Subluxations
"Chiropractic is Concerned with the preservation and restoration of health, and
focuses particular attention on the subluxation.
"A subluxation is a complex of functional and/or structural and/or pathological
articular changes that compromise neural integrity and may influence organ system
function and general health.
"A subluxation is evaluated, diagnosed, and managed through the use of chiropractic
procedures based on the best available rational and empirical evidence." (6)
There is some concerns by some health professionals as to the existence
of subluxations. This is a concern that is ill founded. Chiropractic is
founded on observation of improvements in health of initially 2
patients, one with deafness and the other with a heart problem. The
notion of the subluxation is a "model" or explanation of what was
altered that brought about that change as well as countless other people
who have improved their health as a result of the work of chiropractors
in many parts of this planet (Earth). That thing altered is what we
chiropractors call the "subluxation"
For further on this see "Does the subluxation exist" by Tedd Koren D.C.
The
pathophysiology of Subluxations
When adjoining
bones of the spine become misaligned and/or stuck
and there is an alteration of nerve function occurring as well, chiropractors call these a chiropractic "subluxations".
While stuck joints are easily noticed by a limited range of motion, changes in
nerve function can
go unnoticed
for a long time even for months and years. Only in few instances is our attention drawn to
this problem by pain.
Deterioration begins
Stuck spinal joints are a concern in that the bones tend to deteriorate more rapidly when stuck.
It has been found that joints that are immobile for as little as two weeks start to show early signs
of decay and can become permanent if prolonged. (1) This is because these joints have
abnormal mechanical pressure on them. In the same situation discs have been shown to start
the degeneration process as soon as one week of being subjected to less of movement
due to
the subluxation process. (2)
Discs
Discs, after puberty no longer have an active blood flow to cartilage by means of blood vessels
going to them. So they are even more vulnerable than the bones. Discs only get nutrients via a
slow seepage process (3) which is
a very poor nutrient delivery
system in comparison to an active blood flow via blood vessels.
This easily leads to
Intervertebral (osteo)chondrosis
a degenerative process which is progressive and leads to spinal degeneration.
For this reason it is very important that
children in their most active growing phase be kept not
only in alignment but also have their joint mobility at optimal levels. Optimal levels mean that
joint play is not too great and not too small. Too much joint play can mean that ligaments have
been over stretched. This situation can be helped by nutrition and microcurrent therapy
In children many times the pains that are linked with subluxations are put down to “growing
pains”. The notion of growing pains is a curious one since it presupposes that active growth is
not under the internal controls of the child, or that this internal control is faulty. It is my
experience that these internal controls are actually being interfered with to the greatest extent
by subluxations. And so if a child is not only to be comfortable but also function properly,
subluxations need to be corrected as soon as possible. Because the child still has blood vessels
going to the discs,
it is therefore possible for a full repair of discs to take place. Later on that is
NOT the case.
Adults however, are not in the same position as a child. This is because their blood vessels
have disappeared by the end of
puberty. So adults have great difficulty in getting
nutrients into the disc. There is a constant struggle to make sure that not only are pressures on
the discs as optimal as possible but that the movement of joints be as normal as possible as
well. (4) This is vital for the disc’s nutrient availability for repair and its health.
It is joint movement that pumps fluid and nutrients into the spinal discs.
“Discs have few cells, uneven cell distribution, metabolic variation. This makes them susceptible to nutritional deficiencies. This is worsened by lack of motion, solute shortage [poor nutrient delivery], instability [from injury], calcification, smoking, all causing molecular breakdown due to increased enzyme activity, instability and cell death” [of discs results]. (4)
“Failure to heal within 6 weeks is probably due to poor blood supply….
and uncontrolled mechanical stresses.” ( 5) This is one part of the subluxation process.
For self help on disc repair see the
bulged disc page.
The health of the disks is an integral part of determining the health of the spine. It also has a major influence on the function of the nervous system. And since the nervous system controls
and co-ordinates the whole of the body, it plays a major part in how our body functions. This makes it central to the concerns of not only the chiropractor but more importantly
to the patient.
As the strength of the disc fails, spinal segments experience positional changes
and can be seen in the form of rotation and usually a
retrolisthesis.
The degree of slippage gives us an idea of the degree of instability present.
We can also see that as the discs deteriorate they loose height. This loss of height also closes up the small opening in the spine where the spinal nerves exit from the spine. So the greater the
loss of height of discs the greater the chances of spinal nerves been irritated. This irritation of
the nerves alters the way the nerve functions and this causes an alteration of the messaging
system from brain to tissues and from the tissues to brain.
(See safety pin cycle for a simple
explanation.)
Alteration of nerve function results as
because of positional change in joints (7) The longer
the position is maintained, the longer the nerves being irritated in this manner will send their
signals reflexally to other parts of the body which automatically respond to those signals.
This alteration can result in:
• Pain
• Numbness
• Tingling
• Loss of strength
• Muscle spasms
• And other "odd" sensations such as burning, water flowing, ants crawling and others.
It is common observation that the nerve function alteration (irritation) does have an altering affect on the messaging of signals that control vital organs. A study by Snowball in 2000 reported in the journal "Neuroscience", that 66% of the neural activity around the region of nerve control at the hypothalamic region dealing with organ control normally "driven by somatic [body] structures were also driven by electrical stimulation of the splanchnic nerve...." 9
The Splanchnic nerve is responsible for the innervation of the viscera or internal organs.10
"Somatic receptive fields of these neurons were generally large" 10 These are regions of the brain which also derive a lot of stimulus from the body. Most usually from chiropractic observation this happens in conjunction with subluxations
It is through the sensory portions of these nerves that the alteration can take place that can make the body's organs malfunction, not because of a pathology, but rather as a dis-ease due to alterations of nerve input to the brain being interfered with by a subluxated spine.
Deterioration in bones
As the discs degenerate what we notice is not only a loss of height in the disk but also the
formation of small
spurs that grow off the margins of the bone. Initially this can be quite small but as time progresses in a subluxated state, these bone spurs grow to a greater and greater extent as time goes on and when combined with a loss of disc height, the eventual outcome, can be a total fusion of one spinal bone to the other. This process inevitably leads to a greater and greater loss of motion as the process continues.
Phases of degeneration Spinal appearance
Normal
No
degeneration or wear & tear
Phase
1
Misalignment
but no overt sign of either bone or
soft tissue injury
Phase
2
There
is disc narrowing, misalignment,
early bone
spur formation and early disc narrowing
Phase
3
Discs
narrow further and bone spurs
almost join adjacent vertebrae.
Phase
4
The
vertebrae fuse together
These phases of degeneration are usually slowly progressive under
ordinary circumstances of spinal joint injury, taking many years to progress. In highly traumatic injuries, spinal joints can
progress rapidly (10 weeks) from essentially normal to Phase 3. (8)
Stability
Phase 1 shows signs of misalignment. This means that there is some degree of soft tissue damage but it is usually relatively recent and cannot be detected without specialised testing. Phase 1 can usually repairs well so long as the subluxations are reduced and maintained while a repair takes place.
Phase 2 and 3 are different. Here time has passed and the original injury has not been given a chance to repair under normal alignment conditions. So there are signs of disc injury - narrowing and bone spur formation is present, less in Phase 2 than in Phase 3 where the body is attempting to join the adjacent vertebrae together. Subluxations by definition always have nerve function alteration and as such also slowly undergo a deterioration or atrophy as well. Atrophied nerves like atrophied muscles do not work as well as they were designed to be able to do.
Phase 2 and Phase 3 joints are often unstable and given the chance, will re-subluxate.
All subluxations need to be corrected. It is generally accepted that the earlier subluxations are corrected, the better the outcome. It is better to have a phase 1 subluxation adjusted and stabilised, that to wait till a Phase 2 or Phase 3 subluxation is present.
Phase 4 is stable since the adjoining segments are fused. The problem here is that the nerves have also atrophied and often in a situation where abnormal pressure is still being applied to the nerve. The nerves at these levels are not healthy and may only have very minimal function.
Subluxations can be measured for their positional displacement. The most useful x-ray for this is the lateral or side on view. Measurements can show if a bone has moved either froward or backward of its normal position. see Retrolisthesis for a more complete discussion of stability.
Deterioration in nerves
More importantly the abnormal pressure on the nerve in the small openings in the spine brings
about a wasting (atrophy)of the nerve as well. Now this becomes a big problem because ultimately the job of the nerves is to control your body. So if it is wasting away, how can it do this important job
optimally?
That is the reason why I spend a lot of effort in
adjusting subluxations.
Naturally the earlier this
subluxation process is corrected the better it is for the patient. It means
that there will be less deterioration of the spine and the nerves. There will also be less habit
patterning and the use of the nerves as well as the spinal muscles will more easily return to how
they are supposed to be.
Pain is not what it’s all about
Pain may have been what brought your attention to the problem that you have with your spine. If
pain relief was the
only thing that you are after, you would have taken a painkiller. This is
obviously not the most sensible thing to do. The same is true for
muscle relaxants.11 They make you feel good
but nothing really changes, and the deterioration process continues in the
absence of any symptoms, since the pain killers have silenced your alarm system.
What you want and what you really
need is correction of your subluxation that produced your
pain. This enables your nervous system to control your body to the fullest extent possible
for the amount of injury present. This really is your most optimal attainable state.
Benefits of being subluxation free
When you are Subluxation free your body works better and you:
• Enjoy life more
• Work is easier
• Less disability
• Learn faster and more easily
• Less time off work
• More dollars earned
• Enjoy family and friends more
• Enjoy and performed better at sports
• Make better decisions (less internal stressors)
In short,
life is much better when you are subluxation free.
So keep up your adjustments until you’re nervous system is working the way it was designed to
and then keep up your adjustments at longer intervals to ensure you maintain the gains that
have been achieved.
References
1 Seaman DC, MS DABCN,: JMPT 1999;22(7):460
2 Nelson C, DC,: Top Clin Chiro 1994;1(4):20-29
3 Nelson BW, MD et al,: Arch of Phys Med Rehab 1999;80(Jan):20-25
4 Kraemer MD.: Spine 1985;10(1):69-71
5 Mooney, MD; J Musculoskeletal Med 1995; Oct:33-39
6
http://www.chirocolleges.org/paradigm_scopet.html
7 Sabbahi, Mohamed PhD, PT, ECS *; Abdulwahab, Sami PhD, PT
Spine. 24(2):137-141, January 15, 1999.
8 Hadley LA MD; “Anatomicoroentgenographic studies of the spine”; Thomas 1973
9 http://www.ncbi.nlm.nih.gov/pubmed/10938441
10 http://en.wikipedia.org/wiki/Splanchnic_nerves
11
Subacute Low Back Pain JMPT Vol 27, Issue 6, July-August 2004, Pages 388-398
The discs (above) of the
cervical spine of an adult.
Note the ample amount of
blood in the bone (the
red-brown bits) and the
white of the cartilage discs
(the horizontal white bits).
The whiteness of the disk
indicates that there no
blood contained in it. The
slight pink is
contamination that took
place as a result of the
dissection process.
LINKS THIS PAGE
Subluxations
Deterioration begins
Discs
Bones
Phases of degeneration
Nerves
Not just about Pain
Benefits of being subluxation free
Updated 2 Apr 2009
Health - Naturally
Mornington & Beechworth, Victoria, Australia