If my pain is right here, why are you adjusting me somewhere else?

“Doctor, my pain is in my neck. Why are you adjusting my low back?” –We get questions like this often in our office, and the patient’s concerns are extremely valid.  There are several things that go into deciding what bone needs to be adjusted and surprisingly, the location of the adjustment is not dependent on the location or even presence of pain.

For starters, the need for an adjustment is not reliant on whether or not pain is present.  The nerves that make up your nervous system have several different functions- motor function (movement), autonomic control (organ function), and sensory function (including the feeling of pain).  The sensory aspect of the nervous system is just a small portion of your nervous system, and it is possible to have tension on your spinal cord from a spinal misalignment without the feeling of pain.  This is why an adjustment may be warranted even though you feel asymptomatic.

If pain is present, however, you may actually require an adjustment at a completely different location than where the pain is. There are two main reasons why this may be the case. The first has to do with the close relationship of the spine and nervous system, specifically the spinal cord. The spinal cord attaches to the spine at the very top and bottom of the spine. If the spinal bones in either of those regions are misaligned, it can change the tone or tension of the entire spinal cord. Let’s say a spinal misalignment is present in the neck, changing the tension of the spinal cord; because the spinal cord also attaches at the lower back, an increase in tension of the spinal cord could actually create discomfort in the lower back, even though the misalignment in the neck is what is causing the discomfort. Similarly, a spinal misalignment in the lower back could affect the neck region. So rather than adjusting the area of discomfort, we will adjust the area causing the discomfort.

The second way this could happen has to deal with compensation. Your body was designed for your bones, ligaments, muscles, organs, etc. to work together to keep you alive. Anytime something is not functioning appropriately, your body adapts as best as it can to keep you going. With that being said, if there is a spinal misalignment present, the body’s natural response may be to compensate for that misalignment.  This could mean a change in posture, or even a spinal misalignment in another region of the spine.  If this is the case, you may experience pain as a result of the compensation but because the compensation is secondary to the primary misalignment, we would address the primary misalignment even though the pain is present at the compensatory region.

With so many things to consider, how do we know where to adjust?  This is one of the many reasons we LOVE our analysis.  The analysis we use is very specific at locating the areas where the primary misalignments are (meaning it does not look for compensations).  Once the adjustment is made, the tone or tension of the spinal cord is able to return to a more acceptable state.  When this happens, there can be a decrease in the amount of discomfort caused by that misalignment, whether that discomfort was in the same area as the spinal misalignment or in a completely different region of the body.  In the example of the lower back pain caused by a neck misalignment, once the neck is adjusted and the added tension on the spinal cord is released, the symptoms in the lower back can decrease.  In a similar fashion, if a spinal bone is misaligned and the body responds via compensation, once the primary misalignment is adjusted, the compensation can often times self-correct. 

While it is important to use the presence of pain as a subjective indicator, pain does not dictate the adjustment.  Because your body can respond to spinal misalignments in many different ways, we’d rather use a very specific analysis to determine what needs to be adjusted rather than relying solely on pain, especially since adjusting the primary misalignment/s will help you achieve the greatest results in the shortest amount of time!