What is a subluxation, really?

As many times as we as practioners describe it throughout our careers, I wonder how many Chiropractic Physicians know what a "'subluxation" really is. We have said it time and time again as practioners of the art and the science. We have many times explained it to patients, in various ways, we have explained that the Nervous System controls and coordinates all the functions in the body. Due to Stress, physical dynamic or diet, each can manifest as an occlusion or blockage of the nervous system not allowing the bodies innate process to function at its optimal capacity.  As a patient attempting to understand my body, this is a great explanation due to it simplicity. Once I was asked by another health care professional (not a Chiropractor) the question; What is a subluxation? He goes on to say, "I get the idea that it is a dysfunction of the Nervous System, but in what manner?" I went on to explain, but it bought me to the question What is a subluxation, really?  I did not want to just consider it from a practioner's point of view talking to a patient but consider the concept from an anatomical and physiological point of view that is still simplistic in its understanding.

Based on the information compiled by Dr. Frank Painter, Author of Vertebral Subluxation Complex: An Integrative Perspective believes a subluxation complex is a traditional response of five components in response to traumatic change in homeostasis. These five integrative components include the following concepts:

Component #1 (Spinokinesiopathology) spinal pathomechanics, including alignment motion irregularities

Component #2 (Neuropathophysiology/Neuropathology) compressed or facilitated nerve tissue

Component #3 (Myopathology) muscle spasm, muscle weakness / atrophy

Component #4 (Histopathology) inflammation, edema (swelling) of tissue, usually local to traumatized area

Component #5 (Pathophysiology/Pathology) pathophysiologic and pathoanatomical changes due to the previous four components usually seen locally as degeneration, fibrous tissue and/or erosion locally and peripherally as a loss of global homeostasis

Studies by Holzer P. Herbert M.K. on Basic Mechanisms, Physiology and Pharmacology of Neurogenic Inflammation discusses the so-called flare response to noxious Stimuli.  These studies also show a subluxation complex is related to a neurogenic inflammatory response of the sensory fibers in the peripheral Nervous System (PNS). Activation of sensory unmyelinated neurons by stimuli (Toxins, trauma or stress) evoke the release of neuropeptides, such as Substance P and Calcitonin Gene-Related Peptides (CGRP), from the peripheral nervous system (PNS) sensory nerve endings. This leads to a localized oedemic response, hyperemia and an erythema extending past the site of local stimulation. Functional integrity of the PNS sensory nerve fibers are the key to this response. The release of these peptides are seen as relevant to the physiological and pathological processes in mammals, to include humans. Maintaining this functional integrity is seen as a rationale for therapeutic options for various diseases in which neurogenic inflammation is involved.

In closing, even, mainstream medicine has a definition of vertebral subluxation complexes which basically refers to misalignment or displacement of a vertebra, joint or disc in the spine. The difference in the mainstream concept of subluxation complexes is their view of the concept is conditional. Causes can be attributed to traumatic injury or by age related degenerative spine conditions related to nerve compression producing symptoms of pain, tingling, numbness and muscle spasms. The chiropractic concept of subluxation complexes originates from a more wholistic view point. The founder and innovator of the chiropractic profession, Dr. D.D. Palmer and Dr. B.J. Palmer, respectively, supported the theory of an identifiable relationship between irregularities within the spine-and all diseases. This theory supported that 95 percent of diseases can be directly attributed to spinal irregularities, while the other 5 percent of disease could be blamed on displaced joints elsewhere in the body. The World Health Organization continues to tout, “Lack of empirical evidence” though there is a host of scientific research available to dispute the WHO’s claim. The idea that a vertebral subluxation complex can manifest itself as signs and symptoms of other conditions remain an overarching construct of the chiropractic profession.