Chiropractic treatment techniques
Encyclopedia
Many chiropractic treatment techniques are available for use by chiropractors.
Although the chiropractic
profession is primarily based on the use of the spinal adjustment, many other techniques exist for treating the spine
, as well as other joints and tissues. A modern chiropractor may specialize in spinal adjustments only, or may use a wide range of methods intended to address an array of neuromusculoskeletal and general health issues. Examples include soft tissue therapy
, strength training
, dry needling
(similar to acupuncture
), functional electrical stimulation
, traction
, and nutritional recommendations. Chiropractors may also use other complementary alternative methods as part of a holistic treatment approach.
Spinal manipulation
, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care; in the U.S., chiropractors perform over 90% of all manipulative treatments. Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy
(SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation. The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates
, the "father of medicine" used manipulative techniques, as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine
and chiropractic medicine. SMT gained mainstream recognition during the 1980s. Chiropractors consider themselves to be expertly qualified providers of spinal adjustment, manipulation and other manual treatments.
Manipulation under anesthesia
or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. Typically, it is performed on patients who have failed to respond to other forms of treatment.
, as well as some osteopaths, who use the term "adjustment".
Claims made for the benefits of spinal adjustments range from temporary, palliative (pain relieving) effects to long term wellness and preventive care. Some claims are controversial, particularly with regard to indication
s and health benefits. There is debate concerning the safety of some of the procedures used in spinal adjustments, particularly those including upper cervical manipulations
.
The original spinal adjustment was a variation of a procedure known today as spinal manipulation
. This form of treatment has documented use as far back as Hippocrates and the ancient Egypt
ians and was carried through the ages by families of bonesetters. The modern form of spinal manipulation
techniques have characteristic biomechanical features, and are usually associated with an audible "popping" sound. There is strong evidence that this sound is the result of a phenomenon known as cavitation
.
has rated the following as the most frequently used techniques, here listed with percentages of chiropractors who use them and patients who are treated with them as of 2003:
has made a partial list:
Manipulation under anesthesia
(MUA) is spinal manipulation performed while the patient is under general anesthesia
. This procedure is used in the hospital setting for patients whose condition is unresponsive to other forms of treatment.
Although the chiropractic
Chiropractic
Chiropractic is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. It is generally categorized as complementary and alternative medicine...
profession is primarily based on the use of the spinal adjustment, many other techniques exist for treating the spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
, as well as other joints and tissues. A modern chiropractor may specialize in spinal adjustments only, or may use a wide range of methods intended to address an array of neuromusculoskeletal and general health issues. Examples include soft tissue therapy
Soft tissue therapy
Soft tissue therapy is the assessment, treatment and management of soft tissue injury, pain and dysfunction primarily of the neuromusculoskeletal system....
, strength training
Strength training
Strength training is the use of resistance to muscular contraction to build the strength, anaerobic endurance, and size of skeletal muscles. There are many different methods of strength training, the most common being the use of gravity or elastic/hydraulic forces to oppose muscle contraction...
, dry needling
Dry needling
Dry needling is the use of solid filiform needles for therapy of muscle pain, sometimes also known as intramuscular stimulation. The needles are similar to acupuncture needles. Dry needling contrasts with the use of a hollow hypodermic needle to inject substances such as saline solution, botox or...
(similar to acupuncture
Acupuncture
Acupuncture is a type of alternative medicine that treats patients by insertion and manipulation of solid, generally thin needles in the body....
), functional electrical stimulation
Functional electrical stimulation
Functional electrical stimulation is a technique that uses electrical currents to activate nerves innervating extremities affected by paralysis resulting from spinal cord injury , head injury, stroke and other neurological disorders. FES is primarily used to restore function in people with...
, traction
Traction (orthopedics)
In orthopedic medicine, traction refers to the set of mechanisms for straightening broken bones or relieving pressure on the spine and skeletal system.There are two types of traction: skin traction and skeletal traction....
, and nutritional recommendations. Chiropractors may also use other complementary alternative methods as part of a holistic treatment approach.
Overview
| procedure | % of DCs using it |
% of patients getting it |
|---|---|---|
| Diversified technique |
96.2 | 71.5 |
| Physical fitness Physical fitness Physical fitness comprises two related concepts: general fitness , and specific fitness... /exercise promotion |
98.3 | 64.9 |
| Corrective or therapeutic exercise |
98.3 | 63.2 |
| Ergonomic/postural Neutral spine A neutral spine or good posture refers to the "three natural curves [that] are present in a healthy spine."- Posture :The word "posture" comes from the Latin verb "ponere" which is defined as "to put or place." The general concept of human posture refers to "the carriage of the body as a whole, the... advice |
97.3 | 61.9 |
| Self-care Self-care Self care is personal health maintenance. It is any activity of an individual, family or community, with the intention of improving or restoring health, or treating or preventing disease.... strategies |
96.6 | 60.6 |
| Activities of daily living Activities of daily living Activities of Daily Living is a term used in healthcare to refer to daily self-care activities within an individual's place of residence, in outdoor environments, or both... |
96.6 | 57.9 |
| Changing risky/unhealthy behaviors |
96.6 | 54.9 |
| Nutritional/dietary Diet (nutrition) In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management... recommendations |
97.7 | 51.8 |
| Relaxation Relaxation technique A relaxation technique is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of anxiety, stress or anger... /stress reduction recommendations |
96.4 | 50.1 |
| Ice pack/cryotherapy Cryotherapy Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo meaning cold and the word therapy meaning cure... |
94.5 | 48.5 |
| Extremity adjusting | 95.4 | 46.8 |
| Trigger point therapy Neuromuscular therapy Neuromuscular therapy is a form of massage. It is distinguished from other types of massage in that a quasi-static pressure is applied to the skin with the aim of stimulating specific areas of skeletal muscle... |
91.0 | 45.3 |
| Disease prevention/ early screening Screening (medicine) Screening, in medicine, is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease. Unlike what generally happens in medicine, screening tests are performed on persons without any clinical sign of disease.... advice |
90.8 | 39.7 |
Spinal manipulation
Spinal manipulation
Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints . These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse...
, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care; in the U.S., chiropractors perform over 90% of all manipulative treatments. Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal physiological range of movement without exceeding the anatomical boundary limit; its defining factor is a dynamic thrust, a sudden force that causes an audible release and attempts to increase a joint's range of motion. More generally, spinal manipulative therapy
Spinal manipulative therapy
Spinal manipulative therapy is the generic term commonly given to a group of manually applied therapeutic interventions. These interventions are usually applied with the aim of inducing intervertebral movement by directing forces to vertebrae, and include spinal manipulation and...
(SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues; in chiropractic care SMT most commonly takes the form of spinal manipulation. The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
, the "father of medicine" used manipulative techniques, as did the ancient Egyptians and many other cultures. A modern re-emphasis on manipulative therapy occurred in the late 19th century in North America with the emergence of the osteopathic medicine
Osteopathic medicine
Osteopathic medicine is a branch of the medical profession in the United States. Osteopathic physicians, known as DOs, are licensed to practice medicine and surgery in all 50 states and are recognized in forty-seven other countries, including most Canadian provinces.Frontier physician Andrew Taylor...
and chiropractic medicine. SMT gained mainstream recognition during the 1980s. Chiropractors consider themselves to be expertly qualified providers of spinal adjustment, manipulation and other manual treatments.
Manipulation under anesthesia
Manipulation under anesthesia
Manipulation Under Anesthesia is multidisciplinary manual therapy treatment system which is used to improve articular and soft tissue movement using specifically controlled release, myofascial manipulation, and mobilization techniques while the patient is under moderate to deep IV sedation using...
or MUA is a specialized manipulative procedure that typically occurs in hospitals administered under general anesthesia. Typically, it is performed on patients who have failed to respond to other forms of treatment.
Spinal adjustment
"Spinal adjustment" and "chiropractic adjustment" are terms used by chiropractors to describe their approaches to spinal manipulationSpinal manipulation
Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints . These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse...
, as well as some osteopaths, who use the term "adjustment".
Claims made for the benefits of spinal adjustments range from temporary, palliative (pain relieving) effects to long term wellness and preventive care. Some claims are controversial, particularly with regard to indication
Indication
Indication can refer to:* A synonym for Sign.* Human interface Highlighting the single object pointed to as a cursor is moved, without any other user action such as clicking, is indication....
s and health benefits. There is debate concerning the safety of some of the procedures used in spinal adjustments, particularly those including upper cervical manipulations
Joint manipulation
Joint manipulation is a type of passive movement of a skeletal joint. It is usually aimed at one or more 'target' synovial joints with the aim of achieving a therapeutic effect.- Biomechanics of joint manipulation :...
.
The original spinal adjustment was a variation of a procedure known today as spinal manipulation
Spinal manipulation
Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints . These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse...
. This form of treatment has documented use as far back as Hippocrates and the ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...
ians and was carried through the ages by families of bonesetters. The modern form of spinal manipulation
Spinal manipulation
Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints . These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse...
techniques have characteristic biomechanical features, and are usually associated with an audible "popping" sound. There is strong evidence that this sound is the result of a phenomenon known as cavitation
Cavitation
Cavitation is the formation and then immediate implosion of cavities in a liquidi.e. small liquid-free zones that are the consequence of forces acting upon the liquid...
.
Most frequently used techniques
Chiropractors may include any of hundreds of available techniques and methods in their practices. The National Board of Chiropractic ExaminersNational Board of Chiropractic Examiners
The National Board of Chiropractic Examiners is a non-profit national and international testing organization for the chiropractic profession that develops, administers, analyzes, scores, and reports results from various examinations. Examinations are offered twice a year to students of CCE...
has rated the following as the most frequently used techniques, here listed with percentages of chiropractors who use them and patients who are treated with them as of 2003:
| Technique | % of Chiropractors using technique |
% of Patients treated with technique |
| 1. Diversified technique | 96.2 | 71.5 |
| 2. Extremity manipulating/adjusting | 95.4 | 46.8 |
| 3. Activator Methods Activator technique The Activator Method Chiropractic Technique is a chiropractic treatment method and device created by Arlan Fuhr as an alternative to manual manipulation of the spine or extremity joints... |
69.9 | 23.9 |
| 4. Thompson | 61.3 | 28.2 |
| 5. Gonstead Clarence Gonstead Clarence Selmer Gonstead was a Doctor of Chiropractic and creator of the Gonstead Technique.-Early life:Clarence Gonstead was born in Willow Lake, South Dakota on July 23, 1898, the son of Carl and Sarah Gonstead. A few years later, his family moved to a dairy farm in Primrose, Wisconsin... |
57.2 | 26.2 |
| 6. Cox Flexion/Distraction | 56.5 | 23.5 |
| 7. Sacro Occipital Technique Craniosacral therapy Craniosacral therapy is an alternative medicine therapy used by osteopaths, massage therapists, naturopaths, and chiropractors. A craniosacral therapy session involves the therapist placing their hands on the patient, which allows them to "tune into the craniosacral rhythm"... [SOT] |
49.6 | 15.3 |
| 8. Manipulative/Adjustive Instruments | 40.3 | 15.7 |
| 9. Cranial Craniosacral therapy Craniosacral therapy is an alternative medicine therapy used by osteopaths, massage therapists, naturopaths, and chiropractors. A craniosacral therapy session involves the therapist placing their hands on the patient, which allows them to "tune into the craniosacral rhythm"... |
38.0 | 10.3 |
| 10. Applied Kinesiology Applied kinesiology Applied kinesiology is an alternative medicine method used for diagnosis and determination of therapy. According to practitioners using Applied Kinesiology techniques, it provides feedback on the functional status of the body. AK is a practice within the realm of alternative medicine and is... |
37.6 | 12.9 |
| 11. NIMMO/Receptor Tonus | 33.6 | 13.4 |
| 12. Logan Basic | 26.0 | 5.2 |
| 13. Palmer upper cervical [HIO] (Hole-in-One) | 25.7 | 6.7 |
| 14. Pierce-Stillwagon | 15.4 | 5.1 |
| 15. Meric | 15.1 | 4.3 |
| 16. Other | 12.5 | 10.4 |
WebMD listing of techniques
Over the years, many variations of these techniques have been delivered, most as proprietary techniques developed by individual practitioners. WebMDWebMD
WebMD is an American corporation which provides health information services. It was founded in 1996 by Jim Clark and Pavan Nigam as Healthscape, later Healtheon, and then acquired WebMD in 1999 to form Healtheon/WebMD...
has made a partial list:
- Activator techniqueActivator techniqueThe Activator Method Chiropractic Technique is a chiropractic treatment method and device created by Arlan Fuhr as an alternative to manual manipulation of the spine or extremity joints...
- Advanced BioStructural Correction
- Applied Kinesiology
- Atlas Orthogonal
- Auricular
- Barge Analysis
- Bio Magnetic
- Bio-Energetic Synchronization
- Bio-Geometric Integration
- Biomechanics
- Blair
- Body Restoration Technique
- Carver Technique
- Cervical Care
- Cervical Drop
- Chiropractic Biophysics
- Clinical Kinesiology
- Concept Therapy
- Contact Reflex Analysis
- Cox
- Craniosacral Therapy
- Directional Non-Force
- Diversified technique
- Flexion-Distraction
- Gonstead
- Grostic
- Hole in one [HIO]
- Kale
- Leander
- Logan Basic
- Manual Adjusting
- Meric
- Motion Palpation
- Network
- Neural Organization Technique
- Neuro Emotional TechniqueNeuro emotional techniqueNeuro Emotional Technique is a psychotherapeutic/chiropractic system that combines a number of techniques and principles from traditional Chinese medicine, chiropractic and applied kinesiology...
- Neuro Muscular Technique
- Neuro Vascular Technique
- Nimmo
- Palmer Package
- Pettibon
- Pierce
- Pierce Stillwagon
- Pro-Adjuster
- Receptor Tonus
- Sacral Occipital Technique (SOT)Craniosacral therapyCraniosacral therapy is an alternative medicine therapy used by osteopaths, massage therapists, naturopaths, and chiropractors. A craniosacral therapy session involves the therapist placing their hands on the patient, which allows them to "tune into the craniosacral rhythm"...
- Soft Tissue Orthopedics
- Spinal Biomechanics
- Spinal Biomedical Engineering
- Spinal Biophysics
- Thompson
- Thompson Terminal Point
- Toftness
- Toggle Recoil
- Torque Release
- Total Body Modification
- Traction
- Upper CervicalUpper Cervical Specific ChiropracticUpper Cervical Specific Chiropractic is a branch of chiropractic developed and promoted by B. J. Palmer beginning in the 1930s until his death. According to Upper cervical chiropractic, a vertebral subluxation can only occur in upper cervical vertebrae...
- Vector Point Therapy
- Versendaal
Canadian Chiropractic Association outline according to purpose
Most of these techniques can be divided according to the purpose:Manual articular manipulative and adjustive procedures
- Specific Contact Thrust Procedures
- high-velocity thrust
- high-velocity thrust with recoil
- low-velocity thrust
- high-velocity thrust
- Non-Specific Contact Thrust Procedures
- mobilization
- Manual Force, Mechanically Assisted Procedures
- drop tables and terminal point adjustive thrust
- flexion-distraction and traction-type tables
- drop tables and terminal point adjustive thrust
- Mechanical Force, Manually Assisted Procedures
- pelvic blocks
- mechanical adjusting devices
- pelvic blocks
Manual non-articular manipulative procedures
- Manual Reflex and Muscle Relaxation Procedures
- muscle energy techniques
- neurologic reflex techniques
- myofascial ischemic compression procedures
- miscellaneous soft tissue techniques
- myofascial ischemic compression procedures
- neurologic reflex techniques
- muscle energy techniques
Non-manual procedures
- Exercise and Rehabilitation
- Back school/spinal care courses
- Electrical Modalities
- Laser Therapy
- Thermal Modalities including Ultrasound
- Nutritional counselling
- Acupuncture
Manipulation under anesthesia
Manipulation under anesthesia
Manipulation Under Anesthesia is multidisciplinary manual therapy treatment system which is used to improve articular and soft tissue movement using specifically controlled release, myofascial manipulation, and mobilization techniques while the patient is under moderate to deep IV sedation using...
(MUA) is spinal manipulation performed while the patient is under general anesthesia
General anaesthesia
General anaesthesia is a state of unconsciousness and loss of protective reflexes resulting from the administration of one or more general anaesthetic agents...
. This procedure is used in the hospital setting for patients whose condition is unresponsive to other forms of treatment.