Question
I have recently seen a chiropactor/physical therapist
for pain in my hands and upper back. He did some
excellent massages on my hands that really helped and
he did an adjustment on my upper back. He pushed my
elbows together while i was laying on my back with my
knees up and i could actually feel my back popping
exactly where i have been feeling pain. It feels good
on my left side, but my right side feels a bit stiff
still. My questions are:Can he do something for my
right side as well? When they say they are doing
'adjustments' are they actually moving your vertabrae?
Or are they making the joints pop like when somebody
cracks their knuckles? And also, is their a risk of
spinal chord damage when getting adjusted?
Thanks for any help you can provide,Jason

Answer
Dear Jason Shelnutt,

Thank you for your question about your therapy experiences.  In order to answer it properly, I'll first need to give you some background on anatomy and physiology and how they relate to the chiropractic profession.  I'll then offer my thoughts on how this may relate to the situation you describe.  

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.  

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential, whatever that may be.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as sports, exercise routines, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, food additives, etc.), which are, unfortunately, uncontrollable and regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

You report that you were motivated to visit a chiropractor by  
.  
Tragically, however, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to a connection between the spine and specific symptoms of any kind, including hand and upper back symptoms.  Certainly, every part of the body must have connections to the nerve system so that vital information may be transmitted between the brain and the cells.  There are some who would attempt to review the possible nerve connections between a nerve root and specific organs or tissues, but this ignores the multitude of variables that determine the expression of function.  The question of how your individual body carries out the myriad of activities just to maintain life is enormous and would require your Creator's (or creator's, for the agnostic) knowledge, or at least far more than our educated knowledge of the complexities of life.

The only way to know if someone has a vertebral subluxation is to have that person's spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this procedure is 揳djustment.? You use this terminology in your question to me, yet it is not clear that this is what was actually being performed.  The reason I say this is because the office you visited was addressing your symptoms, not vertebral subluxations.  Adjustment and vertebral subluxation, as we've addressed them here, are terms of art specifically within non-therapeutic straight chiropractic.  The more appropriate term for what was done would probably be 搈anipulation,?which is a movement of a joint, through its range of motion and beyond, with the goal of increasing motion, reducing pain, modifying to average, etc., in short, any number of therapeutic goals.  Whether it makes a noise or not is not a determining factor in distinguishing one from the other.  As we saw above, vertebral subluxation is not reliably able to be linked to specific symptoms or complaints.  

Notably, since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  It is likely, from the limited information you provided, that the chiropractor you had visited is of the therapeutic mixed viewpoint.  Even you are unclear about the proper title to use in describing the experience.  It is quite understandable, then, why he would rely on therapeutically intended procedures, such as massage, manipulation and physical therapy, etc.  

I cannot comment on the need for or risks associated with modalities or other therapeutic measures, including whether there is a risk of experiencing spinal cord injuries with manipulation.  Remember, the two types of chiropractic objectives are not the same.  The non-therpaeutic straight chiropractor will use methods of analysis, as I mentioned, to determine whether you have any vertebral subluxations, and effect necessary adjustments.  Therapeutic modalities are not within the realm of appropriate non-therapeutic straight chiropractic.  

Incidentally, it would be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor even if you still elect to have therapeutic attention for your therapeutic concerns with another provider, whether that is with a therapeutic mixing chiropractor, a physical therapist or some other provider to do so.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  You may also visit www.gschiro.com, a site that represents non-therapeutic straight chiropractic organizations on a state level.

Jason, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.