What Is a Subluxation?
Understanding the term in chiropractic care
If you've spent time in a chiropractic practice, you may have heard the word “subluxation” used before.
It can sound complicated — and depending on where you hear it, the word can have different meanings.
In medical settings, a subluxation generally refers to a partial dislocation of a joint. In chiropractic, the term has historically been used differently to describe changes in joint movement or function that may be relevant to a person's neuromusculoskeletal health.
So, when we use the term at Restore, what are we actually talking about?
What does subluxation mean in chiropractic?
Within chiropractic, subluxation is a term that has traditionally been used to describe an area of the spine or musculoskeletal system where joint movement or function may be altered.
You may also hear chiropractors use terms such as:
joint restriction
joint dysfunction
altered movement
muscle tension
changes in movement patterns.
Rather than thinking of a subluxation as simply a “bone out of place”, it's more useful to think about how an area of the body is moving and functioning.
This is important because joints, muscles and the nervous system don't work independently. Movement creates sensory information that is continually communicated to and processed by the nervous system.
Your spine + nervous system
Your spine provides structural support for your body and surrounds and protects the spinal cord.
Throughout everyday life, your brain receives enormous amounts of sensory information from muscles, joints, skin and other tissues. This information helps the brain understand where your body is, how it's moving and how to coordinate movement.
One important type of sensory information is proprioception — your body's awareness of its position and movement.
Receptors within muscles and joints contribute to this process, continually providing information about movement, position and load.
When an area isn't moving as expected, the sensory information coming from that area may also differ.
This relationship between movement and sensory input is one reason chiropractors assess more than simply where someone feels sore.
What causes changes in joint movement?
There isn't necessarily one single cause.
Movement and muscle function can be influenced by many different things, including:
prolonged or repetitive positions
physical activity and training
injuries
changes in mobility
muscle tension
sedentary periods
occupational demands
pregnancy and other physical changes
everyday physical loads.
For babies and children, chiropractors may also consider factors such as movement development, physical activity and relevant pregnancy or birth history as part of the broader case history.
A particular event doesn't automatically mean a person has a subluxation or requires chiropractic care.
Is a subluxation a bone “out of place”?
This is a common misconception.
The chiropractic concept of subluxation shouldn't be confused with a joint being significantly displaced or dislocated.
A true dislocation or medical subluxation is a structural injury that requires appropriate medical assessment and management.
Chiropractic assessment is generally concerned with joint and neuromusculoskeletal function, rather than claiming that vertebrae have simply moved “out of place” and need to be put back in.
What does the nervous system have to do with it?
Movement and the nervous system are closely connected.
Sensory receptors in muscles and joints continually send information to the central nervous system. The brain uses this information to help coordinate posture, balance and movement.
This is sometimes referred to as sensorimotor integration — the way the nervous system receives sensory information and uses it to help organise an appropriate motor response.
Research has explored how spinal manipulation may influence aspects of sensory processing and neuromuscular function.
However, this doesn't mean that a chiropractic adjustment “resets” the nervous system or that a subluxation is responsible for unrelated medical, developmental or psychological conditions.
The relationship between the musculoskeletal and nervous systems is complex, and research in this area continues to develop.
What might a chiropractor assess?
A chiropractic assessment may consider several aspects of neuromusculoskeletal function.
Depending on the person, this could include:
joint movement
range of motion
posture
muscle activity
areas of tenderness or tension
movement patterns
balance or coordination
relevant neurological and orthopaedic findings.
At Restore, we also take time to understand your history and what has brought you in.
That's important because an assessment finding only becomes meaningful when it's considered within the context of you as a whole person.
What about INSiGHT Scans?
At Restore, INSiGHT scanning technology may be used to gather additional information as part of a broader chiropractic assessment.
Depending on what's clinically appropriate, this may include:
Surface EMG — measures electrical activity associated with muscles.
Thermal scanning — measures patterns of skin temperature along the spine.
Heart rate variability (HRV) — measures variation in the timing between heartbeats and can provide information related to autonomic activity.
These scans don't directly “detect a subluxation”, nor do they diagnose medical or neurological conditions.
Instead, the measurements provide additional information that your chiropractor can consider alongside your history and physical examination.
What is a chiropractic adjustment?
A chiropractic adjustment is one technique chiropractors may use when clinically appropriate.
It involves applying a controlled force to a joint with the aim of influencing joint movement and neuromusculoskeletal function.
The technique and amount of force used can vary considerably depending on factors such as the person's age, size, presentation, preferences and assessment findings.
Care for an adult, pregnant person, child or baby therefore won't necessarily look or feel the same.
Your chiropractor should explain the proposed approach, expected benefits, alternatives and relevant risks before care begins so you can make an informed decision.
Does correcting a subluxation treat health conditions?
It's important to distinguish between supporting neuromusculoskeletal function and treating a medical condition.
A chiropractic subluxation shouldn't be presented as the underlying cause of conditions such as:
ADHD
autism
anxiety
asthma
reflux
constipation
sleep disorders
immune disorders
dysautonomia
hormonal conditions.
Likewise, chiropractic adjustments shouldn't be promoted as treatments or cures for these conditions.
Someone may have these health concerns and also have clinically relevant musculoskeletal findings, but that doesn't establish that one caused the other.
Where another health condition is suspected, appropriate medical or allied-health assessment remains important.
Why does Restore assess the whole picture?
People are more than a single scan, symptom or assessment finding.
That's why your first visits at Restore involve understanding your history, your physical demands, what you're currently experiencing and what you'd like support with.
Your chiropractor can then complete an appropriate examination and explain any relevant findings.
If chiropractic care has a reasonable role to play, we'll explain why.
If something sits outside our scope or needs further investigation, we'll recommend that you speak with your GP or another appropriately qualified healthcare professional.
A simpler way to understand subluxation
The language around subluxation can sometimes make a relatively straightforward concept sound more complicated than it needs to be.
At Restore, a helpful way to think about it is:
We're assessing how your joints and surrounding neuromusculoskeletal system are moving and functioning — not simply looking for bones that are “out”.
Your nervous system and musculoskeletal system communicate constantly, which is why movement, sensory information and physical function all form part of the chiropractic picture.
Our role is to assess what's relevant to you, explain what we find clearly and determine whether chiropractic care is appropriate for your individual needs.
Important information
This article provides general educational information and isn't intended to diagnose or treat a medical condition. Chiropractic terminology and definitions of “subluxation” can vary between practitioners and professions. If you have concerns about your health or your child's health or development, speak with your GP or another appropriately qualified healthcare professional.
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Original article: What Is Subluxation?
Original author: Dr Tony Ebel, DC, CPPFC, CCWP
Original publisher: PX DocsWorld Health Organization. (2005). WHO Guidelines on Basic Training and Safety in Chiropractic.
Haavik, H., & Murphy, B. (2012). The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22(5), 768–776.
Pickar, J. G. (2002). Neurophysiological effects of spinal manipulation. The Spine Journal, 2(5), 357–371.
Proske, U., & Gandevia, S. C. (2012). The proprioceptive senses: Their roles in signalling body shape, body position and movement, and muscle force. Physiological Reviews, 92(4), 1651–1697.
National Center for Complementary and Integrative Health. Spinal Manipulation: What You Need to Know.
Australian Health Practitioner Regulation Agency (AHPRA) & Chiropractic Board of Australia. Guidelines and advertising requirements for chiropractic practice.
Original Article
Adapted from What Is Subluxation? by Dr Tony Ebel, DC, CPPFC, CCWP, originally published by PX Docs.