Anatomy of an adjustment

The chiropractic adjustment is what
sets chiropractic apart from other types of treatment. 

During an adjustment, a
chiropractor applies a very controlled impulse to a dysfunctional joint.  This rapid stretching of the spinal joint
results in significant changes to the joint on several different levels. 

Muscles and ligaments stretch,
blood circulation increases, and nerve fibres around the joint are stimulated
at the moment of the chiropractic adjustment.

Current theory holds that it is the
stimulation of these nerves following an adjustment that cause the relaxation
of muscles around a joint, block pain signals, and cause the release of

Therein is the secret of
chiropractic success.  No other health
care system trains its practitioners to be so adept at palpating joint
movement, diagnosing joint dysfunction and restoring normal full range of
motion to joints through adjustments.

What is that pop?

What could possibly be occurring in
the spine to create a popping noise? 
Many people envision their spine as some complex Lego set that
chiropractors snap together.  They think
the popping sound must be the sound the joint makes when it snaps into place.

The truth is actually the complete
opposite. The adjustment takes a joint that had joint surfaces “pinched”
together and opens them – not snaps them together.   

Like many of the joints in the
body, the joints of the spine are synovial joints, and the joint produces a
fluid called synovial fluid.

Synovial fluid lubricates the joint
and nourishes it. The by-products formed in the production of synovial fluid
are gasses – oxygen, nitrogen and carbon dioxide. The actual pop is called a
cavitation, and it’s the release of gas in the joint fluid that makes the popping

It’s very similar to the release of
gas bubbles when you open a sealed carbonated beverage. 

Why is the adjustment so effective?

Yet, the question remains –
why?  What could be so therapeutic about
someone “cracking” your spine?  What is
really occurring during a chiropractic adjustment?

There are several immediate effects
from the adjustment. 

Now that the normal joint space has
been restored the synovial fluid is able to flush into the joint space. The
synovial fluid can wash away pain producing inflammatory chemicals in the area.

The synovial fluid is also able to
perform its primary function; to lubricate and nourish the joint
cartilage.  There are times when other
structures can be pinched between the joints, and they are now freed.

The surrounding ligaments and joint
capsule which had been held in an unnatural position are no longer
stressed.  There are also many secondary
effects on the surrounding muscles and nervous system.

How much will an adjustment help me?

There are many factors that can
affect how much relief is felt from an adjustment.

A joint that has been badly
sprained will still be sprained following an adjustment and need time to heal.
A joint that has been dysfunctional for a long period of time will likely
require a series of adjustments to fully respond. 

Happily, most people feel a degree
of immediate relief.  First-time patients
are often amazed at the immediately gained range of motion and resulting
decrease in stiffness and pain after just one adjustment. 

The adjustment also stimulates the
brain in such a way that endorphin levels are elevated immediately after an
adjustment (the same feel-good hormones released during exercise).  

Over the long term, the benefit of
having a dysfunctional joint adjusted is an improved range of motion which
allows complete healing.  The cumulative
results of several treatment sessions within a proper treatment plan can be
long lasting. 

Chiropractic adjustment rarely
causes discomfort. However, patients sometimes experience mild aching following
their first few treatments (as with some forms of exercise) that usually
resolves within 12 to 48 hours. 

This soreness is due to the
stretching of contracted tissue and scar tissue, and can mark the first step towards
rehabilitation of a chronic injury.

How are the muscles affected?

We have a special type receptor
where our muscles and tendons meet called a Golgi Tendon Organ.  It is through interpreting the information
from the GTO that the brain knows the positions of the joints.  

The speed and force of the
adjustment does more than just cause the joint to pop, it also stimulates the

When a GTO is activated the
corresponding muscles around the joint relaxes.

The quick speed of an adjustment
appears to be a critical factor in this relaxation effect.  In fact, a slow stretch of the GTO can cause
the opposite reaction resulting in increased muscle tone or spasm. 


What occurs to the joint?

A review article in the medical
journal Annals of Internal Medicine determined that a chiropractic adjustment
had five main effects on the joint:

It releases part of a joint capsule
(a very pain sensitive structure) that has become “pinched” between the joints;
repositions part of an intervertebral disc (the rubbery disc between
vertebrae); loosens fibrous scar tissue formed in a previous injury; reduces muscle
spasm reflexes in muscles of the spine or limbs; and reduces the compression or
irritation of nerves.

The article also cites studies
suggesting that chiropractic adjustments increase the range of joint motion,
increase pain tolerance, increase muscle strength, and improve joint


Dr. Khan performs a back adjustment.
Photo: File