Chiropractic Manipulative Therapy: What is an adjustment?

Chiropractic manipulation is a therapy utilized frequently in our office; Unfortunately, it remains one of the most misunderstood therapies by patients and clinicians alike.  It is a very safe and effective intervention for many types of symptoms; it is however somewhat difficult to explain how and why it works.  In order to appreciate the various mechanisms by which manipulation helps people, it is necessary to have a basic understanding of what condition it treats.fotolia_24252762_xs  Chiropractic manipulation treats a condition called joint complex dysfunction or subluxation.

Joint complex is a term that collectively describes specific joint structures along with tissues that are intimately associated with joint function;  namely muscles, tendons, ligaments, discs, as well as the blood and nerve supply to these tissues.  Joint complex dysfunction describes a state of  reduced mobility that promotes functional and pathological changes within the structures that make up the joint complex.  There are several  common manifestations of joint complex dysfunction; including pain, inflammation, stiffness, muscle tightening and shortening, and the development of myofascial trigger points.

Joint complex structures receive their nerve supply from two main types of sensory nerve receptors: nociceptors(pain receptors) and mechanoreceptors.  Nociceptors  are stimulated by potential or actual tissue damage.  Nociceptor stimulation is interpreted by the brain as pain.  Mechanoreceptors are stimulated by normal movement and the stretch of tissues that make up the joint complex.                                                                                                                                                                 

Joint complex dysfunction causes dysafferentation.  Dysafferentation is an imbalance in sensation such that there is an increase in pain, and a  decrease in mechanoreceptor stimulation.

Chiropractic manipulative therapy restores movement, thereby reducing joint complex dysfunction.  This reduction in joint complex dysfunction induces local, segmental, and suprasegmental(brain) effects.

Local Effects

Chiropractic manipulation improves mobility and biomechanics of the spine and joint complex.  Joint and muscle function is improved: mechanoreceptors are stimulated, tight and short muscles are stretched, weak and atrophied muscles are facilitated, nutrition to discs and joint cartilage is improved.  Chiropractic manipulation restores motion, sensation, function, and nutrition to the joint complex.

Segmental Effects

Mechanoreceptors stimulation continues to be increased after the manipulation, so long as the improved mobility is maintained.  This lasting increase in mechanoreceptor stimulation causes inhibition of the nociceptor (pain) pathway at the level of the spinal cord.  Nerves going to muscles, blood vessels, and glands are modulated.  Chiropractic manipulation inhibits pain and regulates nerves going to muscles, blood vessels, and glands.

Suprasegmental Effects

Normalization of mechanoreceptors input as a consequence of chiropractic manipulation causes excitation of nerve cells within the brain.  Mechanoreceptors stimulate neurons in the cerebellum, brain stem, thalamus, and throughout the cerebral cortex.  These connections are very complex and are responsible for providing a constant level of stimulation to these brain structures.  Consequently, a reduction in mechanoreceptor input due to joint complex dysfunction, has the potential to cause physiological deviations from optimal function in any of these brain areas. This can lead to a confounding array of symptoms that will likely vary from individual to individual, due to uniqueness in "neural wiring".  Chiropractic manipulation increases mechanoreceptor stimulation to various brain structures.


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