How does a chiropractor know where to adjust or crack you?

Chiropractors in Singapore  determine where to adjust based on a combination of patient history, physical examination, and diagnostic tests. Here’s an overview of how the process may look:

Patient History

Chiropractors begin by taking a detailed history of the patient’s current complaint, medical history, lifestyle factors, and any previous injuries or health issues. This information helps them understand the patient’s condition and identify if the patient is a suitable candidate of chiropractic care.

Not everyone is suitable to receive chiropractic adjustments. World Health Organisation published guidelines about safety in chiropractic and it included a list of contraindications. Contraindications identify who are the patients who should not receive spinal manipulation. Some of the contraindications are:

• Spinal cord tumours
• Malignancy of the spine (i.e., cancer)
• Severe or painful spinal disc pathology (e.g., disc herniations)
• Congenital generalised hypermobility
• Osteoporosis

If you have any of the following conditions, please do not seek any form of spinal manipulation for your pain management.

Physical Examination

Chiropractors perform a thorough physical examination, which typically includes assessing range of motion, muscle strength, joint mobility, functional movements, etc. They may also conduct orthopedic and neurological tests to gather additional information.

At Square One Active Recovery, we use dynamometer and biomechanical force plates to assess our clients’ muscle and joint function. These assessments allow us to have objective information about our client’s current physical condition.

Diagnostic Tests

In some cases, chiropractors may request diagnostic tests such as X-rays, MRI scans, or laboratory tests. These tests help to confirm or rule out specific conditions, identify structural abnormalities, and provide a clearer understanding of the patient’s condition.

Unfortunately, chiropractors in Singapore tend to refer all their patients for x-ray. This is not because x-rays are required but rather a tactic use to facilitate fear mongering sales. You can read more about it in our x-ray chiropractic scam article.

Organisations such as American Chiropractic Association and Chiropractic Australia have recommended against imaging in the absence of red flags. Examples of red flags are:

• Major trauma (e.g., car accident) or minor trauma for seniors
• Changes in bowel and bladder function (e.g., urinary retention, loss of anal tone)
• Saddle anesthesia (e.g., numbness in or around genitals, unable to feel toilet paper when wiping)
• Fever, chills, or night sweats
• Night pain (i.e., pain that awakens a patient at night that is unrelated to movement or positioning)

Based on the above list, you can appreciate why most of you do not need x-rays or MRI. If you do experience any of the above red flags, please visit the nearest hospital’s emergency department immediately!

Palpation

Chiropractors are known for using their hands to feel for areas of tenderness, muscle tension, joint misalignment, or restricted movement. They claim that this allows them to identify areas that may require adjustment. According to their reasoning, the specificity they offer is why professionally performed manipulation is different from the ones your friends can do for you.

Unfortunately, research does not support these claims.

Studies have reported that it doesn’t matter where your chiropractor adjusts you. What you see on social media? Likely just theatrics. When researchers, at least three of them who are chiropractors, compare what happens when a spinal manipulation was performed at a “relevant” site versus somewhere completely random, the outcomes were comparable.

This is aligned to what we have been sharing about how pain is not just structural in nature, and a biopsychosocial approach is necessary in finding long-term success in pain management. You can read more about how pain works in our article on Pain Neuroscience Education.

Furthermore, previous research (performed by chiropractors) has also established that palpation for motion restriction (i.e., which part of your spine is stuck) and pain has poor interrater reliability. When different chiropractors were asked to palpate the same people, their finding so where the spinal restrictions were did not match with each other.

If spinal restrictions do truly exist and can be palpated by hands, why can different chiropractors end up with different findings?

How can I find freedom from pain?

There is a lot of mystery in how traditional chiropractic works. Beyond recent studies showing that chiropractic adjustments are no better than placebo, there are many aspects of it that just doesn’t add up.

This is why it is important to consult with an evidence-based chiropractor for the best recovery outcomes. To find out more about how we can help you help yourself find freedom from pain, drop us a message via the form below. Alternatively, you may want to join our Facebook group for the latest research pertaining to pain science.