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Index
Common Chiropractic Terms / The Chiropractic Evaluation / 
Five Components Of The Vertebral Subluxation / 
Five Components Of The Chiropractic Diagnosis /
Common Concomitant Musculoskeletal Injuries / Some Other Concomitant Conditions /
Descriptive Terms For Pain / Common Diseases Of The Spine /
Common Spinal Distortions / Common Developmental Malformations /
Common Degenerative Conditions / Five Phases Of Degeneration /
Course Of Case Management / Types Of Treatment / Muscular Rehabilitation
Optimal Nutrition / Determination Of Recommendations

 

Vertebrae: One of 24 spinal bones, 7 cervical, 12 thoracic and 5 lumbar.

Sacrum: The triangular shaped bone at the bottom end of the spine. It is the base of the 24 spinal vertebrae.

Ilium: The hip bone. The sacrum attaches to both iliums at the left and right.

Disk: The disk or disc is a rounded, flexible cushion between each vertebrae. It functions as a shock absorber and is necessary for movement.

Motor Unit: A motor unit consists of one disk between the vertebrae above and the vertebrae below.

Fixation: When a vertebrae or one or more motor units get out of its proper position and becomes stuck in a chronic situation of stiffness.

Spinal Fusion: The motor unit has lost its normal motion and the disk has degenerated to the point the vertebrae are now growing together.

Vertebral Subluxation Complex: One of the most severe forms of interference known to a healthy body's function. Doctors of Chiropractic know this condition puts pressure on spinal nerves and the related structures, unbalances the body, generates fatigue, lowers resistance to disease, and weakens the whole body. All elements of the body's natural healing ability may be affected.

Pain-Symptom Complex: A chief complaint that may consist of; pain and tenderness, numbness, headache, restricted and painful range of motion, nausea, stomach upset, constipation, light bothers the eyes, nervousness, ringing in the ears, loss of smell, loss of balance, tension, chest pains, sleep problems, dizziness, restlessness, fatigue, cold sweats, depression, fever, memory loss, itching, cramping, tingling, burning, shortness of breath, loss of taste, trouble sitting/standing/walking/riding/bending/lifting, and other related symptoms of the vertebral subluxation complex.

Exacerbation: When the chief condition becomes irritated, worse or re-injured from any cause. Some conditions are subject to exacerbation.

What is Chiropractic Spinal Care? The chiropractic approach to wellness through specific spinal alignment.

What is a Chiropractor? A doctor that has spent years of highly specialized training in order to locate and correct the misplaced spinal bones that impinge the nerves which travel down the spinal cord exiting out through the spinal bones to the muscles, organs and glands of the body. The Chiropractor is the only doctor who can locate and correct the vertebral subluxation complex.

What is a Massage Therapist? A therapeutic health practitioner with a basic competence in anatomy and physiology who has undergone many hours of training in several types of massage. In Florida massage therapists are licensed. Massage has been used throughout recorded history to promote health and well being. Hippocrates, known as the Father of Medicine, used massage for both patients and athletes.

A complete history is necessary followed by physical examination and analysis that includes: postural and gait analysis, regional range of motion, chiropractic instrumentation, chiropractic leg checks both prone and supine and motion and static palpation. A determination is made to continue with muscle testing, sensory testing and orthopedic and neurologic examination. Results of testing may lead to necessary spinal x-ray studies and/or other diagnostic tests.

The chiropractor has long used temperature reading for a diagnostic impression and to monitor patient progress. It is a well known fact, that all disease is accompanied with either and increase or a decrease in skin temperature.

Correspondent sides of the human body should emit the same temperature patterns when measured. Chiropractors use thermographic equipment to monitor this physiologic response to health.

The Chiropractor can determine this abnormal finding and correct it through specific adjustments long before any other positive tests results show up.

The medical profession is aware of this temperature imbalance but since it shows up before a specific diagnosis is made, The medical approach is to wait until other tests are positive to begin a medical course of treatment.

All Chiropractic findings, information and response to care is integrated as a guide for the purpose of further clinical assessment. (For the Professional)

Chiropractors believe that the vertebral subluxation complex is the underlying cause of many health problems. When the vertebral subluxation is corrected the body is able function more normally and initiates the normal healing process.

1. Spinal Kinesiopathology: This is abnormal vertebral positioning and motion. It can be caused by spinal injury, emotional stress or other trauma. This condition prevents normal bending and turning leading to the other following components.

2. Neuropathophysiology: This is a interference of the delicate nerve tissue. The nerve can be pinched, twisted, stretched, or irritated in other ways by abnormal spinal function. This causes abnormal nerve function or dysfunction and may be felt as numbness, tingling, pain or other symptoms.

3. Myopathology: The spinal muscles may weaken, atrophy or go into spasm. Fibrosis and scar tissue may develop making it difficult for the involved muscles to function properly.

4. Histopathology: Swelling and inflammation become involved and can cause irreversible damage to the soft tissue. The involved ligaments can stretch or tear, the involved discs can bulge, herniate or degenerate.

5. Pathophysiology: The malfunctioning spinal joints develop abnormal bony growths like lipping and spurring. Other systems of the body become involved and malfunction because of the subluxation degeneration process, scar tissue and long-term nerve tissue irritation.

NOTE: "The nerve tissue controls and coordinates all organs and structures of the human body." (Gray's Anatomy, 29th Ed. page 4)

Formulating the vertebral subluxation based chiropractic diagnosis is a discovery process in itself. The Doctor of Chiropractic is compelled to correlate all chiropractic evaluation findings including the historical data, physical examination findings, results of x-rays and other tests to arrive at a meaningful chiropractic diagnosis.

l. The principal Condition is the primary cause of the patient's chiropractic problem. It is called the vertebral subluxation.
2. Associated Conditions are neuromusculoskeletal conditions closely joined to, but not necessarily dependent upon the primary condition. Associated conditions may be described as acute, traumatic, chronic, mild, moderate, severe, etc. Some examples of associated conditions are cephalgia, arthralgia, myalgia, neuralgia, radiculitis, and sprain.

3. Concomitant or Possibly-Associated Conditions are included if visceral or systemic clinical findings appear to be related to a particular vertebral subluxation. To properly postulate a possible association between a vertebral subluxation and a particular visceral clinical finding, there must be an evident relationship by regional neurological anatomy between the vertebral subluxation and the visceral structure manifesting the clinical finding. Specific parasympathetic and/or sympathetic nerves which innervate the visceral structure manifesting the clinical finding will be distorted or irritated by the vertebral subluxation.

The possibility of a relationship between the vertebral subluxation and the visceral structure manifesting the clinical finding exists if the onset of clinical findings begins simultaneously with or in close proximity to the onset of the vertebral subluxation.

If after correcting the vertebral subluxation, the visceral findings resolve, it can be concluded that a possible relationship between the vertebral subluxation and the visceral clinical findings existed.

Some examples of concomitant or possibly associated conditions are: depression, high blood pressure, vertigo, weakness, hypoglycemia, weakness and indigestion.

4. Complicating Conditions can be neuromusculoskeletal or biomechanically related conditions that developed previously, in conjunction with, or independently of the vertebral subluxation.

They can be traumatic, degenerative, metabolic, malignant, infectious, auto immune, congenital and or compensatory. They are significant to and may complicate or retard the correction of the vertebral subluxation. Complicating conditions may even contraindicate some adjustment procedures.

Some examples of complicating conditions are: ankylosis, degenerative joint disease, diabetes, discopathy, spinal surgery, emphysema, heart disease, kyphosis and stenosis.

5. Aggravating Conditions are various lifestyle risk factors that include environmental and occupational hazards which aggravate the vertebral subluxation or its components. Some examples of aggravating conditions are: bad diet, excessive or poor exercise, obesity, smoking, stress and occupational and environmental hazards.

There can only be one primary vertebral subluxation listed. Any and all other vertebral subluxations are listed as secondary. The secondary vertebral subluxation can exist independently or it may aggravate or complicate the primary condition.

NOTE: Due to some complicating and aggravating conditions the subluxation can be of a permanent nature and require prolonged or continued care.

Sprain: Most common concomitant musculoskeletal injuries include sprain. A spinal sprain occurs when there is an overstretching or overexerting of the capsular ligaments of the motor unit.

Acute clinical findings include the report of traumatic injury, pain on active or passive motion, relative lack of pain with isometric contraction, bruising and swelling. In a severe sprain the joint can become hypermobile and a chronic problem may develop.

A simple or mild sprain may be characterized by tenderness and swelling over the ligament with only little joint instability.

A moderate sprain involves a partial laceration of the ligaments. It displays tenderness and swelling, possible hemorrhage, lack of normal ligamentous resistance on digital pressure and increased joint movement as seen on dynamic x- ray studies.

A severe sprain involves a gross or complete laceration of the ligaments of the joint. It displays severe swelling pain, and hemorrhage as well as a marked excess of joint motion which indicates definite separation on motion. Dynamic x-rays may show findings of evulsion fracture or small pieces of bone that were torn off with the ligament.

Strain: A strain is an overstretching of the muscular and tendinous structures. Strain is associated with either excessive isotonic contraction, prolonged isometric contraction, overstretching of a joint or even a blow.

Acute clinical findings include pain on contraction, pain on active motion, pain on resisted motion, pain on stretching, swelling and muscular hypertonicity.

Classification of strain injury is similar to sprain with the use of mild, moderate and severe. However, subacute and/or chronic strains will usually result in myofascitis and/or myofibrosis, which are the preferred descriptions. Sometimes the term strain is used as a verb when describing a muscular or tendinous injury. When this is done, the correct diagnosis may be actually a sprain.

With a sprain injury, the pain localizes in the ligaments of the joint. With a strain injury the pain localizes in the muscular and tendinous structures.

Clinically, a sprain will usually elicit pain on movement of the affected joint even without muscular effort, and a strain will elicit pain on muscular effort even without joint movement.

Arthrodynia: This term simply means pain in a joint.

Bursitis: This terms is used when there is inflammation of the saclike joint cavity that is filled with fluid.

Capsulitis: This is known as adhesive inflammation between the joint capsule and the peripheral articular cartilage.

Contusion: This is a bruise that does not involve a break in the skin. With regard to the spine it involves prolonged or transient dysfunction below the level of the lesion.

Dyskinesia: This term simply means painful muscle movementor impairment to the normal range of motion.

Tendonitis: This term is used to describe inflammation of tendons.

Paresthesia: This is abnormal sensory awareness in a specific area.

Radiculalgia: This is used when the nerve roots are affected. Pain is worse paravertebrally and lessens down the peripheral nerves. The Pain is also intermittent.

Neuralgia: This term is used when the pain is worse down the peripheral nerves. There is usually minimal pain paravertebrally.

Radiculoneuralgia: This is an advanced pain stage. The pain is Intermittent equally and severe both paravertebrally and down the course of the nerve.

Radiculopathy: This is paravertebral pain that is worse in the periphery. Paresthesia is associated with this description of pain.

Neuropathy: This pain is worse in the periphery than it is paravertebrally. It is also associated with paresthesia.

Radiculoneuropathy: This pain is characterized as equal paravertebrally and along the course of the nerve. Paresthesia is also present.

Radiculitis: This is maximal paravertebral pain with minimal peripheral pain. The patient will have paresthesia, decreased or absent reflexes. The patient may also have weak or flaccid muscles and decreased muscle tone.

Neuritis: This is minimal pain paravertebrally and maximal pain along the course of the nerve. The patient will have paresthesia, decreased or absent reflexes, weak or flaccid muscles and decreased muscle tone.

Radiculoneuritis: There is equal pain paravertebrally and along the course of the nerve. This patient too will have paresthesia, decreased or absent reflexes, weak or flaccid muscles and decreased muscle tone.

Osteoarthritis: This is a non-infectious degeneration of the joints. The joints remain moveable but with a loss of the integrity of the joint cartilage and proliferative changes.

Proliferative Bony Changes: Changes that accompany the disease. They are called: exotosis, spurring, lipping and osteophytes.

Spondylosis: This is degeneration of the joint accompanied with proliferative changes of the margins of the vertebral body.

Spondyloarthrosis: Degenerative joint disease involving the vertebral body and zygapophysis.

Rheumatoid Arthritis: Joint degeneration characterized by inflammation, proliferation of the synovial fluid membrane with necrosis, fibrosis and loss of bone substance.

Ankylosing Spondylosis: Characterized by ossification of the spinal ligaments.

Marie-Strumpell Spondylitis: Ankylosing begins at the sacroiliac ligaments and ascends the spine. The disc is not involved. Von-Bechterews Spondylitis: Ankylosing begins at the costovertebral ligaments and descends the spine. The disc is involved.

Still's Disease: This is acute febrile rheumatoid arthritis in children.

Osteoporosis: Abnormal loss of bone density.

Intervertebral Disc Syndrome: This includes either protrusion, herniation or prolapse of the intervertebral disc. There are concomitant findings.

Curvature: This is seen as an abnormal bending of the spine.

Kyphosis: This is abnormal flexion of a spinal area.

Lordosis: An abnormal extension of an area of the spine.

Scoliosis: This is an abnormal lateral bending of an area of the spine that involves more than three continuous segments. This is accompanied with abnormal vertebral rotation.

Lateral Curvature: This is an abnormal bending of an area of the spine without vertebral rotation.

Joint Instability: This is a loss of the normal function to stabilize in any plane within normal range of motion.

Spondylolisthesis: Anterior slippage of the body of a vertebra in relationship to the vertebral body below.

Spinal Surgery: Surgery that may fuse the vertebral motor unit with bone grafting or surgical steel screws or rods. Part of the vertebra may be cut away permanently.

Tropism: The asymmetrical development of the zagopophysis.

Sacralization: The anomalous growth of L-5 to S-1.

Lumbarization: The anomalous growth of S-1 as a separate lumbar segment.

Spina Bifida Oculta: Incomplete fusion of the neural arch in the posterior midline without protrusion of the elements of the spinal canal.

Anatomical Short Leg: One leg shorter than the other due to abnormal development, accident or surgery.

Stenosis of the Spinal Canal: This is a stricture or narrowing of the spinal canal.

Transitional Vertebra: Any vertebra that has taken on the regional characteristics of the region directly above or below.

Arthrosis: Trophic joint degeneration.

Osteoporosis: A reduction or loss of bone density.

Osteoarthritis: Degenerative joint disease.

Discopathy: Degenerative disease of the disc.

Compression Fracture: When the body of the vertebra is compressed with a crushing injury.

Phase I Degeneration: At least one motor unit has developed mild narrowing or misshaped disks accompanied by visible spinal misalignment, nerve irritation, reduced range of motion and pain-symptom complexes. Acute injury or spontaneous onset of irritation to this area is marked by pain on movement, mild fixated joint movement and mild muscle spasms. Depending on the type of injury or onset, care ranges from hours to two weeks for pain relief and control. Stabilization or correction occurs usually in 4 to 8 weeks. Follow-up care depends on the individual.

Phase II Spinal Degeneration: The same general progression as in Phase I, but with increased vertebral misalignment, visible osteoarthritic changes, spinal curvature, marked and moderate spinal fixation accompanied by some restricted range of motion with pain. Nerve irritation has progressed to almost daily pain, sometimes constant, muscle splinting and pain upon movement is characteristic. Care ranges from 2 to 6 weeks to alleviate the pain-symptom complex and is followed by 4 to 10 weeks of continued corrective care. Full correction is not always possible. Exercise therapy and massage therapy is very beneficial in this Phase. This should be followed by 2 to 8 months of continued stabilization care. Then followed by maintenance care of 1 to 2 visits per month. This patient usually returns to normal activities.

Phase III Spinal Degeneration: The same progression as in Phase II with moderate disk obliteration in affected areas accompanied by marked osteoarthritis and spurring. Marked limited range of motion and spinal fixation exists, accompanied by muscle splinting and spasm. This patient usually has multiple complaints and daily pain. Nerve irritation and possible permanent damage exists. Natural spinal fusion is taking place. Care is the same or similar to Phase II, however daily visits are usually necessary to alleviate pain and disability. The stabilization and corrective care stage may last 8 to 16 weeks. Very little correction occurs within one year. Care is primarily designed to alleviate the pain, stabilize the condition and slow the degeneration process so that the maximum amount of daily activity can be performed without pain.

Phase IV & V Spinal Degeneration: The same progression as in Phase III, however natural spinal fusion has occurred. Very little correction is possible. Care is for the relief of pain to the degree flexibility can be reached or maintained in the spine. Care is advised on a per-visit basis until pain subsides.

Initial Care: (Also referred to as acute, intensive or entrance care) Daily or multiple visits each week given for relief and alleviation of the pain-symptom complex.

Corrective Care: (Also referred to as reconstructive or transitional care) Some form of the pain-symptom complex is still present. Visits are continued at 2 to 3 times per week.

Stabilization Care: (Also referred to as supportive, continued care or extended care) This care is designed to hold a degenerative process from full progression to the next phase of degeneration. Some correction is possible over a 12 to 16 month period. Visits are usually scheduled 1 to 2 times each week. During periods of exacerbation a more frequent schedule is necessary.

Wellness Care: (Also referred to as maintenance care) This patient has no symptoms and/or maximum improvement has been achieved. Care is both preventative and stabilizing in nature. This care is also referred to as Maintenance Care. Visits are scheduled at a frequency of 1 to 2 visits each month, depending on the individual.

Chiropractic Adjustment: A highly skilled, calculated and exacting push on the misaligned spinal bone, administered by the Doctor of Chiropractic. Sometimes you can hear a slight popping sound when the adjustment is rendered. The actual adjustment itself is usually painless and it's influence on the body's healing ability starts immediately. You may notice a change instantly or within a few hours, depending on the severity of your problem. A longer period of time is necessary when actual damage to the joints, disk and the motor units has occurred. The adjustment is the primary element of your care.

Traction: We use two types of traction. The first is manual traction, primarily used in acute disk injuries of the neck. It is manually done and is very effective in helping to reduce protruded disks that may otherwise warrant surgery.

The second type is mechanical intersegmental traction, used for the entire spine when the vertebral subluxation complex has caused an abnormal curvature of the spine or arthritic changes are visualized on the x-ray studies. It serves to relieve the muscular tension in the spine by adding exercise and mobility, increasing some certain types of disk blood circulation and generally tone up the ligaments and muscles that are restricting normal movement of the spine. This type of traction is used primarily in the corrective stage of care or when a chronic problem is having difficulty responding.

Neuromuscular Therapy: Several methods of muscle stimulation are used in this office. Musculoskeletal synchronization and stabilization technique employs the use of gentile trigger point pressure to relax tight muscles prior to the adjustment procedure. Electronic muscle stimulation is used to relax or tone up muscles that are restricting the spine from returning to a normal state and to help relieve the pain-symptom complex. Ultrasound is used to deliver deep heat to help relax tight muscles, free fixated joints and relieve the pain-symptom complex. All of these methods take just a few extra minutes to help relieve the nerve and muscle areas that are causing pain, discomfort and restricted movement.

Massage Therapy: Massage by a registered massage therapist, is very useful in rehabilitation and relaxation of injured areas. It helps to reduce muscle tension and the associated pain. Massage calms the nervous system and increases circulation, which boosts energy and alertness and aids in helping flush toxins from the tissues. Massage also helps relieve stress and aids in relaxation.

Vibration Therapy: The use of a machine called the G-5 It is a vibratory technique to increase circulation and reduce muscle tightness. It is used to relax the spine.

Moist Heat Therapy: Used prior to the adjustment procedure or in conjunction with massage. Moist heat is applied to the injured area for about 7 minutes. Usually used in chronic conditions.

Therabath Paraffin Therapy: Is used to relieve the pain of arthritis, inflammation, joint stiffness, muscle spasms and sports injuries. It also aids dry, cracked skin.

Ice Pack or Cold Packs: Used prior to the adjustment procedure or in conjunction with massage. Usually used for about 12 minutes in acute cases or when disk injury in suspected.

Myofacial Release: A specific trigger point technique used in conjunction with lower back disk problems at L-4 or L-5.

Cryogel Application: The application of a pain relieving gel to the area of complaint. sometimes used in conjunction with ultrasound or massage.

Kinetic Activity: This is a rehabilitation technique for the lower back, pelvic area and lower extremities. We have 6 different kinetic activity machines that do the exercise for the patient and as they regain their strength and range of motion they actively participate in the exercise program. The goal is to complete 7 to 10 minutes of each different exercise therapy under full participation by the patient. The total program takes about 45 to 60 minutes to complete each session. Usually 3 to 4 session each week for 3 to 6 weeks is optimal. In difficult cases a longer program of exercise may be necessary.

Exercise Therapy: As a health care professional my goal is to help each patient to regain good health, in a conservative amount of time. The importance of at home rehabilitation is paramount in the final stages of the healing process. While under corrective care patients are given a program of progressive exercises so they can advance based on their own progress, ability and schedule. They are taught how to follow the prescribed exercise in the office and what exercises to continue at home. Specific exercises are prescribed for chronic problem areas such as the neck, low back, shoulder, hip, knee or ankle.

Nutritional Supplementation: Scientists around the world agree that the majority of the worlds chronic degenerative diseases, including heart disease, diabetes, arthritis, osteoporosis, cataracts, glaucoma, cancer, etc., are preventable and are caused by nutritional deficiencies and environmental stress factors. For those who want a healthier life style, we recommend only the highest quality nutritional products that include water and air filters, soy foods, weight loss supplements, vitamins, minerals, herbal formulas, homeopath, natural hair and skin products, natural toothpaste and natural cleaners.

It takes the nerves, the adjoining disks and muscles no less than 4 to 6 weeks to begin a healing process toward becoming normal. Actual correction sometimes takes weeks and months when arthritis and
disk degeneration is present. If you have sprained a spinal segment it is a serious injury. Research has shown us that it takes a healthy athlete 9 to 12 months to heal a sprained joint. Most patients are concerned with, "When will my pain, symptoms or physical disabilities go away?" The answer is: We normally see a definite pain- symptom complex change for the better within a very few visits.

Actually how long it takes depends on how much swelling is around the disks and nerves. If you have an acute problem in most cases you will respond very fast. If you have been suffering for a long time it may take a little longer to stabilize your condition.

It is impossible to determine exactly how much of any particular kind of care you will need. The length of care varies form patient to patient and depends on the length of illness or disability, occupation, postural habits and other personal habits or lifestyle related risk factors. We will do our best to get you out of the pain-symptom complex and remove any disability that exists we feel we can help. I will do my part to be the best doctor possible. You must keep all appointments and do all the home therapy and exercises as directed. Once care is given, its up to your body's own healing powers to stabilize and actually obtain a curative effect.