Subluxation and Chiropractic Manipulation

The term "subluxation" is used by doctors of chiropractic to depict the altered position of the vertebra and subsequent functional loss, which determines the location for the spinal manipulation. "Subluxation" has been defined medically as "...a partial abnormal separation of the articular surfaces of a joint."¹⁴

Chiropractors have described the term to include a complex of functions (i.e., the subluxation complex) as "…an alteration of the biomechanical and physiological dynamics of contiguous structures which can cause neural disturbances."

Chiropractic Viewpoint on Subluxation

Chiropractors view subluxation as a process rather than a static condition during which the tissues undergo constant changes, including:

• Hyperemia.¹⁵ Referring to an excess of blood in a specific area of the body, hyperemia may develop when there is an obstruction preventing the blood from flowing normally.
• Congestion.¹⁵ Joint dysfunction affects the muscles in different ways, with some muscles developing trigger points, or areas of congestion, where toxins develop, irritate the nerve endings within the muscle, and produce pain.
• Edema.¹⁵ When the body’s tiny blood vessels (capillaries) are damaged or pressurized, excess fluid may leak from them and build up in the tissues, leading to a swelling known as edema.
• Minute hemorrhages.¹⁵ Referring to a small amount of bleeding or an abnormal flow of blood, minute hemorrhages may develop within the body’s blood vessels as a result of certain triggers, underlying conditions and other risk factors.
• Fibrosis.¹⁵ Detailing the replacement of normal tissue with scar tissue, fibrosis commonly occurs in people dealing with recurrent back pain.
• Local ischemia.¹⁵ A very specific type of muscle pain, ischemia refers to a lack of blood flow in the muscle (often from a muscle spasm), leaving the muscle very painful to touch.
• Atrophy.¹⁵ With muscle atrophy, the muscle shrinks and may partially or completely waste away as a result of inactivity or various diseases and conditions.
• Tissue rigidity.¹⁵ Eventual rigidity and adhesions form not only in joint capsules, but also in ligaments, tendons and muscles themselves.

Spinal Subluxation in Chiropractic

The Houston Conference Classification categorizes spinal subluxation as follows:

STATIC INTERSEGMENTAL SUBLUXATION

1. Flexion malposition

2. Extension malposition

3. Lateral flexion malposition

4. Rotation malposition

5. Anterolesthesis

6. Retrolesthesis

7. Altered Interosseous Spacing (increased or decreased)

8. Osseous Foraminal encroachment

KINETIC INTERSEGMENTAL SUBLUXATION

1. Hypomobility (fixation subluxation)

2. Hypermobility (unstable subluxation)

3. Aberrant motion (paradoxical motion)

SECTIONAL SUBLUXATION

1. Scoliosis and/or alteration of curves secondary to muscle imbalance

2. Scoliosis and/or alteration of curves secondary to structural asymmetries

3. Decompensation of adaptational curves

4. Abnormalities of motion

PARAVERTEBRAL SUBLUXATION

1. Costovertebral or costotransverse disrelationships

2. Sacroiliac subluxation

References

• Article written By:
• Steven G. Yeomans, DC

October 7, 2009

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