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Chiropractors
are trained as "whole person" health care professionals with an emphasis
on the bio-mechanical influences upon the nervous system. The manner of
adjustment to correct subluxations may vary according to the individual.
Therefore, a lot depends on the patient, the practitioner, and the
clinical situation.
Chiropractic
is unlike conventional medicine where a particular drug is routinely
given for all individuals with the same diagnosis. This variation
sometimes creates misunderstanding between professional groups, and
patients. Literature have clearly shown that appropriate spinal
manipulative therapy by adjustment / manipulation improves function,
reduces pain, and disability. The 'art' of performing an adjustment is a
skill acquired through training, and practice. There is a variety of art
forms, so there is no surprise for the occurrence of different
techniques.
In general,
chiropractic techniques can be divided into two categories - high
velocity, low amplitude techniques, and low velocity, long lever methods.
Often a practitioner will use parts of both techniques during a
treatment. This is referred to as diversified technique. Diversified
practitioners tend to use adjunctive physical therapies such as
ultrasounds, traction, and electricity to assist healing. The main
therapy is the removal of subluxations to improve, and restore proper
joint motion.
High
velocity, low amplitude Chiropractic techniques
Subluxations
are corrected by utilizing a rapid thrust with the hand. Frequently, an
audible release (clicking sound) is heard, although at certain stages of
treatment, this may not occur. Frequently, chiropractors order X rays in
the standing position to visualize the spine under the stress of
gravity, establish a diagnosis, and choose the most appropriate
correction, and line of thrust. The adjustments can be applied in many
positions - sitting, lying, standing and side posture depending upon the
clinical situation. Some common systems of 'specific' spinal adjusting
by the hand are Gonstead, Mears, upper cervical toggle recoil adjusting
(HIO), and motion palpation.
Low
velocity, long lever Chiropractic techniques
In these
techniques, the speed of the adjustment is reduced. These techniques use
the arms, and legs to create more leverage, or use mechanical devises
(the adjusting table, wedge shaped blocks under the pelvis, a hand held
device known as an activator or muscle reflex points) to restore proper
joint motion. Although appearing less forceful, movement does occur.
Generally, audible clicking sounds are hot heard. Motion is established
due to the relaxation of the holding elements around the joint (muscles,
ligaments, tendons and fascia).
Some
common Chiropractic techniques are :
Sacro -
Occipital Technique (SOT) :
Along with
hand adjustments, this technique utilizes blocks in certain positions to
balance the pelvis. Reflex techniques to certain muscles, and gentle
pressure to the skull bones are used to balance a natural rhythm, which
should exist during inspiration, and expiration between the base of the
skull (occiput), and the base of the spine (sacrum)
Thompson
Terminal Point Technique :
This is a
commonly used technique which relies on leg length differences in
certain body positions to determine where the adjustment ought to be
given. The adjustments are done by hand, and assisted by sections of the
treatment table dropping beneath the patient at the end of the thrust.
Activator
Methods :
Originally
conceived in the 1920s and popularized in the early 80s, the
practitioner utilize a small hand held instrument to adjust segments
indicated by leg length testing. As with many of these techniques,
audible clicking of the joint may not be noticed. This method is often
utilized in children, and elderly persons with brittle bones.
Cranio -
Sacral Technique :
This is
similar to SOT but more extensive in the assessment, and treatment of
the skull. There appears, despite anatomical education, a very subtle
motion during the respiratory process between the bones of the skull,
and the spinal cord. Torsion in the membranes covering these structures
can lead to a wide variety of symptoms. The pressure exerted during
these maneuvers is very subtle - about 5 grams!
Strain -
Counterstrain
A muscle
technique aimed at restoring motion by using counter pressure in certain
directions for periods of 30-90 seconds. It is very good for pain due to
adhesions.
There are
many other systems of assessment, and treatment of the subluxation
complex, and musculoskeletal pain. This should not cause confusion,
except for research scientists who acknowledge only standardization, and
double blind controlled studies. This degree of 'knowledge' is an
idealized concept, and not a clinical reality for all health care
professionals. What is important is that underlying any technique is a
core body of knowledge upon which can be supported under the scrutiny of
the scientific method.
Chiropractic
physicians as well as the general public can be confident of that
foundation. Individuals only need to seek a practitioner to find out
more about Chiropractic techniques that are helpful to them.
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