From the Guidelines
Segmental dysfunction and chiropractic subluxation are distinct concepts in spinal health, with segmental dysfunction being a biomechanical alteration in spinal joint movement and chiropractic subluxation proposing neurological components and effects on overall health. The key difference between the two lies in their approach and scope, with segmental dysfunction focusing on restoring normal joint mechanics and chiropractic subluxation suggesting a broader impact on health. According to recent studies 1, spinal manipulation, which is a common treatment approach for both concepts, has been found to be slightly superior to usual care for pain and disability in patients with subacute or chronic low back pain, although effects may not be as pronounced after 12 months. Some studies have reported that manipulation and exercise did not significantly differ, and the addition of manipulation to exercise therapy was no better than exercise alone 1. It's also important to note that serious adverse events after spinal manipulation are very rare, with an estimated risk of less than 1 per 1 million patient visits 1. In terms of treatment, practitioners focusing on segmental dysfunction typically integrate their approach within broader musculoskeletal care models, whereas those focusing on chiropractic subluxation may view adjustments as addressing systemic health conditions. Key points to consider include:
- Segmental dysfunction is a biomechanical alteration in spinal joint movement
- Chiropractic subluxation proposes neurological components and effects on overall health
- Spinal manipulation is a common treatment approach for both concepts
- Serious adverse events after spinal manipulation are very rare
- Treatment approaches may vary depending on the focus of the practitioner.
From the Research
Definition and Understanding
- The term "subluxation" is commonly used in chiropractic practice to describe a biomechanical spine derangement that can produce clinically significant effects by disturbing neurological function 2.
- Chiropractors use various methods to detect spinal subluxation, including static palpation, motion palpation, and orthopedic tests, with motion palpation being considered the most reliable method 3.
- The term "subluxation" has been used by different health care professions, including osteopathy, medicine, and chiropractic, and its meaning has evolved over time 4.
Comparison with Segmental Dysfunction
- Segmental dysfunction is a term that may be used to describe a similar concept to subluxation, but it is not a term that is universally accepted or used in chiropractic practice 3.
- Some chiropractors may use the term "dysfunction" to describe the spinal entity that they manipulate, but "subluxation" is still the most commonly used term 3.
- The debate surrounding the subluxation construct is ongoing, with some arguing that it is a vital part of chiropractic identity and others questioning its validity and usefulness 5.
Key Differences
- The key difference between segmental dysfunction and chiropractic subluxation (CS) lies in the terminology and the specific concept being described, with CS being a more specific and widely used term in chiropractic practice 2, 3.
- While segmental dysfunction may be used to describe a broader range of spinal issues, CS is typically used to describe a specific type of biomechanical derangement that is thought to be related to neurological function 2.