones that do adjustments, but there are a lot of osteopaths and some therapists with specialist post graduate qualification that have learned the skills. They’ll just have a different name for it.

Using an adjustment to correct spines

That’s how we restore the movement, so how do we make it last. There’s no short cut. Your spine, including those muscles and ligaments that had shortened and lengthened need to re-adapt over time. The same professionals who’ve studied the spinal mechanics and adjustment have also learned this, so let them manage it. However, I’ll give you an overview here.
Just say we’ve got a stiffened joint that normally moves 10 degrees. An adjustment might get it to move one degree. Now we’ve seen before that if we’ve got a stiffened joint that can only move one degree and we do exercises trying to make it move the full 10 we’ll cause a lot of problems. Instead, we use exercises designed to repeatedly use that one degree movement so your spine starts to adapt. We can then do another adjustment so now we have 2 degrees movement, and use exercises designed to those 2 degrees. If we keep going like this the movement of the stiffened joint will gradually increase, while at the same time the tissues around it will adapt and strengthen.

Other things that can be used to help

So, that’s the simple explanation. As I said it really needs a qualified professional to work out and manage the process, but what while do is finish off with some of the things that he or she might used to help the process along.

Rest, medications and surgery

The first is rest and medications. Is discussed these these never correct anything and can just mask the problem, allowing more damage to occur. However, if your spine is very inflamed they may be used to temporarily to help settle it down in order to allow correction to begin. Also, if there’s a catastrophic failure such as a ruptured disc pressing hard on a nerve you may need surgery, but as mentioned before we don’t want to replace the tyre but leave the bad wheel alignment.

Massage

The extra that’s usually very useful is massage. Over time muscles that are abnormally tight and have their blood flow reduced will deteriorate, and develop lumps called trigger points. Massage is extremely useful to stimulate blood flow and help these recover.
What usually happens though is because of time and cost factors people rarely get all they need. That’s why I had our massagers built. Using these with the appropriate advice patients can have practically unlimited professional standard massage at home. I’ll pop links about these and the muscular problems they help with in the description.

The intrinsic muscles of the spine

I’ll finish now with the one thing most people using massage for spinal problems neglect, which makes it really had to get decent results. We’ve seen how the vertebrae have levers for the muscles to pull on. The most important muscles for controlling the movement of individual joints are the ones that sit between the levers where they are practically impossible for anyone using conventional massage or any form of pressure techniques to reach. No matter how forceful your conventional massage can only get to the layers of muscle above them.
As this diagram shows, the way to massage these important muscles is to use vibration. They are the only thing apart from needles that can get to them, and with all the nerves coming out of your spine needles are not a good option.

As Chiropractor, what I found was once I made and adjustment I could place the head of our General Purpose Massager over the tightened muscles around the joint and let the vibrations penetrate. I’d re-check the joint and find that it’s movement had further increased, indicating that the vibrations had relaxed the muscles around the joint, allowing it to move more.
Anyway, that’s the basics of what adjustments do and how they are used to help correct a spine. I hope it’s been useful. If you have any questions or comments please don’t hesitate, and if you want one of our massagers check out the link above. Thanks very much for watching. It has been most appreciated.

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Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more



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