Subluxation of the Spine - What is it?

Chiropractic is at its most basic level defined as the correction and detection of vertebral subluxation.  What is a vertebral subluxation?  That’s a pseudomedical term used to describe a misaligned and malfunctioning vertebral segment.  The segment must fit certain criteria to determine it being “subluxated”.  The misaligned segment must have abnormal motion, there should be evidence of swelling or inflammation, and nerve irritation.  Understanding the complexity of this criteria requires unique training to properly locate, let alone properly correct. The spine is certainly a unique organ in many ways; its anatomy and physiology allow for the strange phenomenon that is subluxation (intervertebral disc).  There are further mechanical stressors unique to the human spine that allow for this phenomenon.  Our posture and body habits are certainly unique. One is hard pressed to name another living creature that walks on two legs and has fully usable upper extremities and not wings.  Further compound our unique build with strange activities, like sitting for hours and hours daily for years and years, throw in bizarre activities such as roller skating and football, and one can begin to understand that there just might be something to the vertebral subluxation theory.  Today’s focus, however; is to be on how a joint acquires the initial subluxation status… ie joint injury.

Chiropractic, and joint injury:

Joint injury is different from muscle injury in one major way.  Muscles have ample blood supply.  In a muscle, this blood supply brings a steady supply of necessary nutrients, and can remove waste products as needed.  Nothing special is required of the body for this to happen, in fact; this may happen better if the muscle is used less so as not to stretch or broaden the margin of injury…

Joints have a very poor blood supply.  Joints receive the vast majority of their nutrients via synovial fluid.  This fluid comes in and out of the joint via motion.  In an injured joint, normal motion is often disturbed. Should this happen, it is difficult for the joint to receive the appropriate nutrients, and to do away with waste products.  Restoring motion to an injured joint is of the utmost importance for proper healing.  Medicine has most certainly caught on to this phenomenon in recent years.  Rehabilitation for joint surgeries involves movement and use of the joint, usually within 24 hours of the procedure.  This all comes back to the idea that the joint needs motion for proper healing to take place.  This principle has been important since the inception of chiropractic.  Spinal joints are, perhaps, the most complex of joints because of the mechanics of the intervertebral disc.  The intervertebral disc is quite hearty, contrary to archaic misnomers such as slipped disc.  It functions much like a pivotal ball-bearing between each vertebra.  The vertebral “motor unit” as it is sometimes called, also has another joint in it.  The zygapophyseal or, facet joints, as they are more commonly called, are responsible for a small amount of movement, and for restricting excessive rotation.  They are less commonly implicated as problem causers in the spine; as these joints are much simpler in mechanical function and makeup, and are more similar to many other joints in the body in their structure.  The reason these spinal joints are more a focus in chiropractic than other joints in the body is because of their close relationship with the nervous system.  The spine houses the spinal cord, with a pair of nerve roots between each and every vertebral level.  If there is abnormal joint movement at a disc, or a facet the sluggish synovial fluid within the joint can lead to the release of inflammatory drainage right around a nerve root.  These noxious chemicals can irritate the nerve root and result in a variety of symptoms, most usually pain.

Locating these fixated vertebral segments, and inducing motion is the mainstay in chiropractic.  The ideal way to do this is to isolate and move the offending vertebra to a neutral position atop the segment below it.  Chiropractic is a science, so long as it is specific.  Once an appropriate adjustment to the right segment is made, the body is then able to do what it was designed to do, healing can begin.

The principle of joints requiring normal motion is applied to other joints in the body by many chiropractors, myself included.  It follows the idea that motion is required for proper health of the joint, of course, the most appropriate way to do this would again involve analysis to move the bones of the joint into a more normal/neutral positioning, setting the stage for healing.  There is nothing miraculous about the process, the healing will take time, and longstanding misalignment often will require follow-up care to encourage proper joint positioning, and maintain good joint spacing that promotes healing. Written by Dr Alan Alexander, DO.

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