In most cases, chiropractic patients listen to this word after their initial diagnosis and when chiropractors are going through the spinal adjustments and manipulations. But, hearing this word so many times during your treatment plan might leave you asking – what is a subluxation?
Continue reading to understand the meaning behind a subluxation and what they mean to your health.
What Is a Subluxation of the Spine?
A subluxation of the spine is a condition that occurs when a joint begins to dislocate. But, instead of the joint surface completely losing contact, a subluxation is considered to be a “partial dislocation.” In some cases, subluxations can be quite painful, depending on the reason why they form. If left untreated a subluxation can trigger a degenerative process in the surrounding areas, and it might become more difficult to reverse it as the body progressively adjusts itself to the misaligned or partially dislocated shape.
In the chiropractic world, a subluxation is the most important reason to check your intervertebral joint motion and your musculoskeletal system. One could say a chiropractors’ entire world revolves around finding and realigning subluxations to improve and promote wellness.
Types of Subluxation
Some chiropractors like to separate subluxation by the level of dislocation present between the joints. In this case, some types of subluxation include a
V-shape widening, moderate subluxation, advanced subluxation, and finally ending up in a dislocation.
However, a subluxation can occur in one of three types, including:
Anterior Subluxation (forward) – This type is the most common,
it is localized and purely ligamentous, the bone is not involved.
Posterior Subluxation (backward) – This type of subluxation is very rare, and it is often the result of an injury or trauma.
Inferior (downward) – This type of dislocation is also rare, and it entails the joint being displaced downward.
Understanding the Subluxation Causes
Subluxations can occur at any age and can be attributed to various causes. However, subluxation causes can either be physical or emotional, the latter referring to chemical or emotional stressors. Understanding the subluxation cause can help chiropractors steer the treatment plan to target the source of
the problem and not just the symptoms.
Some of the most common subluxation causes include:
Traumas
The most common cause of subluxations, sudden trauma injuries include
car accidents, slip and falls, and so on. However, subluxations can also occur after childbirth, for both the child and the mother. Another physical cause of subluxation can be attributed to sleeping in a bad position, ALSO poor office ergonomics, and walking with poor posture. All of these impacts can nudge
the vertebrae out of alignment leading to a subluxation.
Toxins
While physical traumas are easy to spot, toxins on the other hand?
Not so much. Our bodies are a conglomerate of chemicals, and to stay healthy, our bodies must remain chemically balanced. When we ingest more toxic chemicals whether through the environment, food, or our drinks, we are at risk of impacting this balance. When these chemicals start fluctuating, our muscles can contract, changing the fiber length in the muscles, thus causing a subluxation.
Emotions
It might seem impossible for your emotional state to change your body. However, when you are experiencing stress, or you are going through any emotional distress, your body is thrown off-balance. The levels of tension in our backs and necks begin to change as a result, and the pulling from tight muscles can draw some of your vertebrae out of alignment. Not to mention, stress also alters your chemical balance by raising cortisol levels,
which brings us back to the toxins caused for subluxations.
What Are Some Subluxation Symptoms?
Unlike a dislocation, subluxations cannot be seen and their symptoms
often gradually worsen. Depending on the severity of the subluxation and the location of the joints affected, symptoms may vary. Some patients might feel these symptoms immediately after the appearance of the subluxation, usually when it is caused by a sudden trauma.
Some common condensed symptoms of subluxations include:
– Pain around the affected joint
– Swelling around the affected joint
– Limited mobility of the affected joint
– A sensation of the joint being unstable or wanting to give-out.
What Is Subluxation Treatment?
As subluxations can evolve, early treatment is vital to ensure the joint
remains in the proper position. The best way to treat subluxations is through chiropractic care. The primary goal of chiropractic care is to maintain an aligned body; localizing, analyzing, and adjusting subluxations is critical to keep an aligned body.
Some common at-home subluxation treatments include resting the affected joint, icing the area, and elevating it to reduce swelling. However, these will only help with some of the symptoms, but they will not correct or treat the subluxation itself.
The one and most effective subluxation treatment is a chiropractic adjustment.
In essence, a chiropractic adjustment or a spinal manipulation is a manual technique performed by a licensed chiropractor to treat subluxations.
Through a physical examination, a chiropractor can analyze and locate spinal subluxations. Then, by using precise and manual techniques, chiropractors can realign the vertebrae on the spine to make sure they are placed back in their proper position.
A joint subluxation is a partial dislocation of a joint. It is often the result of acute injury or repetitive motion injury but can also be caused by medical conditions that undermine the integrity of ligaments. The treatment for subluxations may include resetting the joint, pain relief, rehabilitation
therapy, and, in severe cases, surgery.
Symptoms
As opposed to luxation (the complete dislocation of a joint),
subluxations only result in the partial separation of a joint.
Some of the common symptoms include:
Pain and swelling around the joint
A sensation of joint instability
Limited mobility or the loss of range of motion
Loss of feeling or numbness (usually temporary)
Bruising. 1
If the joint injury is serious, call 911 or go to the nearest emergency room.
Signs of an emergency include severe pain, loss of sensation, or the inability to move a joint or bear weight on it. 2
Types of Subluxation
Some joints are more likely to be affected by subluxations than others.
Some of the more commonly affected joints include those of the spine, shoulder, kneecap, and elbow.
Vertebral Subluxation
A vertebral subluxation can occur with trauma to the spine, such as a fall or severe blow. The subluxation may involve a ligament rupture with or without injury to the vertebra (spinal bones) itself. This type of injury can compress
the spinal cord, resulting in shooting pains, referred pain, or loss of nerve function.3
The term subluxation is also used by chiropractors to describe any misalignment of the vertebrae that needs adjustment. Chiropractors typically use spinal manipulation to help place joints in the spine in their proper position.4
Related: Common Injuries to the Cervical Spine
Shoulder Subluxation
A shoulder subluxation means that the ball of your upper arm comes partially out of the socket in your scapula (shoulder blade). Severe injury or trauma is most often the cause of shoulder subluxation.
Sports like swimming, tennis, volleyball, and others that involve repetitive upward motions can loosen the ligaments in the shoulder and make it more likely for subluxation to
occur.5
With shoulder subluxation, your shoulder may feel as it is loose or slipping in and out of the socket. Pain and loss of motion are common and often extreme.
What Happens When You Dislocate Your Shoulder
Patellar Subluxation
The patella (kneecaps) fits in a groove at the end of the tibia (thigh bone).
A patellar subluxation occurs when the kneecap moves partially out of that groove. Patellar subluxation is the most common knee problem in children
and adolescents.6
Patellar subluxation is usually caused by a direct fall on the knee but can also happen if the knee ligaments are loose. Symptoms can vary but may include pain, swelling, feeling the knee “give way,” and a misshapen look
to the knee.7
What Are the Signs of Kneecap Dislocation?
Elbow Subluxation
Elbow subluxations can occur when someone falls onto their hands.
Though elbow luxations are typically very painful, subluxations may not be
as obvious. The elbow may move perfectly well, there may be a dull or sharp pain.8
Children under seven can get a type of subluxation called a radial head subluxation (a.k.a. “nursemaid’s elbow”).
This can happen when the child’s arm is pulled a little too roughly. Because the bones and muscles of younger children are still growing, dislocation can occur quite easily. Although painful, a nursemaid’s elbow can be easily reset by a doctor.9
Common Signs of Elbow Dislocation
Causes
Subluxations most often occur as the result of trauma to a joint. There may be predisposing factors that increase the risk of subluxation, such as older age or participation in contact sports.
Traumatic causes of joint subluxation include:
Blunt force injuries: Including motor vehicle accidents, sports injuries, or a severe fall
Overuse injuries: Including those associated with medial epicondylitis (golfer’s elbow) or patellar tendonitis (jumper’s knee)
Joint hyperextension: An injury that occurs when a joint is hyperextended (extended beyond its normal range of motion) 10
Subluxations can also occur as a result of loose joints. For example, people with generalized joint laxity and Ehlers-Danlos syndrome have joints that are overly flexible. Individuals with these conditions are prone to subluxations, often without any instigating trauma or injury. 11
During pregnancy, the overproduction of certain hormones can also loosen ligaments, making the joints hypermobile and at risk of dislocation.12
Diagnosis
Joint subluxation is typically diagnosed with a physical exam and imaging studies. Even if a joint injury doesn’t appear all
that serious but is limiting motion or “feels loose,” it is important to make an appointment with your doctor immediately.
During the appointment, your doctor will examine the injured joint to check for any visible damage, such as swelling and bruising. The doctor will ask questions about the type of incident, if any, that preceded the injury. You may also be asked to wiggle your fingers or toes to see if there are any ruptured tendons or nerve injury.
To confirm the diagnosis and direct the appropriate treatment, your doctor will order imaging tests to check if there are ruptures, hematoma (a blood pocket), joint effusion (the accumulation of fluid), or a fracture. Imaging options include:
X-ray: A plain film radiologic study that can help characterize the dislocation and identify ruptured ligaments or bone fractures
Computerized tomography (CT): A radiologic study involving composited X-rays that offer a three-dimensional representation of an injured joint
Magnetic resonance imaging (MRI): An imaging study using powerful magnetic and radio waves that can help identify soft tissue injuries13
Doctors will use these same diagnostic tools if you are seen in an emergency room. They will also check for serious injuries, including arterial and nerve damage.
Treatment
After examining the injury, your doctor will likely reset the joint into its proper position using manual manipulation.
This may involve turning or pulling the limb. 14
Once the joint is properly realigned and your doctor has ruled out any complications, the treatment will be focused on reducing inflammation and pain. The standard approach, known by the acronym RICE, involves:
Rest: You will be instructed to limit activity and avoid putting weight on the affected joint.
To improve recovery and ensure stability, the doctor may immobilize the joint with a splint, brace, or cast.
Ice Application: Icing an injury helps dilate blood vessels to reduce pain, inflammation, and swelling.
Apply the ice pack for no more than 15 to 20 minutes several times a day, using a cloth barrier to prevent frostbite.
Compression: Your doctor may suggest an elastic bandage to control swelling, reduce blood flow, and provide structural support to the affected joint.
Elevation: Placing the joint above the heart can also alleviate pain and inflammation by reducing blood flow and pressure to the the joint. 2
Your doctor may also suggest a nonsteroidal anti-inflammatory drug (NSAID) like Aleve (naproxen), Advil (ibuprofen), or Voltaren (diclofenac) to alleviate swelling and inflammation.
Joint Surgery
Occasionally, surgery may be needed if the joint cannot be realigned manually or the dislocation is recurrent.
Surgery may involve grafting bone or connective tissues into the joint space, debriding (removing) cartilage or bone to improve joint mobility, or repairing torn ligaments or tendons. 15
Joint surgery is performed by an orthopedic surgeon who specializes in muscle and skeletal diseases and disorders.
It may require open surgery or be performed arthroscopically.
What to Know About Knee Arthroscopic Surgery
Recovery and Rehabilitation
Once the acute inflammation has subsided, your doctor may suggest a long-term treatment plan. In most cases,
subluxations are one-time events, and you will be able to fully recover the function of a joint with simple at-home exercises.
Severe subluxations can cause long-term impairment and instability. If these symptoms persist after treatment, your doctor will likely refer you to a physical therapist to strengthen the muscles and ligaments and maintain or increase the range of motion in the joint. This may involve in-office procedures and
at-home exercises and treatments. 16
An Overview of Physical Therapy Exercises
Just because a subluxation is “not as bad” as a full dislocation, you shouldn’t ignore it and hope that it goes away on its own. Doing so may lead to permanent changes in the joint space (including the development of osteoarthritis) or result in the impairment of blood flow and the onset of tissue necrosis (tissue death) or avascular necrosis (bone death). 17 In most cases, joint subluxation can be treated conservatively. But, if a severe injury occurs, early treatment almost always results in better outcomes.
Amy N. Heitkamp, DC, CACCP is dedicated to helping people of all ages learn and experience the amazing
benefits of chiropractic. Chiropractic has a unique approach to health and well-being and Dr. Heitkamp strives
to share her wealth of knowledge with community and practice members alike. About Us (blifechiro.com)
Dr. Heitkamp is a proud graduate of the University of Dayton where she earned a Bachelor Degree in Education and
Allied Professions with a major in Exercise Science and Physical Therapy. Her continued interest in the amazing workings
of the body led her to continue her education at Parker College of Chiropractic (now known as Parker University) in Dallas, Texas. This is where she earned her Doctor of Chiropractic degree.
After completing her Doctor of Chiropractic degree, she returned to her home state of Ohio.
Dr. Heitkamp assisted in the opening of a chiropractic office in Mason, Ohio. She began a focus on family wellness care.
This focus has continued with the opening of Balanced Life Chiropractic. As a graduate of Marion Local, Dr. Heitkamp is excited to share her love and passion for chiropractic and overall health and wellbeing with the local community.
Dr. Josh Schmerge is a Botkins High School graduate.
Josh attended The Ohio State University prior to attending Logan College of Chiropractic in St. Louis where he earned his Bachelors in Life Science and Doctor of Chiropractic. While at Logan, Josh worked at Logan’s outpatient clinics, St. Patrick’s Clinic, and the St. Louis Adult Rehabilitation Clinic where he was able to treat patients with a wide range of conditions.
He was active with the sports program at Logan and was able to treat different kinds of athletes at the University of Missouri and aided in the development of the strength and conditioning program at Jefferson Community College for the women’s basketball team. Located in the heart of Greenville, Schmerge Chiropractic LLC focuses on setting your life in motion through conservative care. Dr. Josh specializes in family wellness, sports injuries, and nutrition.
Meet the Doctor (schmergechiro.com)
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