There is a difference between manipulation and an adjustment. With manipulation, a force is introduced into multiple segments with the sole intent of “mobilizing” the area. No care is taken to isolate the specific joint or vertebrae. A contact is made with one’s hands over several segments at one time and whatever “cracks” does so without a specific goal in mind other than global movement.
A “manipulator” gives every one the same “asprin” approach no matter what the presenting conditions are. Every patient is manipulated on their right side and then their left when their lower back is treated, then they lay on their stomach and are pushed on all the way up and down their mid back and finally lay on their back and their neck is cracked from the left and then the right.
While this makes many patients “feel good”, this approach usually results in short term relief because no attempt and specific correction is ever made. In some cases, too much joint movement or worse yet joints that are manipulated that should not be, result in new pains or instability. Manipulation that is SPECIFIC is called an “adjustment”.
The adjustment implies that a detailed examination is performed via a functional assessment by the doctor’s “hands on” palpation of each joint to determine “if” there is a subluxation and exactly “where” it is located and that information is then applied to the xrays to determine the best way to reduce the condition.
The xray provides the information to assess exactly what the quality of the structure is, what areas should not be treated and an expectation of what each person’s results should be. The films tell the story of what phase of subluxation a patient is in whether acute or chronic by the absence or presence of degenerative changes.
The Adjuster contacts the subluxated vertebrae on a specific part of the segment, positions the patient with an exact placement of the appropriate spinal components and introduces the manipulative force with a specific “line of drive” and a calculated amplitude (depth or distance) to produce a cavitation (noise like cracking one’s knuckles). These factors are case specific for each patient. The treatment is accomplished by proper isolation of the adjusted segments and occur within the normal operational range of vertebral movement.