Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.
Spinal adjustments were among many chiropractic techniques invented in the 19th century by Daniel David Palmer, the founder of Chiropractic. Claims made for the benefits of spinal adjustments range from temporary, palliative (pain relieving) effects to long term wellness and preventive care.
Description
The intention of a chiropractic adjustment is to affect or correct the alignment, motion and/or function of a vertebral joint. Specifically, adjustments are intended to correct "vertebral subluxations", a non-scientific term given to the signs and symptoms that are said by chiropractors to result from abnormal alignment of vertebrae. In 2005, the chiropractic "subluxation" was defined by the World Health Organization as "a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity." This differs from the medical definition of subluxation as a significant structural displacement, which can be seen with static imaging techniques such as X-rays.
This intention forms the legal and philosophical foundation of the profession, and US Medicare law formulates it in this manner:
"Coverage of chiropractic services is specifically limited to manual manipulation of the spine to correct a subluxation... Medicare will not pay for treatment unless it is 'manual manipulation of the spine to correct a subluxation'."
Chiropractic authors and researchers Meeker and Haldeman write that the core clinical method that all chiropractors agree upon is spinal manipulation, although chiropractors much prefer to use the term spinal "adjustment", a term which reflects "their belief in the therapeutic and health-enhancing effect of correcting spinal joint abnormalities."
The International Chiropractor's Association (ICA) states that the "chiropractic spinal adjustment is unique and singular to the chiropractic profession", and that it "is characterized by a specific thrust applied to the vertebra utilizing parts of the vertebra and contiguous structures as levers to directionally correct articular malposition. Adjustment shall be differentiated from spinal manipulation in that the adjustment can only be applied to a vertebral malposition with the express intent to improve or correct the subluxation, whereas any joint, subluxated or not, may be manipulated to mobilize the joint or to put the joint through its range of motion. Chiropractic is a specialized field in the healing arts, and by prior rights, the spinal adjustment is distinct and singular to the chiropractic profession." One author claims that this concept is now repudiated by mainstream chiropractic. The definition of this procedure describes the use of a load (force) to specific body tissues with therapeutic intent. This "load" is traditionally supplied by hand, and can vary in its velocity, amplitude, duration, frequency, and body location and is usually abbreviated HVLA (high velocity low amplitude) thrust.
Adjustment methods
As the chiropractic profession grew, individual practitioners and institutions proposed and developed various proprietary techniques and methods. While many of these techniques did not endure, hundreds of different approaches remain in chiropractic practice today. Not all of them involve HVLA thrust manipulation. Most cite case studies, anecdotal evidence, and patient testimonials as evidence for effectiveness. These techniques include: