A Chiropractic Subluxation is a Spinal Instability
I want to talk about the term subluxation and spinal instability. I am a doctor of chiropractic. I have been a licensed Doctor of Chiropractic for close to 30 years or maybe even slightly more. In my profession there is a term called spinal subluxation. Very important because it’s what happens in injuries to the spine. A spinal subluxation is a probably one of the most misunderstood terms in my profession. It’s a very simple term.
The term subluxation, or a spinal subluxation in chiropractic, has gotten a bad rap. It’s gotten a bad name. A lot of doctors don’t even like to use it anymore. In my experience, they don’t like to use it because they don’t understand what it is, and they don’t understand how to evaluate it, how to find it, how to remove it. They don’t understand any of that. I didn’t either as an early practitioner, so my education did not provide me with an understanding of what it was, how to locate it, and how to remove it. Even though I went to one of the finest chiropractic colleges in the world.
So I’m sure a lot of you are in the same position and if you’re a young provider, it’s even worse because the more as time went on, the more confused the market became about the term. A spinal subluxation is nothing more than a misalignment of the vertebra or a vertebra that is an abnormal motion that causes nerve interference. And the nerve interference might be motor sensory or pain problems. Now we could say visceral as well, but that’s a little less explored and a little less understood.
We are just going to stay with motor sensory or pain. So if you have an abnormal position or abnormal motion in the spine and it causes a motor sensory or pain problem, you have a spinal subluxation. Now, my colleagues have confused that term with what’s called a medical subluxation. And a medical subluxation is defined as less than a full dislocation and you see it on x-ray. If you see a misalignment on x-ray medically, that can be called a subluxation, but that’s not what the profession of chiropractic called it. Professional chiropractic calls that a misalignment. If you have a misalignment that’s not causing a motor sensory or pain problem, then it’s just a misalignment. But when it bridges over or it clinically starts to express itself in a motor problem, a sensory problem or a pain problem, then you have an act of subluxation.
Now there’s another term medically that means the same thing and it’s very important in the injury market because the condition that I’m about to share with you is the condition that causes the most amount of chronic pain and disability in the world today. And it’s called a spinal instability, medically. A spinal instability exists in a motion unit when they abnormally move or excessively move, and it causes a motor sensory or pain problem. It’s called a spinal instability. Now, a spinal instability in medicine is exactly the same thing that a spinal subluxation is in chiropractic. They’re identical.
Most chiropractors don’t fully understand what the term spinal subluxation means. They don’t understand a spinal subluxation, that if you have an abnormal motion pattern or an abnormal alignment pattern and it causes a motor sensory or pain problem, you have an active subluxation. Now, you also have an active spinal instability and like both terms, it requires x-ray findings plus a motor sensory or pain clinical correlation. The examinations are very, very easy to do. They’re not standardly being done in my profession of chiropractic or in medicine. A spinal instability examination is not standardly being done. It should be, it should be a standard practice in every chiropractic college.
Now, if you remove the motor sensory or the pain problem that’s associated with the misalignment or mis-movement pattern in the vertebral bodies itself, you have removed the spinal subluxation and you have removed the spinal instability. Even though the excessive motion is still there or the misalignment is still there. If you remove the clinical aspect of what you’re seeing on imaging, you have removed the subluxation or you’ve reduced the spinal instability. It’s just that simple. Now it’s very, very simple to show you what I’m talking about. If I take a pinwheel and I run a pinwheel on the upper part of my outside lateral part of my arm, it’s the C5 dermatome. Means the C5 nerve is somehow affected. Now I can go to the C5 nerve, which I know comes out of the C4-C5 motion unit and I can look and say, is that misaligned or is there abnormal motion there? And if I have this sensory problem, I’m going to see a misalignment or abnormal motion at that unit. And that’s what a spinal instability is, and that’s what an active chiropractic subluxation is.
Now I can address this nerve condition by addressing and bringing into better alignment and restoring the neuromuscular control of the motion unit through spinal adjusting. And I can reduce this sensory problem. Remember I said motor sensory or pain problem, if I reduce it, I’ve reduced the spinal subluxation. I’ve reduced the spinal instability, but routinely understanding every level where it comes out is the job of my profession, the profession of chiropractic, and it should be routinely being done and routinely reported, especially in injury work. Because in injury work, the ligaments and damage to the ligaments are the most debilitating condition that you can have. So being able to perform simple evaluations should be very, very easy for most Doctor of Chiropractic.
And I’m sure there may be in controversy in what I’m saying, because understanding this is the road to standardizing the workups. One of the biggest problems in my profession is that there are no standard workups and there must be standard workups. Imagine if you had the profession of dentistry and all dentists were looking for cavities, but they were all doing it in a different way. There was all kinds of different techniques to try to locate those cavities. It would lead to a pretty confusing profession. In the injury market, especially, if you’re a doctor of chiropractic right now, we need to standardize our examination procedures. And understanding these key two terms is one step toward aligning and standardizing our procedures.
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