There are three important sections to a motion segment: the front part, the spinal canal, and the hole the nerves come out.

(Doctors call them the anterior portion, the neural canal, and the neural foramina, but when you translate from Latin to English it's pretty much what I just said. Sounds fancier in Latin.)

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The front part is responsible for bearing most of your weight. You can see on the picture that the spinal bones (vertebrae) have a portion that looks much more solid and massive, with a fibrous cushion between them. That cushion is called a disc and it allows the spine to bend in any direction, much like the crinkled portion of a bendy straw. It also acts as a shock absorber.

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The spinal canal is formed by the back parts of the spinal bone. In the illustration there is a top down view where you can see that there are more delicate structures that form a ring. These stack like napkin rings would, forming a sheath held together with flexible yet tough connective tissue called ligaments. This is where the spinal cord lives, suspended in cerebral spinal fluid. Both the cord and the fluid are further encased in a tough fibrous membrane that sits within but does not attach to the spinal canal formed by the spinal bones. The body is very serious about protecting this part of you.

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Every so often, a pair of spinal nerves branch off the cord and prepare to exit the spine. They leave, obviously, through the hole designed for that purpose. If you look at the side view of the motion segment, you will see a hole bordered by the front part to the front (including the disc), bone from each of the spinal bones to the top and bottom, and by a very special joint to the back.

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That joint is called a facet joint because the place where the spinal bones touch each other is smooth and flat like the facet of a gem. For now all I want you to know about this joint is that any problem with it--jamming, malposition, restriction of any kind--can affect the nearby spinal nerve as it leaves that hole, as can the disc and relative position of the spinal bones.

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Every part of your body requires a connection with your nervous system to live. It needs information from the brain to control it and needs to send information to the brain regarding how it is doing. The spinal nerves are the interface between most of your body and the brain/spinal cord. The motion segment with its neaural foramina, the hole the nerves come out, is the interface between the mechanical systems of the body and the electrical.

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What Can Go Wrong - Movement

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If a joint is stuck in the wrong position--or even in the right position--a predictable series of events happens.

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Every joint has a capsule that connects the two bones and contains joint fluid (synovium). When the joint sticks, the capsule around the joint swells. The muscles around it tighten, trying to either shift the joint back toward normal or at least keep it from moving further out of place. Either of these activities can irritate or even put pressure on nearby nerves.

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Depending on which nerve is affected you might get pain, burning, tingling or even cramping. You might get skin problems over the joint or pain that radiates far from the area in question. This is one way someone can get sciatic nerve pain, restless leg syndrome, headaches, arm pain--the list goes on.

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You can get a very wide variety of symptoms in a wide variety of places but they all have one thing in common: they started life as joints, usually spinal joints, that were stuck and malfunctioning. Get those joints positioned correctly and/or moving correctly again and the problems get better extremely quickly. This is the source of "Chiropractic Miracles" and "One Fix Wonders". Uncomplicated joint issues causing a multitude of potential symptoms, each one a clue pointing me toward the ultimate source of the problem--the Chiropractic "subluxation", the misalignment and malfunctioning of a joint and it's surrounding tissues.

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How did they get stuck? Gravity trying to crumple you into a ball, slip-and-fall, slip-and-not-quite-fall, sleeping in a twisted position, repetitively reaching in a way your body can't support, arthritis eroding the cartilage (allowing for more movement than the joint was originally designed for)--you know...Life.

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Most of the time your body tries to fix these subluxations itself. It uses random motions, exercises and even unconscious contraction of muscles while you sleep to try to fix itself. I only come into the equation when these methods are not succeeding. I get things moving and hopefully come up with a few more tools to help your body get things fixed in the future.

 

What Can Go Wrong - Structure

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Chiropractors spend a lot of time looking at people's structures.

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Structure to a chiropractor means any of the tissues that create, support or control the joint. This means bone, ligaments (connect bone to bone), muscles, tendons (connect muscle to bone), cartilage (lines most joints), discs, synovium fluid (inside joints allowing surfaces to glide on each other) joint capsules (surround the joint and hold the fluid), and nerves that both send information to and from the joint to the brain.

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What can go wrong with the structure of these things is a much shorter list than the types of tissues: CONGENITAL (born with it), DAMAGE (breaks and tears), and INFECTION. Following are just a few examples of types of structural issues. One potential category of structural issues--INFLAMMATION--is not being discussed here as it will have its own section.

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If you have a CONGENITAL problem, it might be something like a bone didn't finish becoming bone and stayed cartilage. This problem rarely matters except as an incidental finding on an X-ray. All bones start as cartilage and sometimes errors happen as we develop.

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Or maybe your ligaments are a little too long to give you proper stability at the joint--a classic example is someone who is doublejointed. Mostly these types of issues are safely ignorable. Until and unless they cause another issue, such as, say, chronic sprains, scoliosis, or headaches.

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More seriously, sometimes the body gets the plan truly confused during manufacturing, and very serious errors can occur. Depending on the type and location of the problem, this can sometimes be found for the first time at the chiropractor.

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DAMAGE is obvious. We take X-rays and do other types of testing to look for breaks. Tears are harder to find and I dream of MRI becoming as inexpensive as X-ray. Everyone knows someone who has torn a cartilage or had to have a rotator cuff tendon repaired.

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INFECTION can strike any type of tissue. When bone is infected, if it is not stopped, the infection eventually destroys everything it touches. Thankfully bone infection is very rare.

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A more common infection comes from inside a nerve. Specifically Shingles is a virus that reactivated itself after being stored in the cell body of one or more nerve cells. Shingles can mimic a pinched nerve, and a pinched nerve can look like the early stages of Shingles. The good news is the Shingles virus never destroys tissue. It just makes you miserable.

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Lastly, you can have more complicated disease processes that affect joints, from auto-immune disorders to rheumatoid arthritis to metastasis from cancer cells. You can also have more complicated diseases that mimic joint movement issues and vice versa. Anyone who has ever had a left upper rib shift out of position and pinch knows the dilemma of wondering if they need to go to the ER, as it causes sharp left chest pain radiating into the left arm and shoulder with sometimes difficulty in breathing. Understandably nerve wracking to experience as these are not symptoms to take lightly.

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ALL OF THESE THINGS can complicate, amplify, and even cause movement issues as discussed previously. Determining if there could be more than a movement problem is one of the primary jobs of a chiropractor.

 

What Can Go Wrong - Inflammation

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Inflammation to a chiropractor is the great unknown for when we try to figure out how long it is going to take to get you better. Is the inflammation around your joints caused by misalignment, something else specific or has it taken on a life of its own? What can be done about inflammation, other than removing triggers and letting the body sort things out on its own (adjust and see approach) depends on how committed your body has become to being inflamed. Which depends on your genetics, your diet, exercise, and current stage of life.

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Inflammation is a complex subject but a very simple concept. It can be explained in a few sentences and yet we don't really understand it at all.

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Let me explain: Inflammation is the body's immediate response system. It is designed to detect both damage and infection, start healing, fight bad guys, and clear away debris from wounds. It is traditionally described as having four parts: heat (calor) pain (dolor) swelling (tumor) and redness (rubor). As you can tell from the Latin descriptors, this understanding of inflammation dates back to Roman times.

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As we have come to understand how this works, we now know that sentinel cells detect problems and release chemicals that increase blood flow to the area (redness, swelling and heat) bringing in more white blood cells that help to fight the problem. Any dead or damaged tissue is attacked and other chemical messages are sent to start scarring to knit things together if needed. Damaged tissue (and a few of the chemical messages themselves) are detected by bare nerve endings in the tissue and a message is delivered to the brain--pain.

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How these chemicals interact with each other, with your hormones, with all the tissues of your body, and what kind of effects these combinations have on your body...well let's just say that researchers in this field have pretty good job security. Every time we learn one little piece of the picture it seems to change the whole puzzle.

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Inflammation is necessary to heal wounds. Interfere with inflammation too early and too well after spraining your ankle, and studies show that the ankle won't heal as well.

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(For those who are now curious, too soon is before about 15 minutes. You have to let the thing swell just a little, then ice compress elevate and gentle movement without weight and to comfort.)

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Inflammation closes wounds with scar and helps defend against bacterial infection. It clears away damaged tissue.

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But inflammation can cause extra scarring after surgery, is a prime villain in allergy and auto-immune processes, and is intimately involved in arthritis flare-ups. If we could figure out how to control how much inflammation the body experiences and when, then so many of our current treatments would work 1,000% better.

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We don't have all the answers, and there seem to be a million bits to track down and research, but most health care advice is about inflammation control. Here are a few that are well-supported by evidence:

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GOOD:
Omega 3 oils are stop signs to inflammation. Exercise. Most spices (not salt). Laughter. These are only a few general examples.

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BAD:
Saturated fat--with a few exceptions (coconut oil and avocado oil)--makes inflammation burn hotter. As does dietary sugar. Extra weight (fat tissue produces some of the extra chemicals produced in inflammation all the time.)

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This is why the anti-cancer diet is pretty much the same as the rheumatoid arthritis diet and the diabetic diet. It's really the anti-inflammatory diet.

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Before you ask, I don't have a solution that works for all or even most people. Answers work best when tailored to individuals and before and after measures are used to decide effectiveness.

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We know that Omega 3's, for instance, are helpful--but how much? For how long? There are people who can get you those answers, but most people aren't interested in the kind of changes it would take to live that way, nor able/willing to spend the kind of money it would take to find out.

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But we mostly know what we should be doing, and we can all make better choices.

 

​Can I adjust myself?

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I have gone back and forth several times on how to answer this one. And by that I mean the format for answering it. What to include, what to leave out.

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In the end I decided I was over complicating things.

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The simple answer is yes, but things can go wrong.

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Your body is designed to fix itself. When there is a problem with alignment at a joint, the body will immediately tighten muscles that might have a chance of pulling it in the right direction. Then your body hopes that random motion will produce the desired results. This is why people who move and stretch a lot and have strong muscles will generally see me less often than those who don't.

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But the muscles don't always have the leverage they need, or one problem may be in the way of another. That's where I come in, obviously.

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This is why I say there is a 24-48 hour window after the adjustment where your body is adapting. After I remove the obstruction to self-healing, the body takes over and continues the process.

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But can you "help" the process yourself, do your own adjustment?

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Not usually. There are ways to help self-correction. Exercises that can provide opportunities for certain problems to fix themselves. These exercises are distinct from stretching and strengthening exercises in that they are almost always brief, just a few repetitions, and work to mobilize your problem areas.

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And some chiropractic corrections are safe to teach lay people, and can be performed by spouses or friends after a little training to give them confidence. I should note that this does not include any sort of twisting move, especially to the neck.

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But, actual chiropractic adjusting moves performed on yourself are at best ineffective. Usually you can't reach, or if you can, the act of lifting your arms tightens the wrong muscles and prevents correction. Some people will have developed specific stretches and quick moves that produce that "popping" noise that knuckles can make--these can be good or bad long term, and I need to see what each person is doing to judge. In general, though, if it doesn't involve twisting, it's probably not going to hurt you. Twisting I always have to see what you're doing to know.

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​​SUMMARY AND FINAL THOUGHTS

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The mechanical human body is an infinitely complex combination of pulleys, levers and springs.

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The electrical system (nerves) and circulatory systems (blood and lymph) are right next to the places where the pulleys, levers and springs interact.

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When something goes wrong mechanically, it can affect the electrical and circulatory systems as well as other mechanical areas.

Normal activities can cause things to jam and misalign, not just accidents and injuries.

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We are designed to correct ourselves, but it doesn't always work. The stronger and more active we are, the more opportunities our body has to fix itself.

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Because we are designed to self-correct, a chiropractor can help things along that are stuck, remove strain on the mechanical system and indirectly affect the nerves and circulation.

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If the body isn't trying to fix it, or if there are too many factors interfering with correction, chiropractic will not be effective at changing symptoms. However, sometimes a change of a few millimeters is enough, especially when arthritis is involved.

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Chiropractors receive the same diagnostic and science training as medical doctors and thousands more hours of training on the mechanical parts of the body, but less than 10% of their training in pharmaceuticals. We do not prescribe, but in many states (not Wisconsin) can be primary care physicians.

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