Zen and the Art of Chiropractic Adjustment and Healing

Science, Art, and Philosophy of Chiropractic


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What happens when my Low Back Pain makes Clicks and Clunks?

Recently this article came across the Gonstead Clinical Study Society database. The title was “Clicks and Clunks with Low Back Pain: What Do They Mean?” This article was a literature review by the International Musculoskeletal Medicine in April of 2009. Dr. Steve Tanaka D.C summarized this article review.

Summary of the article:

To review knowledge about noises arising from the joints of the back, which can be felt or heard by back pain patients or those undergoing treatment for back pain. Materials and methods: A literature search relating to the clicks and clunks that can be heard or felt by patients with back pain either with normal movement or during manipulation. The databases searched were Pubmed, Embase, TRIP, CINAHL, and Amed. The text terms click, clunk, and pop was used. In addition, experimental work was reviewed which aimed to elucidate the mechanism by which noises can be produced in synovial joints.

The Conclusion of the Review:

Most of the literature deals with the mechanisms of clicks in joints in general and in finger joints in particular. In the spine, there are many references to the ‘popping’ of facet joints in the spine as a result of manipulative therapy. Research has centered around an examination of cavitation and the formation of a gas bubble in the joint cavity when the joint surfaces are distracted. There was scant information about clicks and clunks in relationship to the presentation of back and neck pain. Studies have found no correlation between clicks and the typical electromyographic changes produced at manipulation, nor with therapeutic benefit. Conclusion: The significance of clicks and clunks in joints, whether occurring naturally or during treatment, remains uncertain.

Discussion of the Topic:

Unless something more finite comes along, most people accept the idea that a gas cavity or bubble of carbon dioxide forms. When it collapses or cavitates, a sound is produced. Some have brought up the concept of capsular ligament “snap-back.”

Many studies have been done on the metacarpophalangeal joints. Some studies have been done on the cervical spine, lumbar spine, and sacroiliac joints. Most agree that the sound comes from the zygapophyseal joints. In sacroiliac joint and lumbar manipulation studies, the sound has been found to come from the lumbar spine, and sometimes from multiple levels ( due to the use of “lumbar roll”?).

Comments from Gonstead Clinical Study Society:

“I wonder what actually accounts for the difference between a well-done Gonstead adjustment and the higher pitched sound of many manipulative treatments and less than effective Gonstead adjustment attempts? We say what we think it is—sound of adjusting through the disc, rather than the apophyseal joints.” Dr. Steve Tanaka D.C.

Clicks and Clunks With Low Back Pain

The last comment by Dr. Steve Tanaka mentions between adjusting through the disc rather than the apophyseal joints is a technical comment that most Gonstead chiropractors would understand.

670px-Crack-Your-Neck-Step-20

The apophyseal joints location in the spine is mainly a synovial joint that has fluid that can produce gas cavity or bubble from organic gases from carbon dioxide. Most people will hear this popping noise when there is a slight movement or a quick movement in the joint. These rapid movements with a popping noise are thought to be chiropractic adjustment.

A well-done Gonstead adjustment has a specific force with control into the person’s spine. The goal of the Gonstead adjustment is setting the spinal segment with the health of the disc in mind instead of restriction and movement.

knee chest

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Good, Bad, and the Ugly. Crack My Neck for Relieving Pain.

There are many situations where your spine will crack on its own or intentionally cracking them. The cracking of the spine in any different situations has an effect that can be good, bad, or ugly.

Good:

After a certain time period of a Chiropractic adjustment, the spine tends to realign the other vertebra on their own. Most likely the other vertebra was not in the right position are starting to go in the right position by themselves. When your body introduces any kind of force, such as when you are doing light stretching, turning, bending the spine realign. There is nothing to fear but to let your Chiropractor know what happened. Check out the former blog about this topic: https://zenchiropractic.wordpress.com/2012/11/29/what-happens-when-my-spine-goes-pop/

Bad:IMG_0006

When your spine pops and pain follows immediately then the joint became unstable and causing inflammation and muscle spasm. Even if you didn’t put much stress or any motion on the spine something pops and then the muscles around are creating spasms and sharp pain. Often times these situations are the vertebra was already starting to fall out of place and it was a matter of time when it went out of position. In this case, put ice on the area and get to a Chiropractor that will use x-ray, neurological exams, and education on what has happened and properly adjust that vertebra.

Ugly:

The unprofessional person intentionally twisting of the neck or low back of themselves or to others may create the cracking noise but then they will cause tendon and ligament to tear and create more instability. Over twisting the neck without proper examinations and professional skill then people are at risk possibly damaging artery integrity that is already weakened and may cause cardiovascular problems in the brain. The mistake is to think that by over twisting the joint the crack is more intense and the better you feel.

26real_450That cracking noise is not what Chiropractic is defined by but that is a very big misunderstanding. Cracking in your joints creates an endorphin response that gives you a euphoria for a moment but does not solve the actual joint problem. Properly correcting your spine takes a long training from a graduate level school and getting a state license. A grand total of 4485 hours of clinic hours with health science education. Many people attempt cracking their neck and low back themselves or ask others that are not professionals to crack their spine.

There are many other professional and non-professionals that try to say that they do chiropractic. Professionals such as massage therapists, physical therapists, sports therapists, and even some medical doctors to copy chiropractic because they know how effective Chiropractic care is. Non-professionals such as your friends, families, people you meet at the bar or parties, or any individual that offer to crack your spine or neck on the street. This is why people have an incidence of having a very bad experience with cracking their neck or back because they think it is just cracking is what helps the person. People could get damage to their muscles and ligaments, and damage to the artery structure in the neck.

gonstead and spine

Dr. Gonstead’s Story:

Dr. Gonstead once had a farmer couple come to his office. The wife of this farmer was in a lot of back pain. Dr. Gonstead found the problem after careful analysis and adjusted the spine and told them to come back next week. The former couple did not come back. In fact, they didn’t come back for months. Then the farmer couple came back and the wife of the farmer was in a lot worse back pain. Dr. Gonstead analyzed again and it was much worse condition than before, so he asked the wife what happened. The farmer’s wife confessed that her husband tried to copy Dr. Gonstead after watching him adjust his wife after they went back home. They thought they could do the adjustment themselves not knowing how much science and careful skill that Chiropractic adjustment involved.

Summary:

There are many occasions were your spine will crack on its own. Some are fine because it is the process of our body to correct and heal itself. Some are bad because the spine got very unstable and finally went out of place. The worse is just because you want to feel the euphoria and cracking your neck or low back and causing a major set back of unstable joints does not help yourselves or the person you are trying to help. You could even cause serious damage to yourself or to others. It is not about cracking your neck and it is not about being a crack dealer for people. If it is about helping people, you should become a Chiropractor or go seek one to help your friend. They will find the cause and stabilize the situation.