Questions come at me in rapid-fire fashion all the time about chiropractic in general and some of them are asked more frequently than others. One that has been coming quite a bit lately is, “Does it hurt to get adjusted?” As with almost everything in life there is no clean, neatly packaged yes or no answer to that question, and it takes some time to explain it. When I get into a busy mode at the office and unless a person expresses apprehension about the possibility of pain I sometimes do not get to explain it fully. This week’s column goes out to all of you who have asked and to all of you who wonder.
When a person has a spinal misalignment it creates what we call a vertebral subluxation complex. “Vertebral” describes something that is associated with a vertebra, or bone of the spine; “subluxation” describes a slight misalignment of the vertebra – not so much so that it is dislocated (that would be a medical emergency) but just enough so that it is putting pressure on its corresponding nerve root; and “complex” describes the fact that there is more than one part to the problem. Hereafter, I will refer to the vertebral subluxation complex as “VSC” for simplicity. If a bone is misaligned enough to put pressure on a nerve root, a host of things occur. Among them is localized swelling which causes messages from the brain out to the body to be delivered incorrectly. Organs and tissues which rely on the nerves to tell them what to do cannot function properly when this occurs. Part of this malfunction sometimes results in pain and muscle spasm in the area of the VSC. When a person comes to the chiropractor with a VSC or in many cases multiple ones, pain is likely already present. If muscles are in spasm and have been for a long time it might hurt even to touch the area involved. In this case it would cause some discomfort for the affected joint to be adjusted. The good side of the discomfort is that once the joint that is misaligned is realigned, the pain decreases almost instantly in most cases.
Many subluxations do exist without the pain component. Children come to the chiropractor for a number of reasons and might not feel any pain at all. When they are adjusted there is no discomfort in the vast majority of cases. In most adults there is very little discomfort when the adjustment is delivered as long as the area that is being adjusted is not already inflamed. Sometimes instruments are used in the adjustment in order to decrease the possibility of discomfort in particularly sensitive individuals. Most chiropractors have enough sensitivity about them to determine the amount of force to apply in any given situation.
By definition, a VSC is caused by a spinal bone’s being misaligned. Sometimes this happens quickly as is the case in trauma such as a fall or a motor vehicle accident, but most often this occurs over a very long period of time. If you develop a subluxation over time the muscles surrounding the segment that is misaligned have had time to get used to the misalignment. They forget where the proper position of the bone was in the first place and sometimes get very angry when the bone is put back where it belongs. The bone has been out of place for a long time so when the chiropractor puts it back the muscles go to work right away trying to pull it back out again. Then the chiropractor puts it back in and the muscles pull it back out, but a little less than last time. In this sense one adjustment builds on the next and eventually the muscles become trained to hold the bone in its proper position. During this process, however, sometimes people will have a muscular soreness that is similar to the soreness of a big workout after taking a long time off from the gym. It is essential to differentiate between pain and soreness. Do not be alarmed by soreness but report any pain to your chiropractor immediately.
Most chiropractors are excellent listeners. We truly care about making a difference in your quality of life, so don’t hold back anything during your initial consultation. If you are apprehensive about the fear of pain from any procedures that might be performed, say so up front. There is no reason not to disclose your apprehension in an effort to clear the air and be assured that your needs will be met.
There is the roundabout answer to the question of whether it hurts or not. Generally there is no pain associated with a chiropractic adjustment. There are, however, exceptions to this generality and they can be addressed on an individual case by case basis. Just speak up and you will have an exceptionally beneficial visit with your chiropractor. Treat your body well.