Chiropractic and Manipulation of the Extremities

Chiropractor PhotoChiropractic manipulation dates back to the ancient Greeks. In fact, it is said that Hippocrates was the father of modern medicine. He was known to use manipulation as one of his treatment methods. The theory of chiropractic revolves around the premise that there are 24 freely movable vertebrae, which house and protect the spinal cord, and 31 pairs of spinal or peripheral nerves. These nerves supply the head, trunk, organs, and extremities. If a vertebra misaligns and becomes fixated, jammed, or stuck, it often puts pressure on a nerve or a nerve plexus. Whatever that nerve supplies, there is less than 100% or optimum function. Therefore, there is a proverbial short circuit at that organ, muscle group, or gland, and there is an energy drain on the body, which leaves it susceptible to pain, disease, or dysfunction. The chiropractor detects these misalignments or subluxations by the art of static or motion palpation, orthopedic, and/or neurological examinations and possible x-ray or MRI studies. Sometimes, nerve studies can be helpful to diagnose the levels involved. The public or the lay person may not be aware that chiropractors are often trained to detect and correct subluxations or segmental dysfunctions of the extremities (e.g., hands, feet, elbows, knees, shoulders, hips, and even the ribs and the temporomandibular joint). The difference between the vertebral subluxation and the extremity subluxation is that with the vertebral joints it is likely a spinal nerve is involved. If the chiropractor is working with an extremity joint, for example, a spinal nerve is probably not involved.

The chiropractor utilizes the same methods (e.g., patient history, physical, orthopedic, neurological examination, static and motion palpation, and imaging studies such as x-ray or MRI) to determine if an extremity needs to be manipulated. For example, in the case of tennis elbow or lateral epicondylitis, the elbow as well as the corresponding spinal level may need to be manipulated. In this case, the C6 or C7 vertebral level may also require manipulation. There are several muscles that supply the elbow. But, extensor carpi radialis longus and brevis are the culprits in tennis elbow, which are primarily innervated by C7 or the radial nerve, which corresponds to the C6 spinal level. In addition to the manipulation of C6 and the elbow joint, various soft tissue techniques may be applied to the extensor carpi radialis longus and brevis such as Cross Fiber Friction Massage or Active Release Technique. These techniques break up scar tissue or adhesions and lengthen shortened muscles that are in spasm. Acupuncture can also be utilized to treat the extensor carpi radialis longus and brevis muscles or any other involved muscles. Acupuncture is a separate and distinct healing art. The mechanism behind how acupuncture works is threefold – 1. It brings more nutrient-rich blood to the injured or damaged area to enhance healing; 2. It takes the involved spasmed or shortened muscles and lengthens them by causing the actin and myosin muscle filaments to release or lengthen. It also helps to break up scar tissue and adhesions; and 3. Acupuncture releases natural neurotransmitters into the blood such as endorphins and enkephalins to help alleviate pain, depression, and anxiety as well.

Dr. Eric Minninsohn utilizes all of these various techniques mentioned in this article – spinal and extremity manipulation, soft tissue manipulation, and acupuncture. He works at the Brick office of Advanced PMR and is available for consultation Monday, Tuesday, Wednesday, and Friday from 8:00 a.m. – 8:00 p.m.

Posted in: Fitness, Health & Wellness, Low Back

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