On your first visit, an in-depth health history evaluation will be taken. Vital signs as well as relevant neurologic, orthopedic, and muscle tests will be performed. Once an assessment has been made, the joints (usually of the spine) will be palpated for reduced motion. The associated muscles will be palpated as well. Generally, the muscles are treated first, since tension and/or adhesions within muscles and fascia directly impact joint movement. The affected joints will then be adjusted with a quick, shallow thrust to restore motion in appropriate direction(s).
The thrusting motion is referred to a high velocity, low amplitude thrust (HVLA), which means the force is generated at a high speed but delivered very shallow into the body. Speed is the key, not strength. Other methods of mobilization are often performed, which can also improve motion similar to the HVLA thrust. A joint in the body that is properly isolated (‘locked out’) during set-up is only moved a couple millimeters, so not much force is needed to achieve this.
People often wonder about the ‘crack’ associated with a chiropractic adjustment or other methods of joint manipulation. This noise – currently called tribonucleation (previously called a cavitation) – is associated with gas exchange inside and outside the joint capsule, which surround movable joints in the body. This capsule is stretched and thus made more permeable during an adjustment. The noise does not always occur when restoring motion to a joint and is not a requirement.
Patients typically remain fully clothed during chiropractic and can expect to receive treatment while in a face down position (prone), face up (supine), on their side (side posture), or seated. For best results, the patient in encouraged to relax his or her breathing and muscles. Patients are always encouraged to share concerns and feedback at all times. Similar to massage, if you do not wish to receive an adjustment to a certain body region, you don’t have to. Demonstrating to patients what proper and improper motion in the joints feels like is part of the overall experience, as a means of sharing education and awareness.
In terms of results, patients should expect some decrease in pain as well as an increase in range of motion to the affected region(s). Some residual soreness may be present after treatment, especially in more chronic cases, as the tissues in the body are essentially being re-programmed when motion is restored to a region. Helping patients achieve and maintain good health, free to work toward any goals, should be the primary objective in all forms of healthcare.