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Adjustments and Manipulation


A chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is the primary chiropractic treatment method for back pain.

Spinal manipulation is relieves pressure on joints, reduces inflammation, and improves nerve function. It has been a trusted form of treatment since the ancient Greek Hippocrates documented manipulative techniques in his writings back in 1500 B.C. Today, spinal manipulation is used to treat conditions such as allergies, menstrual cramps and headaches.

How Does Spinal Manipulation Work?

There are well over 100 types of adjustment techniques used by chiropractors throughout the world. Some practitioners may use force and twisting, while other techniques are more gentle. Regardless of how they are performed, these techniques are intended to restore or enhance joint function with the objectives of reducing pain and resolving joint inflammation.

When vertebrae shift out of place, there is an overall systemic response from the muscular system to the central nervous system. Without proper alignment and flow, our nerves, our immune system, and our minds cannot function at their highest peak.

Overall, spinal adjustments and manipulations are an excellent way to keep the body functioning at its highest level without any discomfort. When the body is adequately aligned, it becomes able to respond and perform as it was built to do. 

During a chiropractic manipulation (also called an adjustment), a chiropractor applies a high-velocity, short-lever arm thrust to a bone to decompress a joint, restoring normal motion to the joint and/or normal alignment of the bones. Let me explain in layman’s terms how a chiropractor does an adjustment.

To perform an adjustment, the chiropractor introduces a quick stretch to the muscles surrounding a joint while staying within the joint’s normal range of motion.

Muscles have a quick stretch reflex, and when a muscle is stretched quickly, nerves in the muscle respond by causing the muscle to relax. This autonomic reflex protects the muscles from tearing during any quick stretch.

A chiropractic adjustment does not go nearly deep enough to risk tearing muscles, but the nerves and muscles do not know this. All they know is that an external force is making the muscles stretch quickly, so the nerves protect the muscle from such external forces. Therefore, an adjustment causes muscles to relax.

Fluid is present in the space between the bones. When a chiropractor performs a quick stretch, the barometric pressure on the joint fluid decreases. As with any fluid, decreasing the pressure releases gasses (in this case, oxygen, nitrogen, and carbon dioxide).

An everyday example of this phenomenon is when you open a can of soda. The soda in the can is under pressure; when you open it, the pressure on the fluid decreases, and bubbles come out of the liquid. A joint, however, is a closed “container,” so the “bubble(s)” pop immediately.

Why an Adjustment Helps

Many physiological events occur during an adjustment to facilitate healing. I explain some of these amazing events in the following sections.

Increases Range of Motion

During an adjustment, a chiropractor moves a joint within its full healthy range of motion. It is safe because the chiropractor is far from overstretching the ligaments. If you do not move enough, your joints degenerate. When is the last time you stretched all of your joints to their full range of motion? There is a reason we say, “If you don’t use it, you lose it.” People stiffen as they get older not because of their chronological age, but because of their lack of stretching over time. Look at yogis. There are 100-year-old yogis who are more flexible than average middle-aged Americans.

I like to say that chiropractic manipulations are like going to a partner yoga class, but with a skilled partner who knows how to get to the end range of all your joints quickly and safely. Chiropractic adjustment is like yoga with an “oomph.”

Reverses Degeneration

Bones and joints are not rods of iron that rust with time. They are living tissue that degenerates with abnormal stressors over time. Everyday activities result in micro trauma to tissues. As you age, your ability to heal slows down, so your body begins to lose the healing battle.

When you are young, you heal rapidly because the joints are plump with nutrient-filled fluid, which is why you do not feel this micro trauma occurring. Over time, abnormal stressors of our modern lifestyle cause the joint fluid to slowly seep out, and the cells inside start to die. With less nutrient-filled fluid and fewer cells to repair the damage as we age, each of these injuries is felt more profoundly. You take longer to heal, and the micro traumas begin to accumulate. This results in degeneration and arthritic changes.

But movement can help heal this damage. It was once thought that cartilage in the joints just wears away with time. Now we know that cells (chondrocytes) inside each joint repair the cartilage. Unfortunately, most people cause damage faster than the few chondrocytes can fix it, resulting in degeneration.

We need movement to support the cell repair and to facilitate the flow of nutrients in and waste out required for the repair process. Why?

Blood delivers nutrients to the joints, but for the nutrients to seep into the joint fluid, the fluid has to stir. Movement stirs the joint fluid and allows blood in the capillary bed to deliver nutrients deeper inside the joint fluid. The cells inside the joints receive the nutrients they need for this rebuilding process. Thus, simply moving your joints helps them heal.

When you sit or stand still for too long, the weight of your body slowly squishes the fluid out of your joints (Figure 17-3). Your joints become deficient of the much-needed nutrients that would normally flow into a healthy, moving joint. If you sit too long, you literally starve your joints, causing them to degenerate over time.

Like physical movement, an adjustment literally “feeds” the joints it moves. When the gas bubbles form in the joint and pop, the fluid stirs. Nutrients flow in, facilitating the joint’s healing and reversing the degenerative process.

The increased space between the bones takes the pressure off nerves (decreasing your experience of pain) and allows for more blood flow and lymphatic drainage. All of this facilitates the healing of the surrounding tissues.

Even young adults who do not move enough will experience degeneration in their joints. I am seeing people at younger ages getting degenerative joint disease from sitting too much beginning early in their life.

Relaxes Spastic Muscles

An adjustment relaxes spastic muscles through the quick stretches I described earlier in the chapter.

This is why adjusting the neck (cervical spine) helps with neck pain. One quick adjustment relaxes muscles far more effectively than a whole hour of massage. A cervical adjustment is far safer than taking pain medication and sleeping aids in the long run, and it takes pressure off the nervous system, enabling you to sleep better.

Healing Occurs, Even at a Biochemical Level

During an adjustment, other biochemical reactions occur. The body releases endorphins into the area of the adjustment. This provides the short-term pain relief people report after an adjustment. The long-term effects of an adjustment are faster healing, restored full range of motion, and a body more relaxed and able to sleep.

Chiropractic Adjustments Are Safe

I have patients who come in very concerned about getting their neck adjusted, even though, in my opinion, an adjustment is imperative for a healthy body, which is necessary for better sleep (and vice versa). Unfortunately, these patients have heard that neck adjustments can cause paralysis or strokes.

If a patient has paralysis or a stroke after seeing a chiropractor, then that patient was at risk of paralysis or stroke from any regular activities of daily living. An adjustment does not move the neck outside of the normal range of motion. For something to go wrong, the neck had to have an abnormality that made the patient vulnerable with any kind of movement. Tilting the head back to wash their hair could cause as much injury.

Just by living you are at risk of having a stroke. I have adjusted the necks of several thousand patients dozens, if not hundreds, of times to date. That is tens, if not hundreds, of thousands of neck adjustments I have personally performed. Every one of my patients feels an increase of motion, and most feel an immediate relief of pain after a neck adjustment. Not one of my adjustments has resulted in a stroke, let alone paralysis.

In fact, you are just as likely to have an adverse vascular event within twenty-four hours of seeing your regular doctor as when seeing your chiropractor.  Either you are going to have a stroke or not. Sadly, if it happens after seeing a chiropractor, some people want to blame the chiropractor.

Even medical organizations can’t deny that chiropractic adjustments are safe.

You are more likely to be struck by lighting (1 per 0.96 million lightning strikes) in any given year than to be seriously hurt by a manipulation to the neck (1 per 1.565 million manipulations).

Research validates that chiropractic manipulation is much safer than taking NSAIDs (nonsteroidal anti-inflammatory drugs), like acetaminophen or aspirin. Yet people in our culture are generally more comfortable taking a pain pill than having a chiropractic adjustment! I believe this is due to misinformation. In fact, people die daily due to medicine taken as prescribed. Yet most people feel comfortable taking their medications!

Even the Side Effects of Spinal Manipulation Are Often Beneficial

The health benefits of an adjustment are often greater than expected. By stretching the vertebrae of the spine apart and creating more space for the nerves that exit the spinal cord, blood flow and lymph drainage increase. This allows nutrients to flow into and waste to flow out of the tissues, resulting in ideal conditions for the tissues to not only heal, but to function optimally. Without this space, there is more pressure on the nerves, blood vessels, and tissues.

Nerves especially do not like pressure; they function better with space. Better communication between the brain and the body makes for better functioning organs, leading to a healthier body in general. This is why patients often report their neck pain resolves, their sinuses drain, the pressure in their ears clears, and they no longer suffer from headaches after a neck adjustment. These are all great side effects for those suffering from neck pain. This is why I love chiropractic.

Nerves that exit the neck region send signals to the head and upper extremities. If these nerves are being compressed, they will cause head, neck, arm, or hand pain.

After treating neck pain with a cervical (neck) adjustment, I often hear things like “I haven’t had a migraine since,” “My sinuses have cleared,” “My vertigo is gone,” “My carpal tunnel syndrome resolved,” and “My arms don’t fall asleep or hurt anymore.”

Nerves that exit the mid-back region send signals to the organs in the mid-torso, including the lungs, stomach, spleen, and liver. After treating for mid-back pain, I have heard things like “My GERD has improved” and “My asthma is better.”

Nerves that exit the lower back region of the spine send signals to the organs in the lower torso, including the lower intestines, reproductive organs, and lower extremities. After treating low back pain, I often hear things like “My bowel movements have been more regular than ever,” “My menstrual cycle is more normal,” “My ED (erectile dysfunction) seems to have resolved,” and “I was told by my medical doctor that I was infertile, and now I am pregnant!”

After treating children, their parents report, “They are calmer,” “They are sleeping better,” and “They are able to focus more.”

I prefer these types of “side effects” to the side effects people experience with allopathic medicine, which often have incredibly long lists of possible negative side effects, including “Can cause death.” When you take any medicine, there is always some negative effect; sometimes that negative effect ends up outweighing the benefit.

My Personal Story

I was in a car crash in 2014. The pain was so bad that I could not sleep. Instead of taking narcotics to sleep, I found I could sleep in my floatation pod.

Plus, after my car crash, my allergies worsened, which also affected my sleep. My husband and I keep bees and eat gallons of honey a year to keep allergies at bay. After the crash, the honey didn’t seem to be working as well for me. After two months of chiropractic treatment, my allergies went away. To learn more, check out my Whiplash to Wellness: A Chiropractor’s Journey.

Again, this is why I love chiropractic. Unlike medicine, whose side effects are usually negative (many with the risk of death), chiropractic usually has positive side effects (you sleep better and feel more relaxed and rested, headaches go away, bowel function normalizes, allergy symptoms reduce, etc.).

Determining Whether Spinal Manipulation Is Right for You

I hope the information in this chapter has helped persuade you to see a chiropractor to determine if a spinal adjustment is an appropriate treatment for your condition.

If you are going to receive a manipulation, simply ask how many manipulations your chiropractor performs on a weekly basis and how long they have been in practice. Ask how successful they are at treating your condition. The answers to these questions will help you figure out how skilled and practiced the chiropractor is at treating your condition.

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