Instrument adjusting techniques for limited cervical spine range of motion

Looking at the vertebrae that make up the cervical spine, one might think that it was a delicate, fragile construction.

In fact, the cervical spine holds the weight of the head and allows for flexion, extension, lateral flexion, and rotation. Taken together, those six movements make up an impressive range of motion (ROM). However, as all practiced chiropractors know, the cervical spine can also be a source of pain for patients.

Patients who experience a loss of ROM may have problems with the cervical spine. Healthline.com lists 20 conditions that can limit range of motion, many of which can impact cervical spine ROM, as some conditions, such as arthritis, can affect multiple joints in the body, including those in the neck.¹

There are many reasons a chiropractor may choose to provide instrument-assisted adjustments for patients with limited ROM of the cervical spine. Considering the on-going debate regarding cervical spine manipulative therapy and the possibility of vertebrobasilar stroke, choosing a gentler method may be a better choice, especially for adults over 60 years old.

Leaving the debate surrounding cervical spine manipulation and the risk of stroke aside, practitioners may find the lower force associated with instrument adjustments preferable for a number of other reasons. For instance, patient comfort may be a consideration. If a person has limited ROM, a high-velocity manipulation may temporarily increase the pain level. The lower force adjustment delivered with an instrument may be preferable in such a case.

Spring loaded or electromagnetic instruments are often the tool of choice for those who wish to use lower force to make an adjustment. These tools allow for a high degree of precision and often allow the chiropractor to control the amount of force applied. Patients who are uncomfortable with a cervical adjustment or those who have conditions that require a lower force adjustment, such as arthritis, may benefit from the use of a handheld instrument.

Depending on the cause, a patient’s treatment plan may call for soft tissue mobilization to restore normal ROM. Patients with trigger points often experience limited ROM, and the neck is commonly the site of trigger point pain—some instruments include settings for trigger point therapy.²

More complex instruments, such as those that provide a computer analysis of adjustments, could be even more beneficial when the cervical spine is involved. Such instruments deliver the necessary adjustments, often with either preset protocols or through protocols the DC manually inputs, and provides a detailed analysis of the changes brought about by the adjustment. More information about a patient’s condition and the impact of treatment provided gives the chiropractor a clearer picture of how to continue treating the patient. Often, such adjustments also include patient education materials and reports that can help patients understand how their own treatment is progressing.

References

¹ O’Connell K. “What causes limited range of motion? 20 possible conditions.” Healthline.com. http://www.healthline.com/symptom/limited-range-of-motion. Reviewed September 2012. Accessed January 2015.

² Alvarez D, Rockwell P. “Trigger Points: Diagnosis and Management.” Am Fam Physician. 2002:65(4);653–661.