What is chiropractic?
Chiropractic, meaning “to heal by hand” is a regulated primary healthcare profession. Chiropractors focus on the diagnosis, treatment, management and prevention of neuromusculoskeletal pathologies.
Chiropractors look to subluxations or spinal misalignments for the cause of interference. The two definitions which I feel best describe this are:
“Subluxation is a dissonance in the body that leads to tension in the tissue creating bony misalignment, nervous system distortion, incoherence in the electromagnetic field and incoordination in the neurochemistry of the body.” – Sue Brown, 2002
“A vertebral subluxation is a diminished state of being, comprising of a state of reduced coherence, altered biochemical function, altered neurological function and altered adaptability.” – Australian Spinal Research Foundation, 2017
Although a bit more complicated than illustrated, one of the oldest models depicting this is the Safety pin cycle.
There are four main models which now exist to explain the effects of spinal manipulation.
These are:
Intervertebral Encroachment Model
Dentate ligament cord distortion model
Dysafferentation model
Neuroplasticity model
The two models which I often educate my patients on are the Dysafferentation model and the Neuroplasticity model.
The Dysafferentation model was first sited by Kent (1996), and Seamens and Winterstein (1998). Dysafferentation describes an increase in nociceptive input (pain) and a reduction in mechanoreceptive input (such as touch and sound) resulting in imbalanced input to the brain.
A subluxation increases the firing of the nociceptors however, the activity of the mechanoreceptors is likely to be dulled due to reduced movement from the inflammation, nociception and pain. Increased nociception and reduced mechanoreception can cause pain, visceral symptoms, problems with motor control and proprioception. For normal motor function to occur, the brain must receive continuous uninterrupted input from the mechanoreceptors.
Basically:
Subluxation leads to nociceptive stimulation --> inflammation, poor blood flow and reduced oxygen --> Adhesion formation, joint stiffness, scar tissue and degeneration.
AND
Subluxation leads to decreased mechanoreceptor input --> poor proprioceptive input, disrupted decision making, faulty motor planning and muscle imbalance --> disrupted movement coordination, posture and gait distortion and recurring subluxation.
The Neuroplasticity model was best described by Heidi Haavik (2017).
A subluxation alters the neurological input to the brain, that is responsible for ongoing maladaptive plastic changes in the Central Nervous System that over time can lead to dysfunction, pain and other symptoms.
The Nervous System is capable of constantly changing shape and function, thus making it “plastic.” This is an important characteristic which persists throughout life and plays a key role in maturity, development, learning and repair. Neurological plasticity refers to the neuron’s capability to change short-term or long-term phenotype expression in response to different stimuli or scenarios.
This implies that when a pathway in the nervous system is stimulated repetitively, its pathways will grow, resulting in an increase of firing probability through specific channels and pathways.
This has been proven in animal studies by measuring the presence of immediate-early genes (IEGs) which are responsible for protein productions in response to the internal and external environment. In one study they found that when stimulating the muscle spindles and joint mechanoreceptors, the motor pathways adapted, and when inflicting a painful stimulus, changes were found in the pain and temperature pathways.
Another interesting study by D Lelic et al (2016) found that adjusting fixations in the spine changes the way that the prefrontal cortex of the brain is processes information. It demonstrates that we can change the way that the brain works and shows that spinal function impacts brain function.
The chiropractic adjustment changes the structure and function of the brain. When we have a healthy functioning nervous system, our body is more readily able to adapt to its internal and external environment. This means faster recovery, less illness and better ability of your nervous system to communicate information.
Going to a chiropractor just for pain is like to going to a theme park just to wait in the lines.
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