What is an Adjustment?

The most common chiropractic treatment is the "adjustment." An adjustment is the treatment that a chiropractor applies to a joint with his/her hands by pressing on the patient's back or neck. There is a brief moment of traction, which is often accompanied by a cracking sound.

An adjustment helps by stimulating specialized nerve endings around the joint being adjusted. A nerve signal is then sent to the deep segmental muscles (the muscles that keep your bones aligned) that have tightened up, telling them to relax to a more normal level of tension.

Does an Adjustment Hurt?

An adjustment doesn't normally hurt, just like cracking your knuckles doesn't normally hurt.

However, if the tissues over that part of your body are swollen or inflamed, it might hurt to push on them (like pushing on a bruise). If you feel sore already, the pressure might hurt a bit, but any discomfort goes away as you get better.

Can Adjustments Cause Arthritis?

Adjustments are physical "pushes" on joints that are already too tight or misaligned. They take the joint from a state of being too tight to a state of more normal tension. That is a good thing, both for the health of the joint itself and also any tissue of the body that is associated with that joint by way of the nerves.

If, on the other hand, you habitually self-adjust and the joint you are cracking is already moving fine, then it is theoretically possible to make it more unstable and therefore susceptible to developing arthritis.

Moral of the story - avoid amateur "adjustments."

What Makes the Cracking Sounds?

When an adjustment is made, there is a pressure change inside the joint that forces the carbon dioxide (CO2) that is in the joint fluid to change into a gaseous form. It’s like when you open a bottle of pop and it fizzes or bubbles, only when it happens inside a joint, it happens all at once (because the joint fluid is at body temperature). So, in short, the crack is the sound of CO2 popping into gaseous form.

Will I Have to Get X-Rays?

You will only get x-rays if there is a genuine need for them. Typically x-rays aren't needed to decide how to treat you, but they are sometimes needed to either decide if you should be treated (adjusted) or to what degree we should expect results from treatment.

Will I Develop Arthritis if I Crack my Knuckles Too Much?

Any excessive pulling or stress on the joints can eventually lead to arthritis; especially if you are already genetically predisposed (have arthritis in the family). Occasional cracking of the knuckles is not a problem, but if you do it out of habit and more than once a day, then I would think you'd be at higher risk of developing arthritis (big knuckles).

Are there Other Ways of Getting Treated without the "Crack?”

Yes, we can adjust with either of these two instruments:

  • the Arthrositm instrument
  • the Activator instrument

Although adjusting by hand often gives faster relief, both of these instruments can often be used in place of adjusting by hand for those who are nervous about the "crack" sound of a normal adjustment.

Can I Become Dependent on Adjustments?

Yes and no. Not in the sense that someone can get addicted to medications. Chiropractic adjustments do not cause your spinal joints to "go out" more often.

Yes, in the sense that for those who have lived with chronic pain for years who suddenly become aware that there is a way to feel better may come to appreciate the relief they get from treatments. Obviously no one wants to feel pain for years. But it’s not as though pain gets worse than before if you’re not able to follow through with care.

Can Chiropractic Fix the Problem, or Does it Just Help for Awhile?

Yes, chiropractic can fix the problem. But maybe just for a little while. It depends.

For some people, yes, chiropractic can fix a problem (as long as the patient doesn't repeat the event that triggered the condition in the first place).

For others, the answer is more of a "maybe." A chiropractor can improve or at least stabilize the problem, as long as the patient does his/her “homework” (e.g. their prescribed exercises).

When Should I Use Heat vs. Ice?

Heat always feels good at first, but if there's any inflammation in the area you're heating up, heat will encourage the inflammation, and you'll probably feel worse than before within 20 minutes to an hour.

My general rule of thumb is to avoid heat if:

  • It’s a recent injury (hours to days)
  • If your pain level is more than 4/10

Ice, on the other hand, will never hurt you (as long as you don't give yourself frostbite). Just wrap a thin towel around a frozen gel-pac or bag of frozen peas and apply it to the painful area for 10 to 15 minutes at a time, in a set of 3 applications. Space the applications 10 minutes apart and put the pack back in the freezer during these intervals.

If you're afraid the ice will be too cold (or you just "don't like being cold"), wrap yourself up in a warm blanket and give yourself 30 seconds to get used to the cold. I'm sure you'll be able to make it past that uncomfortable time so you can later appreciate the "numbing" effect the ice has on pain and inflammation.

How to Use Ice

When using ice packs on a painful spot, do 3 sets of the following rotation:

  • 15-20 minutes with ice on
  • 10 minutes off
  • 15-20 minutes on
  • 10 minutes off
  • 15-20 minutes on

How to Make a Homemade Ice Pack

  1. Fill a smaller freezer bag about halfway with the dish soap. Squeeze out excess air and seal. Put the smaller bag into a larger freezer bag to prevent leaks. Squeeze out the excess air in the larger bag and seal. Place the double-bagged ice pack into the freezer until ready to use. When needed, remove the ice pack, wrap it in a washcloth and apply to the swollen area.
  2. Things you’ll need:
    • Plastic zip bag
    • Hand towel
    • Water

Fold your hand towel into a rectangle about the size of the plastic zip bag. Place the folded towel into the bag, leaving a little space in the bag. If your hand towels are too big for your bags, consider other cloth items like t-shirts.

Fill the bag slowly with tap water until the towel stops absorbing it. Add just enough so you can see the water start pooling at the bottom of the bag. You want the towel as wet as possible. Zip up the bag. Place it in the freezer. Take out and use on aches and pains. If it's too cold on the skin, wrap it in cloth.

  1. Ice packs can be made of these 4 other common household items:
    • Gelatin and Freezer Bags - prepare gelatin (your choice of flavor/color) according to the directions on the box and let it cool enough to pour into the freezer bag until three-quarters full. Seal the bag securely and freeze, and you have a homemade, flexible ice pack! When the gelatin melts, re-freeze.
    • Unpopped popping corn - pour unpopped kernels of corn into a small freezer bag and place in freezer. These ice packs easily conform to your body.
    • A sponge - saturate a sponge with water, slip it inside a freezer bag, and keep it in the freezer as a ready-made ice pack.
    • Vodka - Pour 1/2 cup vodka and 1/2 cup water into a freezer bag (you may want to add about 5 drops of food coloring for easy identification...wouldn't want that vodka to get into the wrong hands!). The alcohol doesn't freeze, but the water does, giving you a slushy, re-freezable ice pack.

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