Avoiding the use of medications and surgeries as much as possible, it is mainly through the body handling of the patient that the professional adjusts, aligns and stabilizes the anatomical structures.
It is one of the most used manual therapies and focuses on maintaining and restoring health, establishing a relationship between structure (body) and function (performance).
More specifically, if the impulses (function) that depart from the nervous system and pass through the spine are occurring properly until they reach the muscular and skeletal systems (structure).
For chiropractic, subluxations occur between the vertebrae – minimal misalignments of the spine that are too small to configure a dislocation – that can generate neurophysiological consequences, called the vertebral subluxation complex.
In other words, that back pain , body asymmetry or lack of flexibility can be the result of minor spinal maladjustments.
Chiropractic care, then, uses body handling to adjust or treat changes related to the nervous, muscular or vertebral system – usually in an interconnected way – without the use of medication and avoiding, whenever possible, surgical procedures.
But it is worth mentioning that the spine adjustments are only one of the chiropractor’s actions, as the treatment consists of therapeutic planning encompassing the organism as a complex system.
For this, the professional can also link focused exercises, compresses, behavioral advice (such as changes in diet) and methods to reduce stress .
Although the focus of the chiropractor is the spine, the entire organism can be treated with therapy.
This is because vertebral handling and other professional indications (such as posture and exercises) allegedly help reduce inflammation and release nerves, promoting different results, such as improvements in the respiratory and digestive systems, for example.
In general, the first thing associated with the chiropractic session is the crackling. But the object is not necessarily to make the joints crack, it is just a consequence of the vertebral adjustment.
Chiropractic comes from the Greek “Quiro” (hands) and “Praxis” (to practice), being something like “made with the hands”. Although manual therapies are thousands of years old, chiropractic has a more recent history, and the method was developed in 1895, in the USA.
Daniel David Palmer is the founder of the approach and used several sources for its elaboration, such as medical manipulation, osteopathy and bonesetting (body manipulation to readjust bones in their proper places).
In fact, chiropractic has emerged as a breakthrough. In the same building that Daniel Palmer worked in, there was an employee named Harvey Lillard, who had lost his hearing about 17 years ago.
According to the records, the man had bent down to pick up a bucket and, in the middle of the movement, heard a crack. In fact, that was the last thing he heard with his left ear.
Daniel Palmer, when examining it, noticed a lump or lump in the vertebral region, which was enough for the association between deafness and the crack to be suspected. When pressing the spine, making the vertebra return to its proper place, the employee’s hearing returned.
It was in 1897 that the first chiropractic training school appeared, in the United States of America, in the midst of a period of significant changes and reforms in the medical and therapeutic approach.
Since then, therapy has improved and gained recognition:
- In 1933, chiropractic wins the Federation of Chiropractic Licensure Councils, strengthening its therapeutic and formative aspect;
- In 1997, the World Chiropractic Federation established official relations with the World Health Organization (WHO);
- In 2005, the WHO Guidelines on Basic Training and Safety in Chiropractic are published, gaining a worldwide sphere.
In Brazil, chiropractic was reported in 1922, but it was only in the 2000s that the first undergraduate course was implemented in the standards of the Chiropractic Councils of Education and by WHO.
Currently, Brazil has 2 courses recognized by MEC and more than 800 active professionals.
Chiropractic and the neuromusculoskeletal system
Chiropractic works mainly with spinal adjustments, but the goal is to promote a complex and interconnected body alignment. Which means that the muscular, nervous and skeletal systems benefit.
So, to understand therapy, you need to understand a little about each of these systems:
The nervous system is at the base of the brain and visually resembles the root of a tree, where each segment is linked to the activities and functions of the body.
The spinal cord receives and transmits nerve impulses, controlling and promoting the body’s senses, movements and functions, such as walking or controlling blood flow.
The vertebrae function as protective structures for the spinal cord, as they have a kind of internal channel, through which the spinal cord passes and is protected from external impacts and trauma.
The correct alignment of the column allows the transmission of impulses to be properly carried out. When there are subluxations or joint dysfunction (minor spinal maladjustments), they are able to affect bodily systems and functions to varying degrees – from mild pain to difficulty walking or listening.
The spine is a segment formed by bony structures (vertebrae) and intervertebral discs, but it also has ligaments, tendons and muscles.
The vertebrae in general are responsible for supporting the body, but the spine has structures that make it also responsible for movement: the invertebral discs.
As there is a flexible and relatively malleable segment, the body can bend, bend and twist without causing damage to the bones. In addition, intervertebral discs also absorb impacts.
Naturally, the spine is divided into 4 parts, which are the cervical (part close to the neck), thoracic (upper back), lumbar (lower back or waist region) sacrum and coccyx (pelvic region).
Natural curves are necessary to give stability to the body, as it would be quite difficult for the human being to remain upright, if the back were absolutely straight and inflexible.
Common activities, such as walking, running, sitting and carrying weight, impact the organism at different levels.
Called stress, these impacts, which are normal, affect body structures, such as muscles, breathing, bones, blood flow and, especially, the spine.
For example, carrying heavy backpacks can impact posture, causing the spine to be more curved ( kyphosis or hyperlordosis), causing pain.
However, there is yet another very important aspect for chiropractic.
The vertebrae are not blocks of bones, but structures that form a kind of channel or pipe. The spinal cord and a series of nerves connect the spinal region to different parts of the body.
It is through these nerves that brain commands or messages are sent to the body and reach the muscles, for example. That is, the movement does not appear in the muscle.
When you want to move a leg, impulses are emitted in the motor region of the cerebral cortex, pass through the spinal cord, are conducted through the nerves and finally reach the muscles, resulting in movement – all in a very fast and constant process.
The cervical region (part close to the neck), for example, is related to the medulla oblongata, which is responsible for some activities such as regulation of the heartbeat, dilation or narrowing of blood vessels and muscular contractions of the esophagus (helping in the conduction of food until the stomach).
Activities such as hearing, taste perception, salivation, digestive action and muscle control in some regions are centered on the cervical part.
Therefore, changes or dysfunctions of the spine can affect the proper functioning of these activities.
Muscles are tissues that cover bones and participate in body movement. As they help with body stability and balance, bone changes and poor posture can cause pain, limitations and muscle dysfunction.
Among the muscles most involved in supporting the spine are the extensors (back and buttocks), the flexors (abdominal and hip region) and the obliques (lateral muscles). Together, they mainly involve the regions of the abdomen down to the legs.
For the body to move properly and the person can perform their daily activities normally, it is necessary that the conduction of nerve stimuli is adequate and can reach the muscles.
So, if there are changes in the middle of the path – between the nervous system and muscle tissue – the organism is affected in different intensities.
What is a subluxation?
Subluxation is a term used to define very small changes in the positioning of the vertebrae, but which, due to the dimension, do not compose a dislocation. They can cause pain, reduced mobility and even interference in the transmission of nerve impulses, affecting the integrity of the organism.
By causing a millimetric misalignment in the spine segment, the holes that give way to the nerves (called the intervertebral foramen) are reduced, causing compressions and irritating the nerves.
When nerve damage occurs, other functions of the body are affected, resulting in the Vertebral Subluxation Complex , which is the set of changes triggered by the vertebral maladjustment.
It is very difficult to avoid subluxations, once the triggering factors are present in the vast majority of human activities.
Falls, beats and traumas, although mild, are the most intense, but posture, the use of some medications or drugs, alcohol, as well as emotional factors (stress, anxiety , sadness) are also involved.
Bearing in mind that these alterations, although quite small, can generate great discomfort and interfere with the action of other systems. Thus, the following may occur:
- Losses in the delivery of nutrients to the intervertebral discs and involvement of the muscles, due to changes in the movement of the joints;
- Changes in balance and muscle contraction and relaxation;
- Changes in neural impulses, which can cause damage to various organs or systems of the body;
- Inflammation, fibrosis, tendonitis or other tissue changes close to subluxation;
- Osteoarthritis process, that is, joint degeneration. When subluxation occurs, the vertebral bones can be misaligned and suffer friction, which tends to continually erode the intervertebral disc.
What is chiropractic used for?
Chiropractic serves, in general, to readjust and realign the spine, using body handling and other approaches .
Although the idea of treatment is generally associated with dysfunctions and pathologies, chiropractic can be performed even by people without specific complaints, when there are still no obvious symptoms, as the patient is evaluated individually and the approach is adapted.
The adjustment of the spine aims to make the nerve impulses optimized, as soon as there are decompression and spinal releases that can affect their forwarding to the muscles or systems.
Among the most common conditions met by chiropractors are:
- Back pain;
- Herniated disc;
- Ringing in the ear;
- Herniated disc and sciatica;
- Muscle tension;
- Joint problems (shoulder, elbow, wrist, knee, ankle);
- Movement restrictions or difficulties;
- Repetitive strain injury (RSI) or work-related musculoskeletal disorder (WMSD);
- Asymmetry of limbs due to non-congenital causes.
It is worth remembering that the organism is an integrated system, therefore, the chiropractor can also assist in the diagnosis of other conditions that need specific treatments. For example, with neurologists, endocrinologists, cardiologists or psychologists.
Thus, after an evaluation, it is possible that the source of the problem is discovered and, together with chiropractic care, the patient needs specific follow-ups for the clinical condition.
What are the benefits of chiropractic?
Chiropractic has effects and benefits throughout the body. Often, patients resort to therapy to treat specific problems, such as back pain, but they have improved quality of life and well-being.
Among the results of the practice are:
Some pains and discomforts can be resolved only by performing the spinal adjustment, as nerve compression is the source of the problem. Some conditions, such as fibromyalgia or herniated discs , although not completely eliminated, can have significant reductions in pain intensity.
Improves systemic functioning
Since nerve signals are emitted through the spinal cord, any obstruction of the vertebrae can reduce or interfere with the delivery of these impulses. The result is that even vital organs can be affected, such as the heart, lungs and brain (by not receiving adequate feedback from nerve signals).
Small changes and improvements in the body can result in more quality of life, reducing the difficulties and discomforts encountered by patients in daily tasks. With less pain, better movement, better relaxation and greater mobility, the patient recovers or optimizes well-being.
There are two mechanisms to improve emotional aspects and promote relaxation of the body: as the adjustment helps to alleviate pain, the patient feels lighter, acting directly on the muscular system.
The other refers to quality of life. With less difficulty in daily activities or discomfort (such as headaches), patients feel the reflexes on mental health and well-being, reducing anxiety and irritation.
What are the advantages?
The advantages of chiropractic practice include reducing pain and improving quality of life through non-invasive and non-drug techniques.
Although the use of drugs, when necessary, should continue according to the medical recommendation, the chiropractor does not work with prescription medications and aims to work on the patient’s problem so that no surgical or medication treatments are necessary.
The effects are also usually immediate and gradual, that is, in the first session it is possible to feel pain relief and body relaxation, and as the treatment continues, the benefits are perceived in other activities and the functioning of the body.
In addition, the practice is recommended for all ages and, along with body handling, the professional will indicate other activities that aim to improve the quality of life, such as posture corrections, improvements in eating behavior and indication of other professionals to work together .
How does the treatment work?
The first consultation with the chiropractor consists of assessing the patient, in which the observations, complaints and objectives are heard by the professional.
The body examination will also be carried out, in which the neurological and orthopedic aspects are evaluated, and vertebral adjustment procedures can be performed if the patient is fit for therapy.
In some specific cases, the chiropractor may, before starting treatment, request additional tests, such as X-rays , tomography and MRI, in order to analyze the aspects of the spine in more detail.
These procedures are the hallmark of chiropractic and consist of rapid movements, using controlled force and precision, moving and releasing the joints.
Often, these rapid movements generate crackles, but the action is always careful, safe and does not cause pain.
The next consultations involve adjustments or specific vertebral reallocations for each person, always according to the chiropractor’s assessment.
The length of each session, the duration of treatment and the weekly frequency depend on each treatment and the patient’s condition.
In general, the session lasts between 20 and 50 minutes, and the frequency is between 1 and 2 times a week at the beginning of the treatment.
In some cases, the patient may return to the consultation only as maintenance therapy, making new adjustments weekly, monthly or half-yearly. Thus, there are 3 possible phases of therapy:
- Intensive: consists of 1 to 3 weekly consultations to treat specific conditions or pain;
- Corrective: usually once a week or fortnight to improve posture and flexibility;
- Maintenance: in general, 1 consultation every month, quarter or semester to maintain the results obtained.
Read more: Massage therapy: what it is, types and benefits
Chiropractic approaches and techniques
Although adjustment (and crackling) is closely associated with chiropractic care, they are not the only therapeutic resources. Learn more about some of the possible approaches:
Spinal manipulation is probably the most famous chiropractic intervention. In it the professional applies strength and movement to the joints, in order to adjust the segments and relieve pain or other problems.
The professional can count on some accessories to adjust the spine, such as special stretchers. The device has adjustable axes that facilitate the handling of specific joints, such as those of the hip.
Activation method with Impulse IQ
The impulse IQ is a high-tech portable device that facilitates the adjustment of vertebrae. Similar to a small pistol, it can be used for regions that are difficult to handle or when the patient still feels insecure in traditional handling.
Flexion Distraction / Decompression
In order to stretch the spine and repair intervertebral discs, the chiropractor can use machines or distraction accessories. They are usually adjustable stretchers or positioners (similar to cushions with special curvatures).
Ischaemic Compression Trigger Point Therapy
The professional applies, in the painful region, a deep pressure using equipment (for example, the IQ), in a slow and progressive way until the pain is eased. In this case, the pain has a muscular origin, being called trigger points.
The pressure helps in blood circulation and consequent oxygenation of the region, relieving discomfort and muscle pressure.
Active Release Technique
The chiropractor uses local pressure with devices along with body movement as a way to relieve pain. But, in this type of handling, the patient performs the movements himself, which is why it is called the active relaxation technique.
In order to reduce pressure, increase blood flow and facilitate muscle repair, the chiropractor uses specific instruments on the sore muscle region.
The equipment applies pressure at adjustable intensities, according to the patient, gradually and continuously.
In some cases of muscle pain, the use of ice packs on the site may be indicated. Cold helps in the contraction of muscle fibers, reducing pain and inflammation.
Why does the joint crack?
The crackle, or cavitation, is that noise that the joint sometimes makes, and it is a normal reaction. This is because inside the joint capsule (membrane that covers most of the joints) there is a liquid called synovial fluid, to lubricate the joints.
As it is composed of the gases oxygen, nitrogen and carbon dioxide, the liquid may form bubbles which burst to generate the click noise.
When chiropractic adjustment is performed, there is an increase in joint pressure and the consequent burst of these bubbles. So, that noise.
Remembering that this snap is not harmful and does not harm the organism or the articular region. It is also important to note that the noise is not mandatory, and even if there was no cracking, the joint was adjusted.
Does this mean that snapping your spine is the same as snapping your fingers alone?
So-so. The process is the same: the noise occurs due to the bursting of the gas bubbles. However, snapping the joints on your own is doing it without any technique or need.
The chiropractor analyzes the regions that need adjustments and promotes vertebral realignment, causing cracking to occur sometimes – this is due to the purpose of correcting the misalignment.
When we click through the habit, there is no purpose of correcting or improving the joint, causing a habit to be created that can even aggravate the compressions or deviations.
How long does recovery take?
As with any treatment, the duration of chiropractic depends on a number of factors, such as age, cause or origin of the problem, lifestyle and activities together (such as diet and stress).
It is not exactly a rule, as it depends on the professional’s evaluation, but the beginning of treatment usually consists of between 1 and 3 weekly consultations.
As the patient improves, the frequency decreases. On average, it takes up to 3 months of regular weekly consultations until there is a reduction in attendance. But there are patients who have long-term maintenance appointments – even years.
Such maintenance can consist of a consultation every 3 or 6 months, for example.
Price: what is the value of a chiropractic session?
Chiropractic sessions cost, on average, between R $ 100 and R $ 300, and the first service may have a higher value, due to the professional’s evaluation.
The following consultations may vary in value, depending on the new approaches and procedures performed.
The service can also be provided by the Unified Health System (SUS), free of charge. Therapy is in the category of integrative therapies, along with other modalities such as acupuncture, floral, homeopathy and meditation.
It is important to consult the health and care units to check availability and offer.
Chiropractic can be performed by people of any age, even if they have no specific complaints (such as pain). However, there are some conditions that should always be observed by the professional.
There are general conditions that prevent the person from being subjected to manual adjustments to the spine, such as:
- Joint disorders : such as rheumatoid arthritis, spondyloarthropathies and demining with anatomical displacement, in addition to fractures and bone displacements;
- Disorders that involve bone weakening and destruction : such as bone tumors and bone and joint infections;
- Circulatory and hematological disorders : such as vertebrobasilar insufficiency syndrome and aneurysm;
- Neurological disorders : such as acute myelopathy, intracranial hypertension, cauda equina syndrome;
- Psychological factors : patients with psychological disorders may compromise the chiropractor’s assessment and result in inappropriate treatments. Among the conditions are hypochondria, simulation of symptoms and dependent personality.
Is chiropractic dangerous?
In general, no , as long as it is carried out with duly qualified and qualified professionals.
Chiropractic has good results in relieving pain and discomfort, remembering that the appropriate treatment is carried out before an attentive professional assessment focused on each patient.
It is worth mentioning that every therapy or procedure includes risks and contraindications, with the fundamental role of the professional being able to assess and manage each condition. Some patients may experience headaches, dizziness and stiffness in the manipulated site, but they resolve spontaneously within 24 hours.
These symptoms or manifestations do not, in general, represent anything serious and tend to occur only after the first sessions (they may even occur after physical activities or movements that the body is not used to).
Although it may seem dangerous to manipulate the neck or spine, the practice is quite safe and there are few reports that have been triggered by chiropractic.
Like other professions, to find a good professional, it is essential that he is duly qualified to practice the profession.
Therefore, you can search for a chiropractor close to you through the Brazilian Chiropractic Association, which has an up-to-date and easily accessible register on the portal .
Risks and complications
Like any treatment, chiropractic care can involve risks, even though they are rare occurrences.
In general, complications are the result of poor training or professional assessment, causing therapy to be performed in contraindicated patients.
In rare cases, partial or complete obstructions of the vertebral arteries can occur, compressing the region.
In this case, symptoms such as dizziness, dizziness, disorientation, imbalance, ataxia (loss or reduction of muscle control), nausea or vomiting, dysphasia (difficulty in speaking), paresthesia (numbness) on one side of the face or body, may appear. in addition to sudden and severe pain in the neck or head.
Complications can occur:
- Neurological : severe changes and stroke;
- Cervicals : vertebrobasilar accidents, Horner syndrome, diaphragm paralysis, myelopathy, cervical intervertebral disc injuries, pathological fractures;
- Thoracic : rib fracture and costochondral diastasis;
- Lumbar : increased neurological symptoms resulting from disc injury, cauda equina syndrome, lumbar disc herniation, rupture of abdominal aortic aneurysm.
Read more: What is Paresthesia?
Chiropractic course (college)
The chiropractic course has been authorized and recognized by the MEC since 2005. The subjects involve the concepts of anatomy, organic functions, physiology and biomechanics, involving fundamental aspects for the correct functioning of the organism.
The curriculum includes subjects such as nutrition, health and community assistance, basic medication aspects and specialized academic activities.
Currently, there are two colleges in Brazil that offer higher education in chiropractic, Feevale (RS) and Universidade Anhembi Morumbi (SP), with a 5-year course, and specialization centers for graduated health professionals.
The student will develop and improve the knowledge of chiropractic assessment and intervention, in addition to addressing ethical and social commitment, communication and knowledge production.
With the training completed, the chiropractor is qualified to work in clinics and offices, whether integrated or private.
The vast majority of graduates leave for clinical care, which can be in specialized or multidisciplinary places (working with other areas of health).
What does it take to be a chiropractor?
Chiropractors are professionals with degrees in chiropractic or physiotherapists who have expertise in the field.
Although there are two colleges that offer chiropractic training at a higher level, the practice of chiropractic care is a specialty of physical therapists, according to Law 938/69, since 2001.
Law processes and projects are moving towards making the profession independent, recognizing it as autonomous.
However, the legal exercise of chiropractic is still qualified by the physiotherapist, as pointed out by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO).
Thus, physiotherapists can exercise chiropractic but cannot call themselves chiropractors without having taken the specialization course. For the degree, the physiotherapist must attend, at institutions recognized by the Ministry of Education, a postgraduate degree of at least 400 hours.
Salary: how much does a chiropractor earn?
The salary of a chiropractor is highly dependent on his demand, amount of care, the axis he works on – SUS or the private health network – and training (technician, graduate or chiropractic physiotherapist).
According to data from FIPE (Foundation Institute of Economic Research), among technicians, physiotherapists and chiropractors, the average salary is between R $ 1200 to R $ 3200.
Massage and chiropractic
Chiropractic can be very functional to relieve tension and promote relaxation, as well as a massage, but the mechanisms involved are quite different.
Massages can be performed, in general, by anyone without the need for a very specific evaluation. Chiropractic care, in spite of having few contraindications, requires a very detailed professional assessment.
There are different types of massage, ranging from the simplest and with relaxing purposes – to a self-massage – to those specialized, made by massage therapists and professional masseuses.
The main purpose of massages is to relieve tension, relax the body and relieve pain that has no pathological, inflammatory or functional relationship.
Osteopathy and chiropractic
Osteopathy and chiropractic are two very similar approaches, which use body manipulations to relieve pain and treat changes in the body. In addition, both work without the use of medication and are recognized by the World Health Organization.
However, some differences characterize each therapy. While chiropractic is focused on spinal adjustments, which is the professional’s axis of action, osteopathy pays equal attention to other systems, such as the circulatory, respiratory and neurological systems, also acting on the extremities of the body.
In osteopathy, the medical view takes the patient’s organism as a whole, comprising the weights of each system as equal. Thus, treatment consists of identifying and resolving the source of the pain and not necessarily the painful place.
Complementary and alternative therapies have gained space among patients and, also, the medical community.
As they use non-invasive and non-medicated forms, manual approaches are options for working on the body and health, relieving discomfort, pain and improving the quality of life.
Chiropractic care can then bring significant changes to people who suffer from specific complaints or are looking for more health and well-being.