Chiropractic Manipulation at Kinetic Health
At Kinetic Health, we approach Chiropractic Care with a neuron/biomechanical approach that is strongly supported by the latest scientific studies.
We use Chiropractic manipulation to:
- Treat musculoskeletal conditions
- Relieve pain
- Improve function by restoring freedom of motion
- Improve nervous system function by manipulating both the spinal column and the body’s extremities
At Kinetic Health, we use treatment methods that combine osseous manipulation (hands-on adjustments) with soft-tissue technique, such as Active Release Technique and Graston Technique. These treatments are supplemented by specific rehabilitation exercises that strengthen weakened muscle groups, improve flexibility, and assist in preventing conditions from returning.
Chiropractic care provides a holistic approach to health care. At its best, Chiropractic care:
- Is noninvasive, emphasizing a patient’s inherent recuperative abilities.
- Recognizes dynamics between lifestyle, environment, and health.
- Recognizes the importance of the nervous system and its relationship with both the structural and regulatory capacities of the body.
- Appreciates the multifactorial nature of influences (structural, chemical, and psychological) on the nervous and musculoskeletal system.
- Balances the benefits against the risks of clinical interventions and
recognizes as imperative the need to monitor progress and effectiveness through appropriate diagnostic procedures.
- Prevents unnecessary barriers in the doctor-patient encounter and
emphasizes a patient-centered, hands-on approach, intent on influencing function through structure.
- Strives toward early intervention, emphasizing timely diagnosis and treatment of functional, reversible conditions.
Source: AHCPR Chapter 2 0 Chiropractic Belief Systems, Robert D. Mootz DC; Reed B. Phillips DC, PhD
Manipulation and mobilization are used in the treatment of conditions related to mechanical-type problems in the joints and muscles of your body.
- Manipulation is normally a hands-on procedure that restores normal movement by stretching tight muscles and loosening joints. Sometimes manipulation will act to restore normal movement by unlocking a joint or by breaking down adhesions. Patients often hear a popping sound when a spinal joint is stretched a little beyond its normal range of motion.
- Mobilization simply stretches soft-tissues by moving joints through a full range of movement. Mobilization can increase the range of motion of the arms, legs, and shoulders, but manipulation may be more effective in relieving pain and restoring normal movement in the spinal joints.
Chiropractic manipulation releases joint restrictions to restore normal range of motion.
- The chiropractic manipulation helps to break up the restrictions of fibrosis that forms around spinal joints.
- These restrictions cause friction and increased stress on the normal joint function.
- This increased friction may cause inflammation or just wear and tear of the joints.
This wear and tear is no small matter. Wear and tear causes Osteoarthritis, a progressive breakdown of cartilage. This cartilage forms a very thin layer inside the joint. Thus it becomes very important to remove stress from the joint in order to prevent complete degeneration of the cartilage. Twelve percent of the population suffers from severe osteoarthritis.
It is very important to restore joint function if you are experiencing an inflammatory reaction as a result of these joint restrictions, particularly if you have been experiencing repeated episodes of inflammation. Repeated episodes often lead to chronic problems which effect the surrounding structures: joint capsules, ligaments, muscles, and nerves.
Spinal manipulation is a very effective way of alleviating these types of restrictions and preventing further problems.
Working with soft-tissue restrictions
Chiropractic manipulations also effect soft-tissue, not just the bones. Patients often ask me how an adjustment of an osseous structure (bone) can affect soft-tissue (muscle).
The answer is really quite simple. In your muscles, you have stress receptors called Golgi Tendon Organs. These stress receptors react to situations where muscle tension suddenly increases, such as with a chiropractic adjustment.
- Chiropractic adjustments are very low in force but high in velocity.
- Chiropractic adjustments cause a reflex in the stress receptors (Golgi Tendons) to inhibit all muscle activity in the surrounding area.
- This causes the entire muscle surrounding the joint to go into an instantaneous state of relaxation. This reaction is very important when a doctor and patient are dealing with an acute episode of low back pain (Guyton Textbook of Medical Physiology, p 691-692).
This is by far the most important aspect of chiropractic manipulation. First let’s talk about how our nervous system reacts to injury.
For years, Chiropractors have hypothesized about how adjustments affect the nervous system. We can now scientifically explain how this works. We can also validate our claims with research performed by the conventional research community; by conventional I am talking about accredited allopathic medical journals in the world, not just chiropractic research. Sometimes I hear there is no scientific information out there to validate chiropractic. Obviously these individuals are not familiar with current literature.
One of the central hypotheses of the Chiropractic theory is that dysfunctions of the musculoskeletal structures (relating to or involving the muscles and the skeleton) have a significant impact on the autonomic nervous system.
- The autonomic nervous system is the part of your nervous system that controls involuntary activities, including heart muscle, glands, and smooth muscle tissue.
- The autonomic nervous system is subdivided into the sympathetic and parasympathetic systems.
- Abnormal neurological input from dysfunctional musculoskeletal structures (eg: injury, inflammation) increases sympathetic traffic or activity in this system.
- The sympathetic system is responsible for the “fight-or-flight” response with which we all are hard-wired.
- An injury to the musculoskeletal system results in an overall increase in sympathetic nervous system activity. In fact, injury to this system will cause a shift of the autonomic nervous system towards sympathetic dominance.
- The fight-or-flight response, also called the “acute stress response”, was first described as early as the 1920’s. The response was later recognized as the first stage of a general adaptation syndrome that regulates stress responses.
The onset of a stress response is associated with specific physiological actions in the sympathetic nervous system, both directly and indirectly through the release of the hormone epinephrine, and, to a lesser extent, norepinephrine from the adrenal glands (medulla). These are stress-related hormones.
The release of these hormones is triggered by a substance called acetylcholine which is released from the sympathetic nerves. Acetycholine is a neurotransmitter in the brain which helps to regulate memory, and the actions of skeletal and smooth muscle in the peripheral nervous system.
These hormones (epinephrine and norepinephrine) facilitate immediate physical reactions by triggering increases in heart rate and breathing, constricting blood vessels in many parts of the body (excluding muscles (vasodilation), brain, lungs and heart), and tightening muscles.
Now let’s talk about how restrictions affect neurological function. Injury to the back often involves injury to the facet joints of the spine or to the discs. The facet joints are paired joints located on the posterior aspect of the spine. These joints provide stability to the spine. Facet joints have nerve endings both inside and outside the joints.
- These injuries are often caused by the non-voluntary contraction of the spinal segmental mover (muscles around the spine contracting such as the multifidus muscle).
- These non-voluntary contractions occur not only at the level of injury, but several segments above and below the level of injury.
- This non-voluntary movement/contraction locks what is referred to as the motor unit (two adjacent vertebrae, the disc between them, the nerves that goes through them, and surrounding soft-tissues) into a certain position with reduced movement.
This has the effect of opening what is known as the Pain Gate.
Initially the Pain Gate theory was proposed in 1965 by Melzack and Wall based on the fact that small diameter nerve fibers carry pain stimuli through a ‘gate mechanism’, but larger diameter nerve fibers going through the same gate can inhibit the transmission of the smaller nerves carrying the pain signal.
Chemicals released as a response to the pain stimuli also influence whether the gate is open or closed for the brain to receive the pain signal.
- This leads to the theory that the pain signals can be interfered with by stimulating the periphery of the pain site, the appropriate signal-carrying nerves at the spinal cord, or particular corresponding areas in the brain stem or cerebral cortex.
- It is generally recognized that the ‘Pain Gate’ can be shut by stimulating nerves responsible for carrying the touch signal (mechano-receptors) which enables the relief of pain.
How does Pain Gate Theory Relate to Chiropractic Manipulation
When a Chiropractor/Physician adjusts a section of the spine, they cause the firing of what is called high threshold mechano-receptors.
- This initiates a neurological sequence of events that causes pain inhibition (closes the pain gate), and inhibits the sympathetic nervous system.
- When one considers the wide-spread effects of being in a constant state of flight or fight, the ability to reduce these sympathetic activities with an adjustment is quite amazing.
Poor healing of the back always results in fibrosis caused by scar-tissue formation and adhesions. Chiropractic spinal adjustments are unique in their ability to:
- Break up these adhesions.
- Close the pain gate.
- Reduce involuntary sympathetic nervous system activity.
- Improve overall function.
Journal of Manipulative and Physiological therapeutics January 2005, volume 28, Number 1
Chronic Spinal Pain: A randomized clinical trail comparing medication, acupuncture, and spinal manipulation Spine July 15, 2003;28(14):1490-1502
Gate Control Theory of pain stands the test of time British Journal of Anesthesia. Vol. 88, No6, June 2002, Pg. 755-757
Chiropractic is a hands-on, manual therapy, that can achieve great results for many conditions. In fact, if you review the most recent literature from recognized journals in conventional medicine (Spine, British Journal of Medicine), you will find that:
Chiropractic is considered to be the best choice for treating back pain. Chiropractic care has been shown to be the most effective method for improving and providing long-lasting quality of life for back-pain sufferers. See Cost effectiveness of physical treatments in primary care.
UK Beam Trial (Andrea Manca) British Journal of Medicine Journal 2004;329:1381 December 11, 2004.
Some interesting statistics for your consideration:
- Chiropractors comprise the third largest segment of the health care practitioners in the United States, with over 50,000 practitioners.
- In the United States 21 to 28 million people now receive chiropractic services each year.
- Some of the most recent studies about chiropractic are not only showing how effective it is, but also how chiropractic treatments can help to lower overall health expenditures. This is being achieved by reducing the need for expensive diagnostic procedures, surgeries, and other health related costs.
See Comparative Analysis of Individuals With and Without Chiropractic Coverage; Patient Characteristics, Utilization, and Costs. Archives of Internal Medicine. October 11, 2004;164:1985-1992
Low back pain is often difficult to solve. In fact, the literature shows that there is little association between pathological physical findings and the patient’s pain and disability. In other words, a lot is unknown about the cause of low back pain from a conventional medical perspective.
What we do know is that low back pain is second only to the common cold for visits to primary care physicians. In fact 43% of the population experience back pain in a given month. Direct cost of treating LBP is $33-$55 billion per year, and the indirect costs are $90 billion.
The Journal of Bone and Joint Surgery
Volume 86-A – Number – August 2004
Many factors increase the incidence of Low Back Pain:
- Smokers have more incidences of back pain, more disc herniations, progressive disc degeneration, poor treatment outcomes and poor healing of injured backs and necks.
- Obesity contributes to back pain.
- Repetitive bending and twisting can increase the risk of low back pain and disc herniation.
At Kinetic Health, we know what works, and what does not work for the treatment of low back pain:
- Bed rest for more than two days is a very bad strategy in the treatment of back pain.
- Opioid drugs do not work for back pain over the long run and they lead to drowsiness, dizziness, fatigue, nausea, respiratory depression and constipation. They are addictive and have reduced effectiveness after only a few weeks.
- All narcotics should be avoided in the management of back pain.
- Steroids are associated with substantial gastrointestinal injury, decreased bone mass, and degeneration of the bones of the legs.
- Muscle relaxants do not work for chronic back pain.
- Drugs do not achieve a lasting improvement in chronic spinal pain.
The Journal of Bone and Joint Surgery Volume 86-A – Number – August 2004, Chronic Spinal Pain: A randomized clinical trail comparing medication, acupuncture, and spinal manipulation Spine July 15, 2003;28(14):1490-1502
What is an effective treatment for low-back pain?
So what is the most effective form of treatment for back pain that can be scientifically validated? The answer is simple.
Chiropractic Manipulation – In head-to-head comparisons against conventional medicine, Chiropractic care has been shown to be the best choice.
For example in 2003, the Journal of Spine, the most prestigious medical journal published by the American Medical Association found that chiropractic manipulation was five time more effective than the drugs Celebrex or Vioxx. This was a randomized clinical trial under the highest level of scrutiny.
Chronic Spinal Pain: A randomized clinical trail comparing medication, acupuncture, and spinal manipulation, Spine July 15, 2003;28(14):1490-1502, Joint restrictions lead to biomechanical restrictions, friction, inflammation and eventually degeneration.
Research shows that chiropractic is significantly safer than comparable pharmaceutical and surgical treatments, and produces far fewer (4,000 times fewer) negative side effects.
To further understand chiropractics effectiveness, the Canadian chiropractic profession is currently involved in additional research to further examine neck adjustments. Recent research conducted at the University of Calgary, demonstrated that:
- Neck adjustment are done well within the neck’s normal range of motion.
- No force is applied to arteries during an adjustment.
- Arteries are not stretched during adjustment.
Internal forces sustained by the vertebral artery during spinal adjustment therapy, Herzog W, Journal of Manipulative and Physiological Therapeutics,
Oct. 25(8): 504-20, 2002.
All Chiropractors use standard procedures of examination to diagnose a patient’s condition, and to arrive at an appropriate course of treatment.
Doctors of chiropractic use the time-honored methods of consultation, case history, physical examination, orthopedic analysis, neurological analysis and x-ray examination (as required ) just like any other doctor. In addition, we also carry out a careful structural examination that pays particular attention to the biomechanics of the body.
What makes a good Chiropractor? The same thing that makes any doctor good (my opinion of course)!
Patients moving to a new city often ask me for referrals to local Chiropractors. I am often asked about what they should look for in a good Chiropractor. Here are a few of the things I would recommend:
I cannot recommend any single technique as being better than another. In fact, I would be skeptical of anyone who claims their specific chiropractic technique is the perfect choice for everyone. Chiropractors are trained to use a wide variety of techniques, and can choose from numerous treatment methods for any one condition. Their selected treatment method can vary depending upon:
- Patient response to treatment.
- Patient requests for treatment (some patients prefer certain manipulation methods).
- Patient age and overall health status.
It is very important to talk to, and question your doctor. Communication is critical with any medical professional, chiropractic, Medical, Physiotherapist, etc.
- If you have questions, ask them, and expect a reasonable clear answer.
- Question the logic of treatment. The more you understand, the better off you will be.
- If your doctor is always too busy to answer, or does not provide suitable responses, then consider looking at another doctor who does meet your requirements.
Expect results from the selected treatment therapy. Expect to see changes, whether it is Chiropractic, Physiotherapy, Medicine, Acupuncture, or Massage therapy. If you don’t get appropriate results, go somewhere else.
- Be reasonable, and allow sufficient time for the treatment to take effect.
- Ask your doctor to provide you with a copy or explanation of his/her proposed treatment plan.
- Your doctor should tell you how many visits they recommend, when the review date will be, and what results they are expecting.
Remember 1+1 always equals 2. In other words, if you do the same thing over and over again you will always achieve the same result, good or bad.
- If you find the treatment you are using is not achieving the results you desire, then you need to consider other alternatives.
- If you don’t achieve some results after a reasonable period of time, then repeating the same procedure 112 more times will probably not help.
Rehabilitative exercises are fundamental to good recovery. Your rehabilitation program should address the four fundamentals of rehabilitation:
- Balance and proprioception.
Note: if your doctor does not provide you with exercises for a musculoskeletal condition, then the doctor is missing a key aspect of treatment. Exercise is not an option for treatment, it is a fundamental component.
For more information, visit our online resource centre at www.releaseyourbody.com where you can review the books, exercise protocols, nutritional supplements, and products that Dr. Abelson recommends for his patients.