Chiropractic Adjustment Techniques Explained

A chiropractic adjustment is not one procedure but a family of them, and the differences matter most to the person on the table. A quick thrust by hand and a slow table technique are both adjustments, and they feel nothing alike. This page explains the adjusting methods used at Tradewinds Chiropractic & Wellness in Charlotte Amalie, St. Thomas, in terms of what you would actually experience, so you can ask for what you want by name. All of them are on our services page.

Diversified, the one most people picture

Diversified is the adjustment people picture when they imagine a chiropractor: a quick, specific push at one joint, delivered by hand and over almost before you have registered it. It often produces the audible release people associate with the whole profession, and it works whether or not that sound happens. Does a chiropractic adjustment hurt covers the sensation and the pop.

Gonstead, finding the exact segment first

Gonstead is less a different push than a different way of deciding where to push. It is a specific-analysis approach: the practitioner works through his own sequence of findings first, then positions you so a single segment can be contacted cleanly, often sitting up or on your side rather than face down. What sets it apart is the examination and positioning before the thrust, and the aim of adjusting one identified segment rather than a general region.

Drop table, letting the table carry the force

A drop table, sometimes called a Thompson drop table, has sections that sit slightly raised and release downward as the thrust is delivered. Because that drop carries part of the force, less has to come from the hands. Patients usually describe a firm press followed by a clunk from the table rather than a twist, often with no pop at all. It is a common option for people who find a manual thrust uncomfortable.

Flexion-distraction, a table that moves instead

Flexion-distraction uses a segmented table whose lower section moves under the practitioner's control while he holds contact on your back. You lie face down. The table lowers and lifts in a slow, repeating rhythm, gently opening the space between two vertebrae and easing load off a nerve root. There is no thrust, no twist and no popping. It is one of the gentler techniques in chiropractic, commonly used for disc-related pain and for patients who want something slower than a manual adjustment.

Flexion-distraction is performed by the practitioner on a segmented table, with the movement under his hands and changed moment to moment based on what he feels and what you report.

Extremity adjusting, not just the spine

Joints outside the spine lose motion too, and the same principles apply. Extremity adjusting covers shoulders, elbows, wrists and hands, hips, knees, ankles and feet. The contacts are smaller and lighter. If your complaint is a shoulder that will not go overhead or a foot that hurts on the first step in the morning, the adjusting may happen nowhere near your back.

Why there is more than one

Technique is matched to the person and the problem, not applied as a house style. Your age and bone health, how irritable the problem is on the day, which joint is involved, any prior surgery, and what you say you are and are not comfortable with all change the answer. The exam decides that, and it can change between visits as a joint settles. Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands.

If you do not want to be "cracked"

Say so. That sentence is enough. You do not need a medical reason, and you will not be talked into anything on the table. People who do not want a manual thrust have real alternatives, and the low-force methods above are not consolation prizes. Tell us when you book, at your exam, or partway through a visit. See what to expect after your first adjustment for what the day after looks like, and is chiropractic safe for a direct discussion of risk.

When you should see someone else

No adjusting technique is the right first step for every problem. Pain that keeps escalating through a course of conservative care, or numbness and weakness that are spreading, calls for imaging or a referral to an orthopedist or a neurologist.

Some situations skip the office entirely. Loss of bowel or bladder control, numbness in the saddle area, or leg weakness that is quickly getting worse means the nearest emergency room. So does back pain with a fever, or severe new pain after a serious fall or crash. The worst headache of your life is a 911 call. See when back pain is an emergency.

Getting seen

Call (340) 690-4994 to book, or to ask about technique first. We take walk-ins and same-day appointments. We are at the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802, just east of Charlotte Amalie and a short drive from the Havensight cruise port and Yacht Haven Grande. Hours are Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun. New patient forms are at forms. Tradewinds Chiropractic has more than 180 five-star Google reviews.

Questions patients ask

What is the Gonstead technique?

Gonstead is a specific-analysis approach to adjusting. The practitioner works through his own examination findings to identify one segment, positions you so that segment can be contacted cleanly, often seated or on your side, and adjusts by hand. The distinguishing part is the analysis and positioning before the adjustment, and the aim of adjusting one identified level rather than a whole region.

What types of chiropractic adjustment are there?

At Tradewinds the adjusting methods are Diversified, Gonstead, drop table, flexion-distraction and extremity adjusting. Diversified and Gonstead are hands-on thrusts. Drop table uses a section of the table that releases downward so less force is needed. Flexion-distraction is a slow, rhythmic table technique with no thrust. Extremity adjusting applies the same principles to shoulders, elbows, wrists, hips, knees, ankles and feet.

Do all chiropractors adjust the same way?

No. Chiropractors are trained in several techniques and differ in which ones they use and how often. Even for one patient the choice changes with age, bone health, how irritable the problem is, which joint is involved and what the patient prefers. It is a fair question to ask any chiropractor before you book.

What is flexion-distraction?

It is an adjustment done on a segmented table whose lower section moves under the practitioner's control while he keeps contact on your back. The rhythm gently opens the space between two vertebrae and takes load off a nerve root. There is no thrust, no twisting and no popping, which is why it is often used for disc-related pain and for people who want something gentler.

What if I do not want to be cracked?

Tell us, at booking or at your visit. You do not need to explain why. Drop table and flexion-distraction are both low-force options that do not involve a manual thrust, and you can stop a technique partway through and say it does not feel right.