Back & Neck Pain Treatment Print Chiropractic Terms for Treating the Spine Sublaxation, Manipulation, and Adjustment Defined By Anne Asher, CPT Updated August 09, 2019 Medically reviewed by a board-certified physician More in Back & Neck Pain Treatment Symptoms Causes & Risk Factors Diagnosis Living With Prevention Exercise Spinal Conditions The chiropractic profession has its own set of words to describe what they do. From the chiropractor's perspective, the main thrust of the work of this profession is to apply a calculated force to spinal joints in order to effect a change in alignment and therefore improve the functioning of the nervous system. The chiropractic profession believes that a well-aligned spine positively affects the overall health of an individual. Now that you understand how a chiropractor works, can you speak chiropractic-ese? Below are a few of the most commonly used chiropractic terms. 1 Subluxation AJ_Watt/Getty Images Subluxation is a term that expresses a misaligned relationship between 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 vertebrae; a serious condition often due to trauma which 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 subluxation is much more subtle and refers to a "misaligned" vertebrae. Rather than a disconnect between the vertebrae, sublaxation 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 sublaxations, this can lead to the disregard of the practice altogether unless this difference in terminology is understood. 2 Adjustment Mike Kemp/Getty Images 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. 3 Manipulation Deeblue / Getty Images A 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 taking pain-relieving drugs. Spinal manipulation can, in turn, 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 that lower grades of spinal manipulation. (Most massage therapists, athletic trainers, and personal trainers are not licensed to perform spinal manipulations). As far as efficacy, a review published in the Cochrane Database of Systematic Reviews in 2012 did not find spinal manipulation to be of any greater advantage than non-manipulation therapies for acute low back pain, but only small clinical trials have been published to date. A 2016 review found that chiropractic manipulation appeared to be equally effective as physical therapy for the treatment of low back pain. 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. 4 Motion Segment Inti St Clair/Blend Images/Getty Images 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 health care, 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. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Blanchette, M., Stochkendahl, M., Borges Da Silva, R., Boruff, J., Harrison, P., and A. Bussieres. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies. PLoS One. 2016. 11(8):e0160037. Henderson, Charles, N.R. The basis for spinal manipulation: Chiropractic perspective of indications and theory. Journal of Electromyography and Kinesiology. 2012. Kennell, K., Daghfal, M., Patel, S., DeSanto, J., Waterman, G., and R. Bertino. Cervical Artery Dissection Related to Chiropractic Manipulation: One Institution’s Experience. Journal of Family Practice. 2017. 66(9):556-562. Rubinstein, S., Terwee, C., Assendelft, W., de Boer, M., and M. van Tulder. Spinal Manipulation Therapy for Acute Low-Back Pain. Cochrane Database of Systematic Reviews. 2012. (9):CD008880.