Back & Neck Pain Print Overview of Subluxation and Role of Chiropractor Medically reviewed by Medically reviewed by Emmy Ludwig, MD on December 28, 2015 Emmy Ludwig, MD, is board-certified in gastroenterology and hepatology. She practices at the Memorial Sloan-Kettering Cancer Center in New York. Learn about our Medical Review Board Emmy Ludwig, MD Written by facebook linkedin Written by Anne Asher, CPT Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Learn about our editorial policy Anne Asher, CPT Updated on April 09, 2019 BanksPhotos/E+/Getty Images More in Back & Neck Pain Symptoms Causes & Risk Factors Diagnosis Treatment Living With Prevention Exercise Spinal Conditions In a pain-free spine, the 24 vertebrae plus the sacrum and coccyx bone normally stack on top of one another in a centered alignment. But life experiences of all kinds tend to impose forces of movement that can take one or more vertebrae out of ideal, centered alignment. In chiropractic parlance, this misalignment of one vertebrae in relation to the next is referred to as a subluxation. Subluxation Is a Partial Dislocation But in the conventional medical world, the word subluxation refers to a partial dislocation. Dislocation is a very serious injury most often caused by a traumatic event such as a car accident. Like a dislocation, the full-on medical version of “subluxation” can result in injury your spinal cord; unlike a dislocation, it tends not to result in torn ligaments, facet joint jumping, and locking, or paralysis (or death.) Subluxation From the Chiropractic Perspective According to Charles Henderson in his article entitled “The basis for spinal manipulation: Chiropractic perspective of indications and theory,” which was published in 2012 in the Journal of Electromyography and Kinesiology, a vertebral subluxation is a mechanical disturbance in the normal way the spinal structure is arranged – such that it disrupts the functioning of your nervous system. So if a chiropractor has ever said to you something like, “all disease comes from misaligned vertebrae,” Henderson’s statement may shed some light as to why. Henderson’s statement may also explain why, in the chiropractic world, at least, a subluxation is the most important reason for an assessment of your intervertebral joint motion. Historically —though many chiropractors do branch out to offer physical therapy and nutritional services to their patients — a chiropractor’s entire job has been based around finding and realigning subluxations. Finding Your Subluxations in the Chiropractic Exam A chiropractic exam to identify subluxations generally consists of palpation and radiography — i.e., a manual exam and a set of x-rays. Not all chiropractors use x-rays in their diagnostic process, though. In the manual exam, the chiropractor checks the alignment of your pelvis and other key joints to help her determine what's going on in your spine. She also checks the spine itself. And she may include muscle testing as part of the exam. Henderson says that subluxation in the chiropractic sense tends to have very subtle features — as opposed to the more gross findings that medical doctors identify in their diagnoses. A subluxed spinal joint diagnosed by a chiropractor is characterized not by hypermobility (too much movement) as many believe, but by hypomobility (decreased or restricted motion,) Henderson clarifies. In other words, correcting excessive motion at the spinal joint is likely not the main goal of your chiropractic treatment. But because it can develop secondarily in nearby joints that are hypomobile, your chiropractor may treat the hypermobility anyway. She may do so by addressing the more restricted nearby joints, and/or prescribing an exercise program to strengthen your core The above is an important distinction for some people to make. If you have a lot of stiffness and immovability, chiropractic may help you. But if you tend toward lax ligaments, too much flexibility or you have a connective tissue disease, it could make matters worse rather than better. Who Is Licensed to Treat Subluxations and Who Is Not? Chiropractors, physical therapists some osteopathic physicians and some physical therapists are trained to treat subluxations, while massage therapists, personal trainers and other types of holistic practitioners generally are not. That said, if you have serious symptoms, you may need to consult with a non-chiropractic physician (i.e. an M.D. or D.O. Remember a subluxation is a "partial dislocation.") Unless your chiropractor is knowledgeable, it takes a non-chiropractic physician to discern between a subluxation of the chiropractic type and one that needs medical attention. Non-chiropractic physicians generally use physical therapy, medicine, surgery, and other invasive procedures to treat spinal misalignments. 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. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. University of Iowa Hospitals and Clinics. What types of vertebral injuries can occur? Reviewed March 2018. Henderson CN. The basis for spinal manipulation: chiropractic perspective of indications and theory. J Electromyogr Kinesiol. 2012;22(5):632-42. doi:10.1016/j.jelekin.2012.03.008. Walker BF, Buchbinder R. Most commonly used methods of detecting spinal subluxation and the preferred term for its description: a survey of chiropractors in Victoria, Australia. J Manipulative Physiol Ther. 1997;20(9):583-9. World Health Organization. WHO guidelines on basic training and safety in chiropractic. 2005. Additional Reading Henderson, Charles, N.R. The basis for spinal manipulation: Chiropractic perspective of indications and theory. Journal of Electromyography and Kinesiology. 2012. Continue Reading