CHIROPRACTIC MANIPULATION THERAPY
Manual medicine whose primary purpose is on the joints of the body are designed to induce joint motion through either nonthrust techniques (mobilization) or thrust (adjustment/manipulation).
In the U.S., chiropractors perform over 90% of all manipulative treatments(1).
Even though, chiropractic medicine is modern medicine their technique using manipulation has been used to treat human ailments since ancient times. Hippocrates,
referred to as the "father of medicine," was known to use manual medical procedures in treating spinal deformity. It was not until the days of D.D. Palmer and Andrew Still, the founders of chiropractic and osteopathy, that these procedures were codified into a system. Both emphasized the role the musculoskeletal system played in health and disease.
Manipulation is usual a painless procedure and can be provided through a variety of techniques. To be therapeutic, the adjustment must be directed in a very specific direction. This addresses an important question whether a person popping themselves is harmful. The answer is complex even though an adjustment is such a safe procedure, but the main question should be is the person addressing the right area. In addition, when a person goes to proform adjustment on themselves it is impossible to relax the stabilizing muscle putting them at risk for a muscle tear. During an adjustment, a joint is moderately distracted while a shallow thrust is applied through the joint space to restore the normal position and function of that joint. This thrust moves the joint into what is called “the paraphysiological space”, which may produce an audible ‘popping’ sound. This is simply a pressure change within the joint where carbondioxide, in a liquid form, transforms into a gas under pressure change. The same type of popping sound occurs when you open a can of pepsi or other carbonated beverage. After the manipulation the distance between the joint surfaces are increased, reducing joint compression. Various neurologic reflexes are stimulated in the joint capsule and surrounding musculature that aid in spasm reduced and body awareness.
Manipulation works by restoring normal joint function and position. If a joint is not working in its complete or proper range of motion, another joint adjacent will have to compensate, by altering its position or range of motion. This not only creates an injury, but also predisposes other parts of the body to other injuries, such as muscle spasm. For example, if a person sprains their ankle usually low back pain will follow with the change in biomechanics.
Just the other day, a patient said, “I was working in the garden and I threw my back out.” Then she asked, “When you throw your back out, what exactly is going out and where does it go? And how do you get it back in?” These were good questions and typical questions in a chiropractic office.
The fact is, you cannot actually throw your back out — it's a figure of speech. However, the experience of sudden, severe back pain is no myth to the person suffering through it. And it can certainly feel as though some major structures in the back have moved, or that to feel better something must be returned to its original location. If one could see inside the painful back and increasingly, we can, with imaging tests such as magnetic resonance imaging (MRI). The examiner will commonly see normal anatomy or mild abnormalities that have nothing to do with the pain, even in the face of excruciating symptoms. "Throwing your back out" is mal-posisition of the spine.
Each bone in your spine has a limited contact with each other. According to James Cyriax, a British orthopedic surgeon, a mal-position of 1mm in spinal vertebrae will change the articular congruity 98%. This means the amount of contact surface between joints changed dramatically with very little mal-position. This lack of congruity can cause early degenerative changes. The same type of congruity is evident in joints throughout the body. By restoring alignment and proper joint function, chiropractic manipulative therapy is the key element in the treatment of a wide range of conditions.
Authors: 1. Dr. Peterson 2. Dr. Cyriax