Fixations and Subluxations

A patient who has been with me for about 6 months now shared this observation with me today.  He reminded me that he had been to another DC before consulting our office.  He has a long, long history of debilitating LBP with the usual radiations etc.  He also has sleep difficulties combined with RLS and so was medicated to try and sleep with less pain and spasticity.  His original DC was a young grad working in a downtown rehab styled clinic.  The doc was thankful that he had access to the MRI’s because they “absolutely contraindicated adjustments” and so the course of extended care was only focused on core strengthening.  No manipulations, no passive stretching just core retraining.  My patient was faithful to a fault and finally recognized that he had tapped the expertise of this lad with no appreciable improvement and called to see if there was some way to ease the chronic pain.

I’m not going to comment on the selection process in the colleges but the results are evident when the majority of candidates are kinesiology grads with a biomechanical background.  The challenge that faces all DC’s is defining what makes them and their offerings of chiropractic unique. There is certainly nothing that warrants chiropractic uniqueness in a better approach to core training.  For God’s sake lets all get over the distinction between fixation and subluxation.  What makes the chiropractic approach unique is that the “lesion” that emerges as a consequence of altered neural tone and a limitation in the expression of innate is a subluxation.  A component of the subluxation process is a vertebral reaction that may or may not exhibit a fixation in the biomechanics of a segment or two.  We all endure fixations either episodically or chronically.  It’s part of living in a gravity and motion dependent existence.  Remember the original definition presented by Palmer via Stevenson in 1927.  There were three necessities to claim the existence of a subluxation: loss of position and inevitably motion of 2 contiguous vertebra; an alteration and eventual closure of the IVF and most of all an interruption in the expression of the Innately tuned mental impulse. Well, 1 and perhaps 2 are associated with fixation but there must be a shift in neural-dural tone to qualify as a subluxation. 

If you remember my model of subluxation for patient orientation using the three layers concept, then it is so easy to understand that layers one and two associate with fixation while a persistent disturbance interfering with the communication along the 3^rd layer of neural-dural tone means that the person is no longer suffering from the limited biomechanics of a fixation but rather, they are developing devastating health issues related to the loss of vital communication. Subluxations are identified and adjusted by chiropractors and so that is what our role is within the community of healers and health care providers.  We are also incredibly capable of coaching and advising how to optimize the results while under adjustive care and to share and care for people to limit the potential to become subluxated. There is a lifetime of work to do in our communities let alone within the world.

Back to my patient…  I identified that indeed he was subluxated in several regions of his spinal core.  We reviewed his neural efficiency patterns and looked at the destructive changes to his spine. He was definitely fixated in many regions including his lumbo-sacral region. Undoubtedly the tissues in this region were generating tremendous pain and restrictions.  Joints and soft tissues hurt like hell when they are damaged and stressed out.  We identified his limitations in lifestyle management and we laid out a care plan that addressed his immediate issues and offered to care for him through the reorganization time frame encompassing recovery, restoration and finally, wellness care.  He was told that this was to be a collaborative effort for him to achieve the best results BUT if he chose to just use adjustments as a therapeutic approach, that was OK as well.  This thing called an adjustment works whether the patient is totally compliant with lifestyle modification or not.    In my years of parenting and “spine-parenting” I have learned it is wise to be creative in inspiring people to achieve results.  Guess what?  He is feeling better and healing at the same time.    If we were to look at his MRI and biomechanical parameters he would still be in trouble but his neural scans are shifting and easing.  He describes many wellness improvements such as clearer thinking, less night pain and spasticity, improved digestion and more mobility in the spine and he is happy!  It’s probably all a placebo because his structural metrix are all abnormal still.  I agree whole heartedly with the young DC that manipulation of this man’s lower spine is risky and non productive.

 If managing the deteriorative fixation was the goal of care, I suppose all that I would be left with is the surface approach to soft tissue and mobilization with movement.  As a chiropractor my eyes are on the subluxation and if there is a chance to adjust it, and why wouldn’t there be, then this man will improve and heal.  That’s the law of nature that is embedded in the philosophy and the principles, all 33 of them, of the chiropractic doctrine.  Of course there is limitation of matter but so long as there is a life spark and enough time, there is an opportunity to heal on many levels.

It’s just right to be and act as a chiropractor if you are going to call yourself one.  It’s a glorious and noble profession that has spent too much of its time trying to fit its philosophy and practice into the square hole dictated by medicine and chiropractic licensing boards. Be the artist that you know you are and stop defining the care you do as a modified physio approach.  Find the subluxations and adjust them.  There will be much more healing going on at that table and it won’t be limited to the person lying on it.

Happy New Year to all of you who read and respond to this blog. 2010 is already becoming a powerhouse of change. We have filled up the two coaching spots that were available and so my amazing assistant, Linda, has bribed me to open up two more.  You are welcome to call in and see if my communication training and my methods of practice development are right for you.  If not, I get a chance to meet more cool people from around the globe!  Be well and Be Great!