The Premise of Chiropractic



Dr. Charles Lerner

Chiropractic as a medical art and science is based on the premise that when spinal bones are malpositioned due to anatomical circumstances, nerve roots are compromised as they exit the spine. Chiropractic care involves the repositioning of these spinal bones via a technique known as chiropractic spinal manipulation or adjustment. This technique re-establishes the patency of the intervertebral foramen (hole between the bones) and removes the pressure on the nerve root as it passes through this foramen.

The methodology of chiropractic spinal manipulation (aka an adjustment) can vary greatly in force and invasiveness. The gold standard method is known as Gonstead technique. This is a fairly invasive technique that requires the patient to lie in various positions while the practitioner pushes on the patient’s spine, “locking the joint” in its end range of motion before rendering a “dynamic thrust” that cavitates the joint and resets the bony positioning.

Cavitation means creating space within the joint capsule that prior to the adjustment was not there. Literally, an adjustment is the pulling of the spinal bones apart from each other. When proper cavitation occurs there is a rushing of fluid/gas into the previously evacuated space which emits a sound like popping. This noise is associated directly with the release of pressure on the patient’s nerves. Another example of this action is when one would “crack their fingers”. This is also a type of adjustment and a good example of the sound that’s emitted when spinal joint cavitation occurs. The main difference is that this adjustment is rendered by you not a highly trained practitioner and it’s an adjustment of the finger joints not the joints of your spine.

Other chiropractic techniques that also render an adjustment but are less invasive include:

  1. Drop piece technique. This requires a special table that has chiropractic drops. The drops themselves are nothing more than table sections that can be cocked prior to the adjustment. With the patient prone (lying face down) the table section under the spinal area to be adjusted is cocked in the up position, and then the Chiropractor pushes through the spinal area to be adjusted. The table section drops (a half inch or so) and the technique renders a chiropractic adjustment.
  2. SOT blocking is another method of adjusting involving the use of Sacro Occiptal blocks (wedges) which are placed under the pelvic bones of the patient according to a category listing which is determined by the Chiropractor prior to therapy. In this method the patient’s own body weight on these SOT blocks creates the adjustment. This technique is considered a “non-force technique amongst Chiropractic practitioners and indeed does not require any thrusting on the part of the practitioner.
  3. Activator technique, also considered a non-force technique, is a mechanical tool that renders a very light push on the patient’s spinal bone. The tool is a hand held adjustable device that has an internal spring. When the doctor squeezes it sufficiently it releases with a clicking sound as it gently pushes against the spinal bone, which in turn renders a spinal adjustment.

There are other chiropractic techniques for spinal adjustment but these are the most commonly used. All of these techniques are available in my office.