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DCs are increasingly seeing patients who have neck, shoulder, and upper-back pain as a result of poor posture.
In addition to problem of slouching or slumping, people looking at phone and computer screens all day are also prone to leaning their heads forward. Given that many posture issues involve the cervical spine, instrument adjusting may be beneficial for those patients who have posture-related pain.
When to use instrument adjusting for posture
Instrument adjusting is a treatment alternative for patients who find their symptoms are aggravated by manual adjustments.1 The more controlled action of an instrument is preferable to some DCs and many patients when the cervical spine is involved. Instrument adjusting is most often used to help correct cervical spine posture because of its reliability and safety.2
Spring loaded and electromechanical instruments
Spring loaded instruments have been commonly used in chiropractic offices for decades. Electromechanical instruments are somewhat newer. One study found that there are differences in the minimum-to-maximum peak force excursions between the two types of instruments.3 The best instrument for correcting posture problems depends on the patient, the DC, and the situation.
An instrument that measures the movement during an adjustment may be helpful. Recent technology allows for precise measurements that show the exact impact of an adjustment. Some practitioners find that such measurements are helpful in following a treatment plan, as well as for patient education.
Additional components
Patients can work to correct their own posture. Avoiding sitting for long periods is a common recommendation from experts.4 Stretching is another important activity. While it is easy to assume that most patients understand how to stretch, many need specific demonstrations or written instructions to make stretching effective.
A number of ergonomic chairs claim to help sitters improve their posture, endure less pain, and enjoy all sorts of benefits. A popular option is to use a stability ball rather than a chair, though the efficacy of sitting on a ball is far from proven.5
Choosing a treatment plan best suited to a patient’s situation is, of course, the correct option. If forward head posture is an issue, then the right protocol may well include instrument adjusting, along with education and a regimen of stretching.
Additional Resources:
http://www.chiro.org/LINKS/Forward_Head_Posture.shtml
http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56868
References
1 Polkinghom BS. Treatment of cervical disc protrusions via instrumental chiropractic adjustment. J Manipulative Physiol Ther. 1998;21(2):114-21.
2 Rustler T, Yamasaki M, Crunick J, Becse T, Laskey L. Literature Review for SA201 Adjusting Instrument. http://www.sigma-instruments.com/files/Literature_Review.pdf. Published June 2004. Accessed July 2015.
3 Coloca CJ, et al. Comparison of mechanical force of manually assisted chiropractic adjusting instruments. J Manipulative Physiol Ther. 2005;28(6):414-22.
4 Biswas A, et al. Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults: A Systematic Review and Meta-analysis. Ann Intern Med. 2015;162(2):123-132.
5 Centre of Research Expertise for the Prevention of Musculoskeletal Disorders. “The use of stability balls in the workplace in place of the standard office chair.” http://www.ahs.uwaterloo.ca/~cre-msd3/kn_stability.html. Published August 2007. Accessed July 2015.
