There are many types of chiropractic therapies available.  Each individual can choose a chiropractor based on their philosophy, such as “straight” or “mixed”.  With each type of chiropractor, there are techniques that can be employed to maximize the adjustments and benefits for their clients.

Straight vs. Mixed

Straight chiropractors are less common, but they tend to feel that “adjustments to the spine can solve nearly all of the ailments”, according to Dr. Paul Curcio, whereas mixed chiropractors “opt for an overall broad-spectrum approach to wellness”.  They are the more common form of chiropractor, and they will employ multiple techniques including physical therapy, massage, nutrition, exercise, and other methodology in treating clients.¹

Spinal Manipulation

The most common chiropractic technique is spinal manipulation, also called “spinal adjustment” and “chiropractic adjustment”.  In general, this means that “hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues.”  It involves a force, or sudden (audible) thrust, in order to increase the range of motion of a joint.  In fact, adjustments have been done for at least 3000 years in China, during the time of Hippocrates (Father of Medicine), and in other ancient cultures. Spinal manipulations (SMT) have become a “mainstream” treatment since the 1980s.²

Diversified Technique

Diversified Technique (DT), is the most common, “generic” adjustment method used by chiropractors.  It is a “high-velocity, low-amplitude thrust”.³  A chiropractor will find which vertebrae is out of place, by palpating, and then perform a quick and precise adjustment to realign the bone.⁴  This causes a “cavitation of a joint”, or the “popping noise” most associated with chiropractic manipulations.⁵

Activator Technique

Arlan Fuhr developed an “alternative to manual manipulation of the spine or extremity joints” called the Activator Method Chiropractic Technique (AMCT).  In this method, a softer version of an adjustment, the chiropractor uses a mechanical force manual assisted (MFMA) instrument.  It creates a small impulse to the spine through spring activation.  Its aim is to create just enough force to make the vertebrae adjust, but without injury.  In AMCT, a chiropractor will have a patient lie down, examine the length of the patient’s legs, and see if one is shorter.  The chiropractor will also do various other arm movement tests to figure out where there might be a misalignment (by seeing if the leg lengths change).⁶

Gonstead Technique

Clarence S.Gonstead developed a method of chiropractic assessment that involves 5 criteria:  Visualization (looking for movement changes), Instrumentation (“The Nervoscope detects uneven distributions of heat along the spine which can be indicative of inflammation and nerve pressure”), Static Palpation (feeling the spine when the patient stands still), Motion Palpation (feeling the spine when the patient is moving), and X-Ray Analysis (to examine for disc problems and misalignments).⁷  “Gonstead adjustment is to be as specific, precise and accurate as possible, addressing only the problem areas (areas of subluxation).”⁸

References:

1 http://comparechiropractic.com/chiropractic-education/neck-pain/chiropractic-types-straight-or-mixed/

2 http://en.wikipedia.org/wiki/Chiropractic_treatment_techniques

3 http://en.wikipedia.org/wiki/Diversified_technique

4 http://www.drbrownsoffice.com/2011/11/01/what-is-diversified-technique/

5 http://www.firstchiropracticcenter.com/index.php?p=110520

6 http://en.wikipedia.org/wiki/Activator_technique

7 http://www.gonstead.com/index.php?content_type=general_content&content=10

8 http://www.gonstead.com/index.php?content_type=general_content&content=12

See more chiropractic techniques.

A chiropractic tool that is used by some chiropractic physicians is an activator. A chiropractor activator is a small, handheld device that is spring-loaded to produce enough generated force to manipulate a spinal joint. This treatment is called the activator method chiropractor treatment or AMCT. This method begins with a patient lying prone with the chiropractic physician measuring their leg length. Many times, one leg will appear to be shorter compared to the other leg. The physician will then conduct muscle testing to activate certain muscular attachments to specific vertebrae. If this muscle activation changes the leg lengths, then it is determined that at that vertebra, an adjustment must be performed. This testing will check all segments of the spine, beginning at the lowest segment and moving in an upward direction towards the head. According to the National Board of Chiropractic Examiners, in 2003, 69.9% of practicing chiropractic physicians used this technique and 23.9% of patients received the treatment. Almost all chiropractic schools teach activator method and it has been reported that over 45,000 chiropractic physicians around the world use this method, or a form of it. This method has been practiced since the late 1960’s. Chiropractic physicians are able to attend activator seminars throughout the year to become more proficient with the method.

Leg Length Testing

While a large percentage of practicing chiropractic physicians utilize this method of testing and treatment, there is some speculation as to whether leg length testing is wholly accurate. Although it is used, this form of leg length testing is not considered to be an anthropometric technique, as legs are many times not of equal length. It has also been medically determined that leg length testing is far more accurate when a patient is in a standing position compared to a prone position. Another finding has shown that leg length will change when the two legs are held together and moved slightly from one side to the other. Clinical research regarding the activator method varies widely, for some patients, they find relief with this method, for others, no beneficial effects were reported. Whether or not it will work well for you, there are generally no side effects and little to no discomfort during the treatment.  For patients who are interested in receiving this form of chiropractic care, they can visit the website www.activator.com to find out more information about the method and to find chiropractors in their area that offer this form of conservative care.

References Cited in this Article

www.activator.com

www.wikipedia.org

Check out more info on the Activator Method.

Definition and Symptoms

Fibromyalgia is a condition distinguished by musculoskeletal pain happening throughout the body and is accompanied by loss of sleep, fatigue and moodiness.  Doctors believe this condition intensifies painful sensations and affects how the brain processes signals of pain.  Symptoms may begin after surgery or trauma, although in some cases symptoms occur on their own with no reason at all.  For patients who develop this condition without cause, it is likely that it fibromyalgia runs in the family.  It is more common for women to develop fibromyalgia than men.  While there is not cure for fibromyalgia, certain medications can control symptoms and even exercise and relaxation can help reduce pain.  Alternative medicine such as acupuncture and massage therapy are becoming a popular choice for pain relief.  In some patients, the symptoms may come and go and widespread pain can last at least three months.  Currently, there are no lab tests that can identify fibromyalgia, but physicians can rule out other conditions through a series of blood tests.

Treatment with Medication

Medications can reduce pain and help improve sleep.  Some common choices are analgesics and antidepressants.  Analgesics such as Tylenol help ease the pain but the effectiveness varies for each patient.  Some doctors will recommend anti-inflammatory drugs such as ibuprofen to reduce swelling and relieve.   Antidepressants can help improve sleep patterns and reduce fatigue.

Alternative Treatment

Alternative therapies for stress and pain management are becoming more popular with people who have chronic illnesses.  Treatments such as acupuncture and massage therapy may help relieve pain and stress and are becoming more popular in conventional medicine.

Acupuncture has been practiced for thousands of years and started in the Chinese culture.  Acupuncturists believe balance can be restored in the body by placing fine needles through the skin in various places of the body.  The needles are placed in the skin to help increase blood flow and improve the number of neurotransmitters in the spinal cord and brain.  Studies show that this treatment is effective for some patients but not all.

Massage Therapy Massage therapy has been used as a healing technique for centuries in many cultures.  For years, people have used the method of touch to induce the healing process for aching body parts and muscles.  Not only does massage relax the body and mind, but it offers a drug-free and natural approach to improve physical and mental health.  Some benefits include: decreased anxiety, enhanced sleep quality, greater energy, improved concentration, improved condition of the skin, and increased circulation of blood and lymph flow.

Are you suffering in silence with Low Back Pain?  You’re not alone, it is estimated that nearly everyone will experience some sort of bout pain within their lifetime.  Many more suffer chronically and have tried nearly every treatment known to them.  Low Back Pain is one of the most common reasons for work absenteeism today.  There is no need to suffer anymore; today’s treatments are vast and proven to be effective in the treatment of Low Back Pain.  Some of these treatments include but are not limited to the following: Chiropractic care, Acupuncture, Massage Therapy, Spinal Decompression units, Inversion tables, physical therapy, and Surgical Intervention in severe cases.  In addition, your doctor may suggest the use of physiotherapy modalities for home and treatment use.  Such therapies include: ultrasound, electrical muscle stimulation, cold laser treatment, diathermy, ice application, heat packs, cold therapy gels and sprays, etc.

Chiropractic Care

Chiropractors work to balance the ever-important nervous system.  The nervous system is the most important system, controlling and coordinating every organ and body part.  They will search for interference within this system.  They will perform this through static and kinetic palpation.  Once located, they will deliver an HVLA thrust to correct the mis-alignment, or subluxation.  They may use a host of techniques such as Diversified Technique, Flexion-Distraction Technique, SOT, Thompson Technique, Cranial-Sacral Technique, and Activator Methods.

Chiropractic BioPhysics (CBP)

They may utilize x-ray analysis to view the curvatures of the spinal column.  If these are abnormal in any way, many doctors will use Chiropractic BioPhysics (CBP) to deform the mis-shaped ligaments and bring the curves back.  This is started by placing the patient on mechanical traction for a minimum of six minutes and this is slowly increased until twenty minutes is reached.  Ligaments tend to plateau in their stretching abilities after this time.  For spinal correction, mechanical traction is needed a minimum of two to three times per week to be deemed successful.  The reason being is that the ligaments need that constant stretch over and over so they don’t bounce back; ligaments are very elastic as resilient so they have a tendency to bounce back quickly if the stretch is maintained.  If the patient has a reversal in their cervical spine, two-way traction with sand bag weights will be introduced into the treatment plan.  This particular mechanical traction is not performed for twenty minutes; rather it’s performed for a maximum of ten minutes and the weight of the traction is slowly increased to patient tolerance.

See more about low back pain and chiropractic treatment.

Have you ever had a pain in your mid-back that was so severe that you thought you were having a heart attack?  This could be Rib Discomfort or a Rib Subluxation.  It is very common for rib heads to subluxate or misalign, especially within the thoracic region because that is where they are all housed.  There are twelve thoracic vertebrae, each with a corresponding rib head.  The most common way for a rib to subluxate is posterior.  This is why Chiropractors will take the rib head and adjust them posterior to anterior to correct this type of misalignment.  Rarely do rib heads subluxate anterior but sometimes they do and when this happens it is extremely painful for the patient typically.  In this instance, the Chiropractor will take the rib anterior to posterior at the rib head junction.  There are many ways to adjust ribs and no two adjustments are similar.  They can be adjusted with an activator directly over the rib head and taken either posterior to anterior; they can be addressed using a unilateral pisiform contact directly over the rib head; or they can be taken with a palmer contact with the other hand stabilizing the anterior ASIS or hip.  The ASIS stands for Anterior Superior Iliac Spine.  In this adjustment the doctor will stand on the ipsilateral side of the subluxated rib and contact it with a pisiform palmer contact facing the patient perpendicular.  His or her line of drive will be posterior to anterior with a lateral to medial thrust while pulling anterior to posterior on the ASIS.

Physiotherapy Modalities

It is crucial to follow-up a rib adjustment with physiotherapy modalities such as cryotherapy, also known as ice.  This should be applied for twenty minutes on and at least sixty minutes off and then repeated as necessary.  Ideally two to four times daily in the acute phase; the acute phase lasts anywhere from 24 to 72 hours in duration.  After this, the patient is in the sub-acute phase which can last several days.  After the sub-acute phase has run its course then it’s said that the patient is in the chronic stage of healing.  Chronic can be anywhere from 3 months up to a year in duration.  Anything beyond this is still considered chronic and the healing process is very minimal if at all.  Analgesic creams such as Biofreeze and/or Sombra may also be used to decrease pain slightly within the muscles themselves.

Common causes of injuries due to overuse activities of the hand, wrist, and forearm are very common.  Forceful exertion such as weight lifters and gymnasts, and constructed workers set themselves up for repetitive stress injuries.  Dental professionals perform finely-skilled movements all day with instruments.  They should not exceed more than 45 degrees in their wrist.  Other individuals susceptible to Carpal Tunnel Syndrome include: pianists, barbers, hair stylists, food processing workers, motor vehicle assemblers, secretaries, assistant workers, housewives, and bakers.

Pregnancy

Vibration, temperature extremes, and repetitive motion are all causes for Carpal Tunnel Syndrome.  Taking certain medications like birth control pills can cause water retention, making Carpal Tunnel Syndrome worse yet.  Pregnant women can suffer greatly from Carpal Tunnel Syndrome as they typically swell in the hands and feet.  This can make for a significantly long nine months.  The National Institute of Occupational Safety and Health Administrated, “60% of all on-the-job injuries will be caused by repetitive motion injuries.  Of these, Carpal Tunnel Syndrome is the most frequent.

Median Nerve

We need to understand the relationship of the arm, wrist, and hand.  We need to know how to prevent and correct these injuries.  Neck injuries from falls, whiplash, and poor posture can irritate the median nerve in the neck causing the same symptoms as damage to the median nerve in the wrist.  When the median nerve is damaged in both the neck and the wrist this is referred to as Double Crush Syndrome.  This is where pressure of the nerve is felt in two places.  Many physicians believe that many individuals diagnosed with Carpal Tunnel Syndrome most likely have Double Crush Syndrome.

Surgery

In many cases, surgery is recommended to relieve the symptoms of Carpal Tunnel Syndrome.  Surgery usually fails because surgeons simply cut the ligament between the carpal bones.  Surgery may not address the true cause, which could be Double Crush Syndrome.  The surgery could lead to additional problems because scar tissue begins to develop inside the canal.  Those individuals that receive the surgery, 80% have returning symptoms within two years of getting the surgery performed.  They’re left with additional symptoms from the surgery such as scar tissue build-up leading to decreased range of motion within the wrist.

Chiropractic care

When a segment of the spine is mis-aligned causing pressure and irritation on a nerve, the condition is called a subluxation.  The two vitamins that have been shown to reduce inflammation and swelling are Vitamin B6 and Vitamin B3.  Chiropractic treatment three to four times per week should be considered along with rehabilitation exercise and nutritional supplementation.  Overuse Activities and Carpal Tunnel Syndrome go hand-in-hand; talk to your primary care physician today about your treatment options.

Do you suffer with wrist pain?  Wrist Conditions are extremely prevalent in this era due to what individuals do on a regular basis.  With computers and technology ever-demanding, Americans are forced to spend long grueling hours behind the computer typing and performing data entry with the keyboard and mouse.  One of the most common wrist conditions includes Carpal Tunnel Syndrome.  This syndrome is when the nerves, arteries, and tendons become entrapped in the tunnel leading to pain, inflammation, and reduced range of motion.  There is so much to travel through the small place that chronic repetitive actions of the wrist can force a person to severely restrict their actions.  This can limit all ranges of motion of the wrist including flexion, extension, radial deviation, and ulnar deviation.  In addition, it can cause muscle hyper-tonicity in the forearm extensors and flexors.  These hyper-tonic areas can lead to muscle trigger points.  Trigger points are hyper-irritable spots within muscle tissue that may cause pain and local inflammation.  In addition, these areas may refer pain to other parts of the body such as the distal extremities.  When an individual experiences 11 out of 18 noted trigger points they are diagnosed with Fibromyalgia.  This is sort of a catch-all diagnosis that is often misdiagnosed by physicians when an underlying condition should be addressed.  Many times an autoimmune disorder should be considered with Fibromyalgia.  Other Wrist Conditions include trigger finger, cysts, tumors both benign and malignant, tendonitis, and more.

Treatment for Wrist Pain

So what are my treatment options for common wrist complaints?  First, the condition needs to be correctly diagnosed to determine a diagnosis.  Then, either conservative or medical management needs to be decided as the route for treatment.  Some conservative treatments include but are not limited to the following: ultrasound, paraffin bath, cold laser therapy, braces, ice, heat, Chiropractic care, massage therapy, acupuncture, stretching, surgery, physical therapy, pain medications, anti-inflammatories, and natural supplements.  Some natural supplements include Biotics KappArrest which is an all-natural anti-inflammatory as well as Biotics proteolytic enzymes known as Intenzyme Forte which can also be used as a dietary aid as well.  When the condition is truly Carpal Tunnel Syndrome, a cock-up splint may be given to keep the wrist in an anatomically correct position, especially in the evening hours when sleeping can be difficult for the patient.  It is important to remain in a neutral position at night with the arms due to cutting off the blood supply; this can cause numbness and tingling symptoms into the hands and fingers.

Are you a Headache pain sufferer?  How often do you get them and what type are they?  There are many different types of Headaches such as the following: tension, migraine including classic and common, cluster Headaches, sinus, metabolic, caffeine, and cerebral.  The two most common presentations of headache pain would have to be tension and migraine Headaches.

Tension Headaches

These types of headaches are probably the single most common type of Headache.  These are typically stress-induced and can happen to literally anyone.  They tend to wrap around the patient’s head in a Mohawk distribution.  In addition, they also usually happen around the mid-afternoon instead of morning or evening hours.

Migraine Headaches

These types of Headaches are probably the second most common type of Headache.  They are divided into two categories: common and classic.  Common migraine headaches do not possess an aura or prodrome before the Headache appears.  In Classic migraine headaches, the patient experiences an aura (halo) in their visual field before the migraine appears.  These migraines may accompany light flickers and the patient may experience sensitivity to light and sound, nausea, vomiting, and a feeling of dis-ease.  Migraines in generally are typically one-sided and last anywhere from 4-6 hours in duration usually.

Cluster Headaches

These types of Headaches are more commonly found in middle-aged men.  They tend to be unilateral in presentation and can affect watering of the eye and nose.  The unique thing about this type of Headache is that the patient may experience them for a long duration of time then experience nothing for months.  The presentation is truly vague with these Headaches.

Treatment

Although many Americans reach for the medicine cabinet when a migraine ensues this is usually not the answer.  It is very important to look at the underlying structure of the spinal column when determining the cause of a Migraine headache.  Chiropractors are notorious for analyzing the curves of the spinal column to determine biomechanical stresses placed on the spinal column.  They may incorporate physio-therapy modalities and mechanical traction to speed up the recovery process.  Mechanical traction is stretching of the ligaments of the spine to re-shape the curves.  The bones are therefore able to move and the muscles are able to relax.  The patient will maintain the stretch on the mechanical traction for at least six minutes.  This will be slowly increased in one-minute intervals until twenty minutes is reached.  The patient should be instructed to put ice on the area post traction to reduce any local inflammation and pain.

See more information about chiropractic treatment and migraines.

A chiropractic office is unique in that they will have different supplies for offering patient care depending on the type of chiropractic care that they practice. Some chiropractic physicians treat their patients with therapeutic rehab exercises and therefore will have supplies that can provide physical therapy modalities for patients. These types of offices will generally have exercise equipment, therapy balls, yoga mats and may also have weight machines. Some chiropractic clinics have diagnostic imaging equipment within the practice so will have an x-ray machine located on-site. Some chiropractic clinics focus on providing acupuncture treatments and will have all the necessary supplies for that form of conservative care. While traction may be a common practice among chiropractic physicians, some will offer decompression therapy for their patients as well. If a chiropractor offers this form of care, they will have a decompression machine at their clinic. This machine varies in appearance and size but generally it is quite a large piece of equipment that will take a lot of space in a therapy room. Smaller chiropractic tools include a hand-held device called an activator, hot packs and cold packs, electric stimulation machines that may also provide ultrasound, massage therapy tables and chairs, traction tables and chiropractic adjusting tables. Many chiropractors will use lotions such as biofreeze for muscular pain relief for their patients. As mentioned previously, depending on the type of chiropractic physician that is chosen, the types of chiropractor supplies they have will vary from clinic to clinic.

Health Care Tools

There are other types of chiropractic supplies that are not used as health care tools for their patients but are used in the day to day functioning of a chiropractic office. Every chiropractic office has their own sets of patient forms for collecting medical, personal and insurance information from patients. Chiropractic physicians will also have personalized business cards for their office as well as appointment reminder cards that are unique to their office. A chiropractic physician may also choose to send patients monthly health newsletters for more patient education and they may market with personalized clinical brochures. Chiropractic office supplies may also include specific clothing worn by all employees of the office. These different types of office forms and marketing supplies are an important tool used by chiropractic physicians as they define the practice style and type of clinical setting. Many times these supplies give a patient their very first impression of the chiropractic clinic that they have chosen.

References Cited in this Article

www.chirocity.com

www.chirosupply.com

www.scriphessco.com

Learn more about topical pain relief.

There are many tools and equipment that a chiropractic physician may use in treatment of a patient. Physical modalities such as electricity in the form of interferential current, therapeutic ultrasound, ice, moist heat, infrared, and many others are utilized to help reduce inflammation, decrease pain, decrease spasm depending on the tool used for the purpose of passive treatment.  Soft tissue therapy such as different massage techniques help with pain and function as well.  When it comes to chiropractic manipulative treatment, chiropractors may use a very wide array of techniques, both with their hands and/or with the assistance of various tools. One such tool is called an “activator” instrument. An activator is a hand held tool which was developed in 1967 by Co-founder Dr. Arlan Fuhr (DC). It is important to note that the technique that goes along with the instrument that was developed is based upon elements of other techniques including Logan Basic, Truscott and Derefield. The Activator Method Chiropractic Technique, when performed by a trained activator chiropractor, uses gentle, low-force delivery through the instrument to correct dysfunction in the vertebral, segmental and nervous system, which in turn alleviates a specified problem. The instrument can be set to different amounts of thrust which allows for a safe and effective delivery of the force desired. The entire protocol is based upon more than just usage of the instrument, however.

Loaded Mechanism

The technique requires analysis of leg lengths, reflexes of the nervous system and biomechanics of one’s body all for the purpose of identification of spinal joint dysfunction. The advantage of using an instrument such as this is that it applies a very quick force before a patient can guard, or stiffen up to resist the force given. This allows for a more effective change directed at the nervous system and joint complex. The tool is generally safe for children and fragile adults who may be suffering from a bone disease such as osteoporosis in many cases which makes it desirable over a traditional technique such as high velocity low amplitude thrusting. The activator instrument itself works via a spring loaded mechanism which gives off approximately 0.3 J of kinetic energy in the course of 3-milliseconds. In 2003, a survey from the NBCE (National Board of Chiropractic Examiners) found that approximately 70% of chiropractors used the technique in some form or another. There are many knock off instruments which rely on the same mechanism described. There are many research studies and case studies to back up some of the claims as to how the technique works and the effectiveness of such, however it is acknowledged that much more needs to be studied in the area of biomechanics, neurophysiology, and statistical analysis regarding the many questions of how the technique may best be utilized and shown to be useful for the treatment and help of patients in need.

References Cited in this Article

http://www.activator.com/about/

The Activator Story: Development of a New Concept in Chiropractic. http://www.activator.com/the-activator-story-development-of-a-new-concept-in-chiropractic-2/

http://en.wikipedia.org/wiki/Activator_technique

Status of Activator Methods Chiropractic Technique, Theory, and Practice  http://www.jmptonline.org/article/S0161-4754(05)00002-3/abstract

Learn more about the Activator Method.