Do Chiropractors Put Bones Back in Place?

Do chiropractors actually move bones?

A common misconception about chiropractic care, especially with a new patient, is that a chiropractor puts bones back in place. For this to be true, it would require that a bone was first "out of place." Bones can go out of place; however, it is extremely rare and involves a significant accident or injury. Additionally, in the rare case that it does occur, it is a medical emergency, not something that can be put back into place with a chiropractic adjustment or other chiropractic treatment.

That being said, some internal structures within the small joints along the spine can "get stuck," causing pain, restrictions, and an overall feeling of spinal misalignment. Instead of thinking about bones being forced back into place, it is more accurate to consider removing restrictions and nervous system reflexes as the mechanisms for how chiropractic adjustments work to provide relief from discomfort and/or pain relief.

How does a chiropractic adjustment work?

The most evidence based understanding of how a chiropractic adjustment works involves reflexes and entrapments of small structures within a joint.

Reflexes

Many researchers describe spinal manipulation as a reboot for the nervous system. For example, research shows that muscle tension is decreased in an area immediately after chiropractic care. Other researchers note increased coordinated movements after people are adjusted.

Spine alignment

Another explanation for spinal manipulation is that it resets internal components within joints. There are 24 bones in the spine, connecting from the skull and neck down to the sacrum and pelvis. With joints on each side, there are over 50 small joints along the spine.

Some of the main components of these joints are; cartilage, synovial fluid, and ligaments. Cartilage is a very smooth substance that lines the bone within the joint to allow the surfaces to slide on each other easily. Synovial fluid is a very slippery substance that enhances the joint's ability to glide even better. Finally, ligaments hold the joints together.

A final smaller component within spine joints is something called synovial membranes. These synovial membranes are a very thin layer of softer cartilage that lines the cartilage and can also rest between synovial fluid and the ligaments. Sometimes, they fold inward and get pinched between the joint surfaces. The term used to describe this is meniscoid entrapment or entrapped synovial fold.

These entrapped synovial folds have pain receptors and can cause discomfort and irritation. Also, it is theorized that they block normal functioning motion. This can make a chiropractic patient feel stiff, uncomfortable, and "out of alignment." 

It is thought that spinal manipulation (adjustments) helps release those entrapments and reset those joint internal structures. This is probably why people feel like spinal alignment has been achieved after a spinal adjustment. They can often move better with much less discomfort or pain.

Why does it feel like I have something out of place?

A lot of times, it can actually feel like something is "out of alignment." The reason for this has to do with tiny little nerve receptors in joints, muscles, tendons, and ligaments. You have a wide variety of these microscopic receptors—each with different ways they sense and feel. For example, some can feel sharp pain, dull pain, minor irritations, deep pressure, light touch, stretching, etc. 

The receptors that feel pain are familiar to you already. They are why you would pull your hand away from a hot stove. Essentially, pain receptors recognize when something is harmful, and they make us very aware of the danger.

The other nerve endings, called proprioceptors, are less familiar to most chiropractic patients. I like to think of them as small position sensors in our joints and muscle tissue. They sense where our body and joints are in space and how well we move. An excellent example of thinking about how they work is to close your eyes and touch your nose. You can do this because of the proprioceptors (position sensors) in your body. The better your proprioceptors work, the more balance, coordination, and body awareness you will usually have. 

So, now you have enough information to understand the initial question; why does it feel like something is out of place?

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Answer:

When a joint or muscle is injured or even slightly irritated, many of the different pain receptors are firing, which can interfere with or override the proprioceptor's ability to have proper body awareness. This can distort your body perception, leading to a sense of "feeling out of alignment." When this happens, people will usually say that it feels like something needs to pop or stretch "back into place." In many of these instances, the entrapped synovial fold, previously mentioned, is irritated and interfering with normal movements.

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