The chiropractic profession is filled with a diverse group of doctors all in search of the answer to long term health through removal of subluxation. The philosophy that is taught in chiropractic colleges across the country is sound in theory, but lacks the clinical protocol to back it up. Subluxation a so-called bone out of place theory is out dated and unrealistic. Individual bones or segments of the spine do not mis-align unless the ligaments are torn, a rare condition caused by significant trauma or genetic connective tissue disease. The majority of spinal subluxation, a word that should be redefined or gotten rid of, implies that there exists a bone out of place when in fact every radiology report that I have ever received from a radiologist states “no subluxation is present”. But yet you go to the chiropractor and he or she says;”yep there it is it’s your C5, T7, and L4 they are out of place and need to be adjusted back into place” Then you receive the adjustment “Crack,Click,Drop” there you go all set, back in place. Right? Wrong.
I have been in practice for over 10 years now and about 60% of the patients I have examined have had chiropractic adjustments before. How many of these patients had normal posture and healthy alignment on x-ray? None. Why? Because chiropractic adjustments do not correct bad alignment. If we look at the research regarding spinal biomechanics we understand that the spine and lower extremities are linked together and that your body misaligns globally, also why a radiologist won’t pick it up. In addition there has to be an origin or primary event which starts this chain reaction. The spine and extremities compensate after the primary event occurs, creating a global postural distortion. So when you show up in the chiropractors office, he or she will use segmental analysis to find the hot spots(subluxations) and adjust those segments, temporarily changing the natural compensatory mechanism that was created by the initiating event. In english this means you get a temporary shift in your pattern, which often, about 80% of the time, creates a good feeling or a sense of wellness. Once in a great while the initiating event is so fresh, that the one adjustment actually corrects the global alignment, very rare though less than 1% of the time.
So what is an adjustment doing? A spinal adjustment or sudden applied force to a spinal segment causes joint movement slightly beyond the physiological barrier of passive motion. Huh! It unlocks restricted joints in your spine or extremities. Because it releases the restricted joint, it has a temporary relaxing effect on the muscle that moves that specific joint. This causes a temporary increase in range of motion, decreases pain through the thalamic(section of the brain) system, and decreases muscular tension. Oh by the way, these are all good things! The problem isn’t with the adjustment, the problem is that your postural mechanism will cause you to return to your pre-adjustment position within hours of the treatment. So in reality you feel better for a while, but your initiating event wasn’t corrected so the poor alignment returns and so does the tension, stiffness, and pain. The nervous system also remains unhealthy do to the postural distortion that is left uncorrected. Your body shortly after the adjustment coils itself back into it’s unhealthy position.
So what about exercise or stretching alone or in combination with the adjustment? Close but no cigar. Active exercise is great for a body that has good alignment and proper mechanics, but not so good for someone with bad alignment/posture and poor body mechanics. Active exercises like core strengthening and isometrics do not affect the slow twitch muscles that control posture. Stretching feels great but is temporary. Also if you stretch a muscle that is programmed to be shortened by the brain to help stabilize the spine it can cause further problems. You can now see that simplifying a very complex system to include adjustments and exercises just won’t cut it. This probably explains why we still have 80% of the population suffering with back and neck pain but yet chiropractic has been around for over 100 years and who knows how long exercise has been prescribed for back problems.
The majority of people with chronic problems have poor postural alignment. This poor alignment stresses certain joints which eventually cause pain and even arthritis if not corrected. Poor alignment causes certain muscles to be overworked which leads to myalgia (muscle pain) due to a lack of blood flow through the overly tense muscle. This decrease in blood flow causes excess metabolic waste accumulation in the muscles and eventually can cause permanent fibrosis commonly referred to as fibromyalgia. These babies get rock hard and sensitive! The other often overlooked component of poor alignment are ligaments. Ligaments connect the bones to create stability and are non-contractile tissues, meaning they can not be exercised back to health. Ligaments are also the primary reason you can not change alignment through exercise and chiropractic adjustments. This must explain why 95% of chiropractors do not take post x-rays, they know the spinal alignment on x-ray will not have corrected.
It is published in many prestigious spine journals, anatomy text books, and other related spinal health literature that your spine and posture have measurable healthy normals. The best and most reliable way to check the health of a persons spinal structure is with x-rays and posture analysis (Dr. Ventura’s Posture Analysis software is very accurate). Now if I can measure your poor alignment with an x-ray and posture analysis, would it not make sense to take another x-ray and do posture analysis after the treatment to see if I did my job?
The good news is that through many research studies and new technology we have found a good, consistent way to correct poor alignment. Spinal adjustments combined with re-active muscle training and sustained ligament traction are very effective for long term correction. In addition, traction force chiropractic adjustments are far more effective at breaking up adhesions in chronically restricted joints than the traditional compressive adjustments taught in chiropractic college, including instrument and drop table adjusting. Re-active muscle training makes sense because your posture is merely an adaptation to the environment that you put it in. for example if you slump at your desk and stare at a computer all day, your body will literally mold into your slumped forward position. If you always use your right hand to carry stuff, the natural compensation for this will be overuse of the left side spinal muscle to help stabilize the added weight to the right side of your body. Reactive muscle training uses the principals of compensation. If you have a right dominant posture (you lean right while standing straight) measured with posture analysis, I would add weight to your right side to cause an automatic brain controlled activation of the opposite side muscles causing your body innately to move its posture to the left. Bingo, we are starting to get somewhere. In addition to adding weight, I would have you stand on a vibration platform set at a specific frequency and amplitude so the postural muscle activity would be increased by about 30 times resting levels. This speeds the learning process up so you don’t need 5 years to get it done. The shortened ligaments only, need to be elongated. This is done trough pressure(stretch) over time. A ligament typically will respond after about 15 minutes of pressure. This uncoiling process is termed “ligament creep”. Unfortunately doctors will need specialized equipment in order to get to the correct shortened ligaments especially those ligaments affecting rotational misalignment measured with AP or frontal x-rays.
There are many schools of thought when it comes to the chiropractic profession. I have heard and seen a lot of chiropractic techniques in my 11 years as a practicing chiropractor. Most of these ideas focus on adjustments, and some on soft tissue rehabilitation through exercise, stretching, cold laser, muscle stimulation, active release and countless other modalities. The one consistent undeniable truth still remains: Spinal alignment is controlled through a complex system involving slow twitch postural muscles and ligaments. Without the proper training and equipment, these two areas will remain neglected and therefore the world of chronic back problems will go on.