Every time I type "adjust clinic" into Google to pull up my website, I find a search result for the Mayo Clinic's definition of a chiropractic adjustment. The Mayo Clinic is a very trusted source. So I'm interested in what they have to say. Does what they say properly reflect what I experience every day in practice?
With that out of the way, What does the Mayo Clinic have to say? They say that people go to chiropractors to get adjusted to take care of low back pain, neck pain, and headaches.
Here we go. Right away, they want to start to talk about the risks for chiropractic care. Actually, to be fair, they are just talking about adjustments, which is only part of the wide breadth of what chiropractors are licensed to do. So, they aren't talking about the risks of exercise therapy, or hot packs.
They say the risks for chiropractic care include:
There are no references in this article. It was written by the Mayo Clinic staff, and frankly, I'm disappointed. References were hidden.
People come to chiropractors because they have herniated discs. Herniated, bulged, or sequestered discs are major sources of back pain. I don't know if the authors think that if you twist someone's back, it will squish the disc like a grape, but it doesn't work like that. I don't know of any cases where a herniated disc got worse after an adjustment. Discs are very robust structures, and you would have to use some crazy forces to tear the fibers of the disc. Ridiculous.
Evidence suggests that if you have a herniated disc, a chiropractic adjustment is a great choice for pain relief.
Compression of nerves is a curious one. I'm not sure what they are talking about here. If people come in with nerve compression, then I suppose their condition could degrade further, but that's usually not form spinal manipulation.
The stroke issue is a tricky issue, because chiropractic adjustments don't cause strokes, but we could aggravate a stroke in progress if a patient presents with severe neck and head pain. And if we don't screen them out. Chiropractors need to be vigilant about red flags. The Cassidy study looking at the incidence of vertebral artery dissections shows us that people are just as likely to have a stroke in their medical doctor's office as they are in a chiropractic office. They are presenting with a horrible headache and neck pain, and they aren't being screened for a vascular pathology.
But Mayo Clinic would rather perpetuate the myth of chiropractic causing strokes, just like many pseudo-skeptics would want you to believe.
This stroke topic is such a hot topic that researchers have measured the amount of stretch a vertebral artery can withstand during normal head rotation, head extension, and during a very forceful spinal manipulation, and they couldn't over stretch the artery in any physiological range of motion, or that para-physiological space where an adjustment occurs. It's impossible to give someone a stroke with spinal manipulation unless they already have a stroke in progress.
They don't say this at Mayo, but these are things that doctors of chiropractic screen for. That's why we are doctors. We are supposed to look out for red flags.
However, I have to take issue with the numbness or tingling point. If you have numbness or tingling in an arm or leg, then a chiropractor should be the *first* doctor you go see. We are trained to diagnose what is happening in your spine or limbs that could be causing the numbness or tingling. Unlike physical therapists, we are trained in differential diagnosis.
I put chiropractic "visit" in my header instead of "adjustment" because I want to emphasize that a chiropractic visit is more than just a simple adjustment. Chiropractors are trained and licensed to do adjustments as well as a multitude of other conservative care modalities. So if you are in pain, and you come to this office, you might get a hot pack and interferential treatment along with your adjustment.
"During a typical chiropractic adjustment, your chiropractor places you in specific positions to treat affected areas. Often, you're positioned lying facedown on a specially designed, padded chiropractic table. The chiropractor uses his or her hands to apply a controlled, sudden force to a joint, pushing it beyond its usual range of motion. You may hear popping or cracking sounds as your chiropractor moves your joints during the treatment session."
Mayo Clinic once agains downplays how amazing it feels to get adjusted by saying that research only shows a modest benefit for adjustments for low back pain. They are ignoring the fact that if you combine adjustment with other amazing care, like exercises to strengthen and stabilize your spine, then the effect of care is multiplied.
Maybe what the Mayo Clinic should mention is that when you go to see a competent chiropractor, they should be following the evidence across all of the modalities available to the chiropractor's license.
But I have to say, in my experience, if you only get adjusted and nothing else, a chiropractic adjustment still feels amazing, and you end up feeling empowered to take better care of yourself afterward.