Patient Media

« Monday Morning Motivation | Main | Monday Morning Motivation »

What Does an Adjustment Do?

Do you steal from patients?I get some revealing answers when I ask chiropractors, especially those still in chiropractic college, what they think an adjustment does. After a long, uncomfortable pause I can tell that they’re either not sure, have never thought about it or more likely, they’ve never actually had to put their own mental representation into words. Some, I suppose, are fearful that their working model of an adjustment might be amateurish or miss the mark completely. Yet, there is very little more important than being clear about what an adjustment is, what it does, what it doesn’t do and what your intention is when delivering one. Without clarity on this vital issue, you’ll resort to being a spine “fixer,” deluded into thinking you’re the one doing the healing! Many chiropractors have fallen into this trap.

But before considering the adjustment, consider the circumstances that appear to necessitate an adjustment, namely, a spinal bone that is malpositioned relative to the one above or below it. Before attempting to “correct” the situation and rescue the patient from their subluxation, consider how and why the bone got malpositioned in the first place.

A Survival Strategy

Apparently, when the body cannot accommodate some physical, chemical or emotional stress, it attempts to adapt by assuming a defensive posture. Thus, subluxation is a survival strategy. Since bones are static structures that only move when muscles contract, and muscles only contract on the command of the nervous system, a subluxation is essentially a nervous system phenomomen. To override the intelligence of the body that put the bone into a particular configuration, without first considering the physical, chemical or emotional cause, is not only presumptuous and egotistical, but the height of folly if you have any hope of being an instrument to making significant or lasting change.

That makes a subluxation a symptom. But it can also be a cause, producing collateral damage, not unlike a damaged roof can be the cause of a stained ceiling or a water-damaged carpet.

When Chiropractic Doesn’t Work

Why is the joint fixated? Is the stressor still present? Or does the body lack the resources or awareness to restore a more normal relationship? Naturally, you’d want to make this determination before injecting any type of energy into their spine in an attempt to make a correction!

Has their frustration and anger from being trapped in a dead end job been resolved? Has the habit of drinking three Starbucks double espressos in the morning and a six-pack in the evening been abandoned? Has the stress of sleeping on their stomach on a sagging 20-year old box spring mattress been discarded? When the patient asserts “I didn’t do anything!” doc, it’s tempting to look past the cumulative hidden emotional and chemical stressors. But neglect them, and you’ll be confronted with an increasing number of situations in which it appears that chiropractic doesn’t work. Enough of them and it may even call into question the career path you’ve chosen. Or more likely, prompt an ever-ending quest for a new technique or modality that can give your healing intent greater horsepower. (Decompression, laser therapy or acupuncture anyone?)

If the patient’s circumstances suggest that thrusting along facetal joint planes is appropriate, just what is it going to do? Many chiropractors (and most patients) assume that the thrust puts the bone back into its rightful place. Of course if this was true, it would only take one adjustment and you’d send the patient on their way. True, in a few cases, a single adjustment does produce symptomatic improvement, these are often the same patients who experience a relapse and want a similar one-visit repeat performance! So, something else must be in play.

Take No Credit

What if the adjustment simply adds energy that the body uses as it sees fit? What if an adjustment is merely a nudge; a coaxing that assists the body in making the necessary change? What if the adjustment is merely a physical means for delivering your intention? What if the adjustment was just a way to attract the attention of the patient’s body and remind it to abandon its defense strategy?

Since there isn’t a recorded instance of a doctor (of any ilk) ever healing a patient, why is there the temptation to not only be responsible, but to take credit for restoring a patient’s spinal biomechanics and reducing their most obvious symptomatic complaint? Not only can you not control such outcomes, it makes you and your adjustment big, while making the patient and their God-given ability to heal, small. If an adjustment merely helps the body right itself, and all you actually do is to determine if, where and when the adjustment will be delivered, it would seem that by taking credit for what the patient’s body is doing is actually a form of stealing!

Comments (4)

The adjustment is the introduction of energy into a person's body that innate uses to correct subluxation. The addition that I would like to make to this definition is that the closer the doctor is to delivering the energy the body actually needs, the quicker and more permanent the response is. Many times health returns slowly because the body has to spend time converting the energy of non-specific gross mechanical motion into what it needs to return to vitality. The better you are at assesing the needs of the patient and delivering it, the more quickly the patient will respond to care. While this is going on the doctor should be addressing the physical, mental and toxic causes of the subluxation to minimize the continued need of correction.

Will Atkinson:

The question is unclear in defining who I would would explain adjustment effects to. Do you want me to explain my concept to other DCs, medical doctors, attorneys, lay persons, or just who?

First of all I have to define 'adjustment' for this discussion as a 'correction' of an abnormal condition. Adjustments can be performed by different measures. I feel that the mechanical adjustment in a chiropractic sense is only one avenue of adjustment.

I find this discussion interesting insofar as we don't even have a good working model of health that I'm aware of, and in its absence how do we even know what the markers are for improvement effects of the adjustment. In other words, when we see a patient complaint, we can't be sure that the complaint isn't just part of the body's attempt at healing a problem.

While I have resolved in my own thinking that the terms manipulation and adjustment aren't interchangeable, they are almost inseparable. I think that both have a healing effect to some degree, and during the manual adjustment tissue mobilization has a healing effect.

As a background I have been in practice for 31 years and have always been personally very inquisitive as to what happens to a body in response to an adjustment. To this end I have poked my nose into many different techniques and procedures, some being seemingly bizarre, to try and figure out their unique influence on the body. I have investigated laser therapy, color therapy, homeopathy, physical therapy, psychotherapy, nutritional therapy, and even dabbled in many of them. I have seen successes in all of those areas of adjustment.

How I would explain the effects of, or the reason for, the adjustment depends on the audience I am explaining this to. The common lay person would need a different type explanation than a more scientifically based thinker so the explanation would have to be modified.

I simply tell people that the adjustment frees up irritation of the nervous system so improving its ability to do its job, which is running the body and keeping it as healthy as possible. I metaphorically compare the nervous system to the federal government in that it governs, regulates, and coordinates all functions of the body. 'Pinched nerves' serve as a satisfactory explanation to some while others rail at its simplicity. For those folks I usually go into a light discussion of energy management, and enhancing the flow of energy along the lines of communication between the brain and the various parts of the body.

But in my self-talk explanation,I believe the effects of the adjustment are buried in quantum physics, quantum mechanics, energy management, and yet undiscovered aspects of String Theory that govern universal intelligence. We are but an expression of universal energy and an extension of universal intelligence from a providential source. I don't believe that we will ever totally understand exactly why the chiropractic adjustment intervention works, and why another DC can do the same treatment and it is not effective. There has to be an interaction of unseen body forces that help or hinder the healing effect.

It is an unexplainable phenomenon that despite all the many diverse chiropractic approaches to the body, they all seem to achieve an 80:20 effect of patient improvement. 80% get better, 10% get worse, and 10% stay the same.

Like gravity, which was around long before Newton put a word to it, it yet defies complete understanding, I feel the effects of the adjustment will never be explained fully.

Will Atkinson

I graduated from chiropractic college 35 years ago. We were taught the bone is out of place and the adjustment put it back. Years later, we were taught the bone was "stuck" and the adjustment "released" it and the body put it back. I grade lesions with subluxation being a true nerve impingement situation. These are not as common as chiropractors seem to think but when they are corrected the changes in the body are dynamic and life changing. Fixations are the next classification are areas producing musculoskeletal pain and tend to recur. It's great that with instrument adjustment and rehab we can see the body get ahead of these recurrent problems.

I have witnessed the miracles of our divinely created bodies regaining health. I hope to live long enough to see chiropractors grow out of their petty "subluxations" and egos to finally be able to see chiropractic flourish.

Wow. I've always enjoyed reading your prospective on chiropractic, this was great. I am guilty of telling different patients different things when it comes to explaining the adjustment. I know it's driven by logic and acceptance for the patients so I might appear like I can solve their problem (pain). When I should be explaining the adjustment in way that stirs up patients to take interest and accountability in their health! Thanks Bill.

Post a comment

(If you haven't left a comment here before, you may need to be approved by the site owner before your comment will appear. Until then, it won't appear on the entry. Thanks for waiting.)

From August 15, 2007 8:53 PM

This page contains a single entry from the blog posted on August 15, 2007 8:53 PM.

The previous post in this blog was Monday Morning Motivation.

The next post in this blog is Monday Morning Motivation.

Many more can be found on the main index page or by looking through the archives.