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One of the most common reasons a patient might seek out a Chiropractor is to find pain relief through Chiropractic Manipulative Therapy (CMT). This is commonly referred to as adjustments or spinal manipulation.
The goal of an adjustment is to temporarily restore the range of motion of a restricted joint, decrease pain, relieve local spasms and muscular tension, and improve how you move functionally through proper biomechanics. We commonly describe it as "natural WD-40" and "natural ibuprofen”.
The popping sound you may hear is called a cavitation and is gas leaving the targeted joint as it is stretched to end-range and the rapid pressure in the joint system drops. This is when the joint transitions from past the passive range of motion into the paraphysiological space, which is the elastic barrier and a safe velocity, low amplitude adjustment occurs. Unfortunately, due to the youtube and TikTok videos of chiropractors using fake or artificial audio and unnecessarily aggressive manipulation, someone watching can expect something that is not realistic or be scared to seek treatment. Cavitation is not the limiting factor to a “successful” spinal adjustment.
When a joint becomes restricted, something called dysafferentation can take place. This process occurs when a mechanoreceptor input decrease while nociceptive input (pain) increases. A chiropractic adjustment affects the A-beta fibers (joint receptors) and Golgi tendon organs that the adjustment dampens the pain receptors via an afferent loop to the central nervous system. This sudden flood of mechanoreceptive input from an adjustment inhibits vasoconstriction, spasm, and nociceptive irritation (via A-delta and C fibers), leading to a normalization in muscle tone. This leads to the desired result of decreased sympathetic hyperactivity, and biochemical changes.
A thorough and in-depth examination can determine if CMT is right for you and should be a part of your treatment plan. If you are seeking pain relief, it is essential to understand and talk with your clinician about what is causing your pain. For example, pain from a joint could also come from hypermobility and/or trauma. It makes sense that you would NOT try to manipulate a patient’s knee who just tore their ACL. If an adjustment is described as "natural WD-40" then more stabilization is needed at this time and in this analogy would be more utilization of “duct tape” to stabilize the joint motion.
We pride ourselves on not being clinicians who scare patients into thinking they need to be adjusted three times a week for the rest of their life. There should be an evidence-backed treatment plan with goals for discontinuation of care that you can measure and that is realistic. A saying I love is that “If the only tool you have is a hammer, everything looks like a nail.” I can not over-emphasize how important it is to use the newfound range of motion and pain decrease that can be associated with manipulation to perform corrective and rehabilitative exercises. If we fail to correct the faulty biomechanical patterns then the adjustment will only continue to have short-term relief. Post adjustment you are neurologically primed and utilizing the central nervous system, the joints and ligaments (passive system), and muscles (active system), which is called Panjabi’s Control Triad, which gives you the best chance for long-term relief and functional improvement. One of the reasons we utilize hour-long appointments is that we understand how important it is to bridge the gap between getting out of pain and becoming more resilient to future setbacks.
Are you interested in how Chiropractic Manipulative Therapy can be integrated as a part of your injury rehabilitation and sports performance? Give us a call today at 727-228-3030 or schedule an appointment online at strengthchiro.com
Dr. Caleb Hebert, DC
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