Adjustments and Techniques:
The most common treatment provided by a Chiropractor is spinal manipulative therapy, SMT, commonly known as an adjustment. It is a manual therapy where the Chiropractor mobilizes a fixated joint in order to restore proper motion which, under the Chiropractic paradigm, restores health and promotes healing.
An adjustment occurs when a medical practitioner, most often a Chiropractor, carefully takes a joint past the normal physiological range of movement without exceeding the anatomical boundary limit. Its defining factor is a dynamic thrust, a sudden yet gentle force that restores the joint’s range of motion and often is accompanied by an audible release.
The medicinal use of spinal manipulation can be traced back over 3000 years to ancient Chinese writings. Hippocrates, the "father of medicine" used manipulative techniques, as did the ancient Egyptians and many other cultures.
Many different Chiropractic techniques have been developed since its founding in the 1890s. Each specializes in certain locations in the spine or type of manipulative force used in providing an adjustment. A skilled Chiropractor will be knowledgeable in several of these techniques and able to recognize and apply the most appropriate technique based upon the needs of the patient.
Below is a list of Chiropractic treatment options we offer at our location:
Diversified is the most common technique used by Chiropractors today. Diversified is considered the most generic Chiropractic manipulative technique and is differentiated from other techniques in that its objective is to restore proper movement and alignment of spine and joint dysfunction. It is taught in most Colleges and is characterized by a high velocity low amplitude thrust, meaning a fast but gentle impulse targeted at a fixated spinal joint.
Extremity adjusting is very similar to Diversified. It also involves high velocity low amplitude manipulations, but is directed at joints not located in the axial skeleton (skull or spinal column), but rather the appendicular skeleton (shoulders, hips, arms, legs, hands, and feet).
Flexion/Distraction is a gentle, low-force procedure which utilizes specialized adjusting tables with movable parts. Treatment is performed on a special table that extends, and flexes or bends in the middle. Studies have shown this to increase the intervertebral foramen, the gap between vertebrae where the nerve root exits after branching off the spinal cord, more than 20%. This provides relief by reducing pressure on the nerve root, allowing healing and proper function to return. Cox Technic is a copyrighted flexion and distraction technique with its own treatment protocols.
Spinal decompression works by gently stretching the spine, changing the forces on, and positions of the vertebrae (the bones in your spine) and pressures in the spinal disks (the gel-like cushions between these bones). Over time, this therapy can help reduce or eliminate bulging or herniated disks, relieving the pressure on the nerves and other structures in your spine. This in turn, helps promote movement of water, oxygen, and nutrient-rich fluids into the disks so they can heal. The DRX9000 is a copyrighted and patented machine which operates under this premise, but treatment plans can be significantly more expensive.
Both flexion/distraction and decompression are effective for reducing the effects of degenerative disc diseases and lumbar, cervical and thoracic disc herniations, and offer several benefits for people who do not want to undergo surgery to treat their back pain.
A Chiropractor can also utilize a “drop table” in order to provide adjustments. A gentle thrust is applied to a specific joint, which in turn, sets the drop piece into motion. The padded drop piece falls ¼ to ½ an inch, using gravity to aid the adjustment. This allows for less force to be used by the Chiropractor, providing a gentler adjustment. Thompson Technique is a copyrighted drop table technique with its own treatment protocols.
A Chiropractor may also choose to place padded blocks or wedges under their patient’s pelvis. Block placement depends on how the pelvis is distorted, and the patient can be positioned either on their front or back. The patient lies on these blocks for a few minutes and as muscles relax, the pelvis assumes a more natural position. SOT practitioners believe that this has implications on the musculature of the entire spine, especially the neck. Sacro Occipital Technique (SOT) is a copyrighted pelvic blocking technique with its own treatment protocols.
Many Chiropractors use a spring loaded adjustive instrument to deliver their manipulations as an alternative to manual manipulation of the spine or extremity joints. This mechanical force manual assisted (MFMA) technique is sometimes regarded as a “softer” or less forceful manipulation. Activator Technique, is a copyrighted MFMA technique with its own specific diagnostic and treatment protocols.
Chiropractic manipulation focuses on restricted joints, but many patient complaints also involve nerves, muscles, tendons, ligaments, fascia, skin, fibrous tissues or synovial membranes (collectively referred to as soft tissue). We therefore also frequently utilize other treatment choices to maximize patient outcomes such as:
Chiropractors offer several types of manual therapies for soft tissues. This can include localized massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion), manual lymphatic drainage, manual traction, or Post Isometric Relaxation/Proprioceptive Neuromuscular Facilitation. These therapies help relieve pain, spasms, muscle tension and reduce scar tissue, and are often used prior to an adjustment to help the patient relax.
Instrument Assisted Soft Tissue Mobilization (IASTM) is designed to effectively and efficiently address soft tissue lesions (such as scar tissue), fascial restrictions and decreased range of motion. It can be a powerful treatment option to help the restoration of pain-free movement and function when combined with Chiropractic adjustments. The Graston Technique is a copyrighted IASTM technique, and Dr. Mondschein is listed as a Graston Provider.
Interferential Current (IFC) has been used in physical therapy treatment for many years and has been proven to be very safe. The IFC machine produces electrical currents that pass through the affected area of the patient. The current tends to penetrate deeper than other electrical modalities, such as TENS, and has a number of physiological effects that have therapeutic value. The physiological effects include:
Increasing local blood flow which can improve healing by reducing swelling and as a result helps remove damaged tissue and bring nutrients necessary for healing to the injured area
Stimulation of local nerve cells providing a pain reducing effect
Muscle stimulation to overcome some of the muscle inhibition often caused by local injury and swelling
During treatment patient will feel a tingling or 'pins and needles' sensation at the area being treated which may continue for a period following treatment.
Ultrasound is a therapeutic modality that has been used by therapists since the 1940s. Ultrasound is applied using a wand or probe put in direct contact with the skin. Ultrasound gel is used on the surface of the head to reduce friction and improve the transmission of the ultrasonic waves. The sound waves that pass through the skin cause a vibration of the local tissues which can cause a local heating effect though usually no heat will be felt by the patient. Ultrasound has been shown to cause increased tissue relaxation, local blood flow, and scar tissue breakdown. The increase in local blood flow can help reduce local swelling, chronic inflammation, and may promote bone fracture healing. The intensity of the ultrasound can be adjusted depending on the desired effect.
Therapeutic exercises are often recommended to develop strength and endurance, improve range of motion and flexibility, and to reduce the likelihood of future episodes