Chiropractic Terms for Treating the Spine

Subluxation

Subluxation is the misalignment of adjacent spinal bones. Subluxations are the main pathology treated by chiropractors.  

It's important to note that the term subluxation means something very different to medical doctors than to chiropractors. To medical doctors, a subluxation refers to a partial dislocation of ​a vertebra. This is a serious condition, often due to trauma, that can result in a spinal cord injury and consequent paralysis and/or death. On an X-ray, a conventional subluxation is an obvious disconnect between the vertebrae.

The chiropractic version of a subluxation is much more subtle and refers to "misaligned" vertebrae. Rather than a disconnect between the vertebrae, subluxation in this context refers to position changes in the joints and soft tissues of the spine. This "misalignment of vertebrae" is thought to lead to pain and abnormal intervertebral joint motion.

This difference between the conventional medical definition of the term and the chiropractic use of the term may cause some people to dismiss these treatments. Since the primary focus of chiropractic treatment is often treating subluxations, this can lead to the disregard of the practice altogether unless this difference in terminology is understood.

Adjustment

The chiropractic adjustment is the hallmark of chiropractic treatment. It is the manual adjustment (done with the chiropractor's hands) which is used to realign joint subluxations.

An adjustment involves applying force to motion segments to bring them back into a centered alignment.

The idea behind adjustments is that by realigning the vertebrae, the nerves can transmit signals unimpeded, resulting in a positive effect on overall well-being.

Manipulation

Manipulation is a general term that includes—but is not limited to—adjustment. Other types of providers besides chiropractors also give manipulations.

According to the National Center for Complementary and Integrative Health, spinal manipulation also includes things like exercise, massage, and physical therapy. They say that it yields mild to moderate relief of low back pain and that it works as well as some conventional treatments, such as pain-relieving drugs.

Spinal manipulation can be divided into different grades of mobilizations.

• Practitioners of several disciplines may be licensed to perform grade 1 to grade 4 mobilizations, depending on their training.
• In general, only physical therapists, osteopathic physicians, and chiropractors are licensed to perform grade 5 mobilizations, a type of mobilization that is more forceful and direct than lower grades of spinal manipulation.​

Most massage therapists, athletic trainers, and personal trainers are not licensed to perform spinal manipulations.

There have been studies examining the effectiveness of these treatments. A 2018 systematic review published in The Spine Journal examined the results of 51 trials. The authors concluded that "There is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe. Multimodal programs may be a promising option."

As with any form of treatment, it's likely that results vary from person to person and with different chiropractors.

There are also potential risks with spinal manipulation. Though uncommon, cervical, carotid, and vertebral artery dissections have occurred with manipulation of the neck, and lumbar disc herniation has been reported with manipulations of the lower back.

Motion Segment

Motion segment is a technical term used by chiropractors and surgeons alike. It refers to two adjacent vertebrae and the intervertebral disc located between them. This is the area chiropractors assess and adjust.

A Word From Verywell

Many people choose chiropractic treatment for a variety of conditions, most notably back pain. As with any type of healthcare, it's important to be your own advocate in your care and find a practitioner who you trust. Understanding the terminology used, and the reasoning behind these terms, allows you to ask educated questions as you discuss your symptoms.

While chiropractic adjustments or manipulations are a backbone of this care, many chiropractors now address factors such as diet which can contribute not only to your discomfort​ but your overall level of wellness.