Chiropractic Adjustive Technique and Therapeutic Management
Match technique to patient
Choose technique for the patient, not the practitioner's habit: age, body habitus, bone quality, region, acuity, prior response, and preference. Thrust manipulation and mobilization both have support for musculoskeletal pain; the audible cavitation is not a measure of success. Obtain informed consent naming material risks (transient soreness, rare serious events), alternatives, and the right to decline.
Contraindications
Absolute: fracture or dislocation at the site, unstable ligamentous injury, active infection, malignancy at the segment, and severe myelopathy. Relative: significant osteoporosis, anticoagulation, inflammatory arthropathy, recent surgery, and pregnancy (positioning). Screen vertebrobasilar symptoms before cervical work, understanding that association with dissection is not established causation.
Dose and adjuncts
Pair passive care with active care: exercise, graded activity, education, and self-management. Typical initial frequency is two to three visits weekly with formal reassessment at two weeks. Warn patients about 24–48 hours of transient soreness.
Traps
Never reassessing; treating indefinitely; overpromising ("this will cure it"); confusing a relative with an absolute contraindication.
Rule of thumb
Set functional goals and a review date at the outset. If the goals are not met at review, change the plan or refer.