What is an adjustment?

What is an adjustment and what is it actually doing? This is a very controversial debate among chiropractic physicians as well as the general medical community. Depending on what chiropractor you go to you will get a different answer. This is what, in my opinion, divides the chiropractic profession from each other. So, let's look at the research and see what is actually happening. 

Let’s start by addressing what the adjustment doesn’t do. The adjustment is NOT putting your bones back in place nor is it realigning your spine. These are beliefs that many old time, traditional chiropractors believe because of old research. There is also a subset of chiropractors that will take x-rays, measure how “out of alignment” your spine is, and adjust from there hoping to put your bones back in place. Realignment is also one of the main reasons why people go to a chiropractor. They believe that they feel “out of alignment” and they want me to put them back in place. Although their feelings are valid that they may feel out of alignment, there are likely other factors playing into this. 

Now, what is an adjustment? There are many different ways an adjustment can be delivered but the most common is a high velocity, low impact thrust through a specific joint. With that, there may be an audible sound such as a crack or a pop. The crack or pop is simply just gas releasing from the joint. Although it is not necessary to hear that crack or pop for the adjustment to be effective, some people find it extremely satisfying. The adjustment should not hurt but it is a quick movement so it may be a little startling for some.

So, what does the adjustment actually do? The adjustment is one of the quickest and most effective ways to improve range of motion in a specific joint. If you have ever had an adjustment, you would know the effects are pretty much instant. A great example of this, and where I see the most benefit, is in the cervical spine (the neck). If you have a stiff neck and cannot get full range of motion, an adjustment will fix that almost instantly. It is also a great temporary pain reliever. The reason why it decreases pain is because in the joint there are two receptors, mechanoreceptors (detect motion) and nociceptors (detect pain). When you have pain, your nociceptors are overriding the mechanoreceptor. Then, when the adjustment is delivered, stimulus bombards the mechanoreceptor and now the mechanoreceptor overrides the nociceptor which in turn decreases the nociceptor stimulus and feeling of pain.