What happens when my back "goes out" or a bone goes "out of place"?

To answer this, I’ll start with a little chiropractic history. The concept of a bone out of place dates to the origin of chiropractic in 1895 when D.D. Palmer restored the hearing of a deaf man by “racking a displaced bone back into position”. In the context of 1895 anatomy and physiology, the early chiropractic theories are based on positional relationships of bones, with mechanical pressure on nerves that can be relieved by a manual adjustment to free the pinched nerves. He named these out of place bones “subluxations” (a small luxation, or dislocation), emphasizing the mechanical aspect of chiropractic that causes nerve interference.  D.D. Palmer was definitely ahead of his time with his concept of nerve interference, but more than a century of scientific discovery in the fields of clinical neuroanatomy and physiology reveals a broader and more complex explanation for the success of chiropractic throughout its history. The bone out of place concept still provides an easy, simplistic explanation for what happens in a chiropractic adjustment, but the truth is much deeper and getting more interesting as time goes on.

Current neurological models reflect the complexity of internal communication within the body with continuous adaption to perceived external and internal conditions - via sensors in the tissues that allow feedback and monitoring. These sensors are broadly called mechanoreceptors and chemoreceptors. Trauma or stress (from a wide variety of sources) has the capacity to alter the accurate signaling of these receptors and perhaps initiate the transmission of “error messages”. If these errors are compounded with further inappropriate feedback, a dis-ease condition may result. An associated experience of pain or a particular symptom can alert us that something is wrong, and apparently “out”, but it may not necessarily be a bone out of position.

 Introducing a new stimulus or input to this system in a specific way can change the signaling that directs the response or output. A specific and appropriate chiropractic adjustment targeting muscle or ligament mechanoreceptors may cause an updated recognition and response to erroneous neural activity. It can result in reduced pain whether acute or chronic, and improve functional biomechanics.

“A single trauma or cumulative microtrauma may cause subfailure injuries of the ligaments and embedded mechanoreceptors. The injured mechanoreceptors generate corrupted transducer signals, which lead to corrupted muscle response patterns produced by the neuromuscular control unit. This can result in muscle incoordination affecting individual muscle force characteristics such as "onset, magnitude, and shut-off."     - M.M. Panjabi, PhD    (Yale Biomechanics Lab)

 “The adjustment does this by facilitating the effects of mechanoreceptor afferents.”  -  Dr. Matthew McCoy, DC     (Editor – Journal of Vertebral Subluxation Research)

“Chiropractors don’t take pressure off nerves – they put pressure on mechanoreceptors” - Dr. Ted  Carrick, DC, PhD    (Chiropractic Neurologist)

Since the nervous system has wide control over most body functions, the effect of a chiropractic adjustment is not limited to neck and back pain, but is directed toward restoring overall health.

 Taking it even further, there are systems of internal communication in the body that D.D. Palmer could not have even imagined in 1895. These include concepts that are far beyond the scope of this article such as tensegrity, extracellular matrix and ground regulation, biophoton communication, electromagnetic field characteristics, and the acupoint meridian complex. The following quote from the book, Energy Medicine: The Scientific Basis by James Oschman illustrates the tremendous flow of information that influences what we experience in our bodies.

“The electrical activities of nerves and muscles are well known, but there are many other kinds of energetic signaling systems. The entire living matrix is simultaneously a mechanical, vibratory or oscillatory, energetic, electronic, and informational network. Hence the entire composite of physiological and regulatory processes we refer to as ‘the living state” takes place within the context of a continuous living matrix.  We are now discerning that the living matrix itself is a high-speed communication network linking every part with every other.”

Regardless of the model, the outcome is the same. The action of “putting a bone back into place” may or may not reposition the bone, but the cybernetic stimulus that the adjustment provides has the net effect of relieving pain and increasing function, just as it has for more than a century. Ultimately, using any of the modern non-forceful chiropractic methods can produce an informational “reboot” that transforms painful or dysfunctional patterns into greater function and ease, in a gentle manner.