Fun fact: Did you know that there are over 200 different chiropractic techniques or “schools” that have branched off since the founding of chiropractic? Each one has differences on how chiropractors approach the health of their patients.
At Palmer College of Chiropractic — where Dr. Stout and I both studied — we were exposed to a few techniques which we still practice today, sometimes called the “Palmer Package.” I practice using the Gonstead system of adjusting and analysis. Dr. Stout uses a CBP or “Chiropractic Biophysics” system of analysis and a mixture of diversified, Thompson, and Gonstead adjustments. We both also work on extremities in the office. Today, I want to explain briefly some of the ways in which these techniques differ and how we practice in the office.
This is the category that Gonstead (and similar techniques) fall under. In this frame, practitioners find a couple of specific joints that are dysfunctional and focus on those joints to give adjustments. Upper cervical techniques usually focus on the first two vertebrae, C1 and C2. With the Gonstead technique, we may only adjust one to three joints per visit (minus extremities if needed), but we look to the full body for dysfunction. Segmental techniques don’t ignore posture/structural changes in the spine, though. These can change contact points for adjustments and in some cases even change which joint will be most efficient to adjust. In theory, if the specific problematic joint is fixed, the body will de-compensate in other problem areas on its own. After that, it’s time to fix muscular issues and posture to stay out of trouble in the future.
The next category is postural. Postural techniques usually focus solely on bringing someone’s posture and global curvatures back towards normal through adjustments, traction, and different exercises. In some cases, the adjustments aren’t always focused on one specific joint, but instead focus on moving multiple joints on a curve. Postural techniques don’t necessarily ignore functional changes either. Dr. Stout does postural checks on his patients to assess the areas to focus on and then uses motion palpation to find specific joints that need to be adjusted in that area and to help reduce the postural abnormality.
Side note: You might notice that a lot of these ideas make techniques similar if one stops to look at the big picture. What usually differs are the priorities one deems most important.
Some techniques put a lot of emphasis on their analysis and how they determine what to adjust, when to adjust it, and how to adjust it most effectively. Some of the most common ways to analyze include temperature differentials using different tools, x-ray views, palpation (touch), and visualization. Most chiropractors use motion palpation (touch) and visualization at the very least to determine what to adjust on a day-to-day basis. In our office, we both use x-ray analysis, palpation, and visualization. I also check for a temperature difference from segment to segment using an instrument called the Nervoscope which is used solely in Gonstead analysis.
4. Manual adjustments
Most techniques and chiropractors you visit use their hands to adjust. The word Chiropractic comes from the Greek words “cheir” and “praktikos” which mean “done by hand.” A lot of the manual techniques have similar set ups that have been passed down and perfected since the founding of chiropractic. Some chiropractors have to change how they adjust based on skill, hand size, personal preference, patient preference, history of injuries sustained by the practitioner, etc. There can be many variances even within the same technique or system of adjusting.
5. Instrument adjusting
Finally, there are a category of techniques that utilize instruments to make adjustments rather than hands. There are many reasons why a practitioner would choose to use an instrument to adjust, but the biggest benefit is consistency — an instrument can always deliver the same amount of force (which is minimal) to a patient who may need a more delicate procedure. Some common instruments used to adjust are the activator, integrator, and the new pro-adjuster machine.
Side note: some instrument techniques also have their own form of analysis. This can affect what is adjusted with the instrument as opposed to manual techniques.
At the end of the day, the majority of chiropractors have the same end goals: get the patient well and use a consistent protocol to decide what is best for the patient clinically on each visit. Not every chiropractor is the same. Just like any profession, each professional has his own style and priorities. Multiple schools of thought can potentially get to the same end point.
This is another reason why it is important to be consistent with your appointments. It is also important to work with the same doc to be consistent in your care. We all know what it’s like to have doctors who aren’t working together and communicating on your case.
Here at Stout Chiropractic, we work together to find out what has worked for you in the past, but we also like to use different analyses and techniques to see what else can help. Come in to get checked if it has been awhile!