From the Guidelines
Segmental dysfunction and chiropractic subluxation are distinct concepts, with segmental dysfunction being an evidence-based approach focused on restoring normal joint mechanics, whereas chiropractic subluxation includes broader, less scientifically validated claims about neurological and systemic effects. The key difference between the two lies in their underlying principles and the scope of their applications. Segmental dysfunction is characterized by restricted mobility, abnormal motion patterns, or altered position of a vertebral segment, which can be objectively measured through changes in joint play, tissue texture abnormalities, and pain upon movement or palpation 1. In contrast, chiropractic subluxation encompasses not only the mechanical aspects of joint dysfunction but also proposes that vertebral misalignments can interfere with nerve transmission, potentially affecting organ function and overall health beyond local pain. However, the subluxation model's broader health claims lack substantial scientific validation, as noted in the diagnosis and treatment guidelines for low back pain from the American College of Physicians and the American Pain Society 1. Some interventions like spinal manipulation, which involves applying loads to the spine using short- or long-lever methods and high-velocity thrusts to a spinal joint beyond its restricted range of movement, may be used in the treatment of both concepts, but the approach and rationale differ significantly. Key aspects of segmental dysfunction treatment include:
- Restoring normal joint mechanics
- Addressing biomechanical alterations
- Focusing on musculoskeletal health Whereas chiropractic subluxation treatment may involve:
- Spinal manipulation
- Mobilization
- And other techniques aimed at correcting perceived misalignments and their purported effects on nerve function and overall health. Given the emphasis on evidence-based practice, segmental dysfunction represents a more contemporary and scientifically grounded approach to spinal health and treatment.
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.