How Do Chiropractors Know Where To Adjust?

By Dr. Philip Cordova

April 24, 2024


Chiropractors use a combination of observation, palpation, patient history, and sometimes diagnostic imaging to determine where to adjust a patient’s spine or the joints of the extremities. The goal is to deliver a safe and effective adjustment to alleviate pain and pressure on the nerves. It’s not just about “hearing things crack.” Adjustments should have a specific purpose, location, and line of drive in order to work the best. Here’s a breakdown of the process:

Patient History

Chiropractors begin by asking patients about their symptoms, medical history, lifestyle, and any factors that may be contributing to their pain or discomfort. This helps them understand the context of the problem and possible causes.

During the consultation, we are primarily looking to see if you have a problem we can help or if you need to be referred out. Many conditions can present as “back pain” – even if it has nothing to do with your spine. The initial consultation helps us to rule out many conditions that could be causing your pain.

Physical Examination

Next, we perform a thorough physical examination, which may include assessing posture, range of motion, muscle strength, and reflexes. The examination also includes palpation, or feeling the spine and surrounding tissues with our hands, to identify areas of tenderness, stiffness, or misalignment.

A lot can be accomplished during palpation in assessing the spinal joints that need to be adjusted. When chiropractors determine where to adjust, palpation occurs on every visit. The joint that needs to be adjusted may feel tender to the patient, but to the chiropractor it will feel stuck, possibly an increased temperature, and small amounts of swelling may be present. This is common to the condition chiropractors treat, a subluxation.

Diagnostic Imaging

In our office, we start with x-rays as part of our determination as to where to adjust. We do look for fractures or pathology, but our analysis includes measurements that we refer to each visit to know where adjust. We may order diagnostic imaging tests such as MRI scans or CT scans to get a more detailed view of the spine and joints. These images can help them identify specific structural issues or underlying conditions.

However, additional imaging usually doesn’t occur until after a few weeks of treatment. If you are not progressing fast enough, we may order additional studies to help determine what could be the reason. Many insurance companies will require 2 – 6 weeks of therapy before ordering advanced studies, but exceptions can be made for some conditions.

where to adjust

Chiropractic Assessment

Based on the information gathered from the patient history, physical examination, and any diagnostic tests, the chiropractor formulates a diagnosis and treatment plan. We identify areas of subluxation or misalignment in the spine or joints that may be causing nerve interference or musculoskeletal dysfunction.

This is how we determine where to adjust. Some chiropractic techniques involve instrumentation, which may include a special testing device that measures areas of tension or heat along the spine. That’s not something we do that our office, but it is another way chiropractors determine where to adjust on any specific visit.

Feedback from Patients

Throughout the treatment process, we rely on feedback from patients to assess the effectiveness of adjustments and make any necessary adjustments to the treatment plan. We have several methods of adjusting and will start with the one we think will work best for our patient. However, if for some reason we don’t feel like it’s working like it should or if you simply don’t like it, we can change it.

Getting the best results is very dependent on knowing where to adjust, but working with our patients allows us to get consistent results and keep them moving in the right direction as much as possible and as quickly as possible.

Overall, chiropractors use a combination of clinical judgment, physical examination findings, patient feedback, and diagnostic tools to determine where to adjust and tailor treatment to each individual patient’s needs.

Dr. Philip Cordova

About the author

Dr. Philip Cordova is a chiropractor in Houston, Texas. He grew up in Phoenix, Arizona and decided to become a chiropractor after hurting his back as a teenager and getting help from chiropractic care. He is speaker on health & posture. Click Here To Read His Full Bio

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