Overview of the Three Most Common Chiropractic Treatment Techniques
Gonstead, Diversified and Activator techniques are the top three chiropractic treatment methods. Collectively, they represent over 95% of what chiropractors use when treating their patient. In this article, we provide some background information on all three. However, before we begin our discussion, let’s briefly go over the purpose of chiropractic. Chiropractic care is the most effective treatment method for many conditions such as neck pain, back pain, scoliosis, sciatica, slipped disc, joint pain, sports injuries, spondylolisthesis, and spondylosis. There are hundreds of other conditions that could be effectively treated by a Doctor of Chiropractic. Moreover, there are thousands of published studies that reveal the health benefits of chiropractic care. Some reporting chiropractic and spinal manipulations (adjustments) to be two times more effective than the traditional medical care for the spine.
There are over two hundred chiropractic adjustment techniques. Some use the hands-on or manually provided forms, while others treat with a handheld instrument. Also, there are overlaps in both the manual and handheld instrument techniques; each having some degree of uniqueness.
What are the Best Methods of Chiropractic Treatment?
Gonstead, Diversified and Activator are the best three chiropractic treatment methods. Yes, these three methods top the list. However, in our opinion, treatment rendered through an Activator is better than Gonstead or Diversified. There are several reasons why we treat patients through an Activator instrument. We are going to cover them in the coming sections. First, let’s see what makes a given technique superior to others.
The best of chiropractic adjustments are those that are segment specific (targeted), short lever and high velocity while maintaining low amplitude. More specifically, short lever applies to the specific contact on the vertebra and the high velocity refers to the quick application of force. The low amplitude is relating to force depth.
Chiropractic adjusting procedures via the long or short lever approaches induce motion and increase mobility. With the manual methods, the mobilization produced impacts multiple segments, as opposed to restricting the mobility to a given part as performed by the activator method. The hands-on chiropractic adjustments (short or long lever methods) lack the specificity in targeting a single segment or joint, and as such, they are deemed non-specific.
How Specific are the Chiropractic techniques provided in a Side-lying position or those requiring Rotation of the Neck or Back?
Procedures such as the side posture adjustment (lying on one’s side for the low back treatment), anterior thoracic adjustment and the rotatory cervical or neck treatment accompany are examples of non-specific treatments. They are non-specific as they provide mobilizations for multiple segments. In short, they lack the precision needed for targeting one segment. Generally speaking, these are the methods where a “cracking” or audible popping sound is heard. In other words, they are general mobilizations that induce mobility. General mobilization is best for the non-acute patients presenting with multiple hypo-mobile segments. In our opinion, patients presenting with acute conditions, torn discs, inflamed joints or injured soft tissues are better treated through targeted methods that allows precision.
Methods incorporating precision targeting are better tolerated compared to the rotatory (twisting) techniques. Patient tolerance is an essential factor. Most manual methods require specific positioning of a patient in need of care. Patients in pain will almost always feel a varying degree of discomfort with most pre-treatment positioning of the manual (hands-on) methods. For example, a back pain patient may experience more discomfort when they are rolled forward from their side-lying position with a flexed knee. An increase in discomfort at the time of positioning or during the process of adjustment causes an involuntary muscle tightening. The same applies to those receiving care from a rotational treatment for neck pain. The involuntary muscle tension is an uncontrollable automated response known as paraphysiological muscle guarding or response.
Importance of Paraphysiological Muscle Response During the Chiropractic Adjustment
Your nervous system controls the entire body. This controlling mechanism is either voluntary or involuntary, and it impacts every cell or tissue including muscles, ligaments, joints and spinal discs. Physiological muscle response occurs when a muscle is stimulated; resulting in contraction or tightening of that muscle. Paraphysiological muscle response is an automatic guarding mechanism that protects us from injury. It occurs when our body or part of our body is positioned oddly. Let’s look at the Gonstead, Diversified and Activator methods and their impact on physiological muscle response.
The manual methods (Diversified and Gonstead) require the patient to be positioned laying on one side with the knee flexed or having the neck bent and rotated towards one side during neck treatments. Both positions are unnatural and uncomfortable, especially for those in pain. These unnatural pre-treatment positions usually cause uncontrolled muscle guarding (paraphysiological muscle response). Discomfort and uncontrolled guarding are present in all pain patients in pre-treatment set-ups. Prolonged patient positioning yield higher degrees of discomfort and paraphysiological muscle guarding (response).
Adjusting (treating) patients during an uncontrolled guarding (paraphysiological muscle response) or discomfort is the leading factor in aggravations of symptoms. Patients who experience higher degrees of discomfort (pain) or exhibit intense guarding may even worsen. Therefore, pain patients and specifically those presenting with acute conditions get better results from methods that avoid guarding or cause an increase in discomfort or pain during treatments.
The instrument-assisted methods as provided by the Activator prevent muscle guarding or incontrollable subconscious tightening. Patients treated by an Activator instrument are not required to maintain an uncomfortable position, as such treatments are provided in a natural, relaxed state.
Should You Avoid the Rotational Chiropractic Treatments?
While the rotational chiropractic adjustments feel good, it may be harmful. Published research in reputable chiropractic journals calls for non-rotatory methods of chiropractic treatments. The main reason for this is to avoid further injury or damage. Rotational methods and techniques are associated with an audible popping sound or cracking. We understand that the cracking of the spine feels good for most, but if you have a degenerated disc, slipped disc (bulging or herniated disc), sprained back or scoliosis; than the rotatory methods of chiropractic treatments are not for you. Let’s assess the Gonstead, Diversified and Activator systems of care and their rotational components.
Of the Gonstead, Diversified and Activator, Diversified and Gonstead are both rotatory chiropractic techniques. However, the degree of rotatory movements is less with the Gonstead method. Non-the-less, there is a rotatory component, especially when the patient is larger than the chiropractor. Larger patients treated through the side-posture methods of Diversified or Gonstead are often a challenge for the short or small chiropractor. Short or physical weaker chiropractors may apply more force and rotation to overcome height or strength issues.
Forceful Versus the High-Velocity Chiropractic Treatment or Adjustment
The goal with Gonstead, Diversified and Activator treatments is to restore stability in joints and soft tissues. As mentioned, there are hundreds of methods used by chiropractors, some of which are forceful. Techniques that use more force can cause soreness or complications. Patients with acute conditions such as a disc disorder, sprained or sprained spine or joint shouldn’t opt for treatments through a forceful method.
Generally speaking, the vast majority of chiropractic techniques are minimally forceful. However, even the minimally force methods of chiropractic treatment can aggravate a spinal disc disorder or an injured joint. The degree of the forcefulness of chiropractic treatment is not just dependent on the technique, but also the chiropractor providing the treatment.
The three most common chiropractic techniques along with a short overview:
- Diversified Technique: A rotatory method that involves some force.
- Gonstead Technique: Mildly rotatory methods with minimal force
- Activator Chiropractic methods: Non-rotatory methods without force
It’s important to understand what each one does and how it can have an impact on the human body. So, in this article we provide an overview of the three most commonly used methods (Gonstead, Diversified and Activator), starting with the Activator method. Here is a look at the value of the activator technique and why it has become the number one option for chiropractors looking to provide targeted corrective care.
What Is the Activator Method?
The activator method refers to a unique treatment system for treating neck pain, back pain, joint pain, sports injuries, scoliosis, slipped disc patients and those who present with headaches or migraines.
It is a method that is completed using an “Activator Adjusting Instrument. The Activator is a hand-held device that delivers small doses of high-velocity impulses into the spine or joints. The aim is to maximize stability and improve mobility in the vertebra or joints. It’s important to note this technique is a direct replacement for a manual technique such as the Diversified or Gonstead methods.
There are several advantages with treatments given by the Activator Adjusting Instrument or Activator Chiropractic Methods (ACM). It provides precision targeting of joints and spine at a degree not possible with the manual or hands-on method of Gonstead or Diversified. The depth of treatment is also controlled at better levels with an activator. ACM is a well-researched non-rotatory, non-forceful method. Its’ proven clinical successes are the main reason why so many Doctors of chiropractic have started to use it as their primary means of care.
The Advantages of ACM Treatments
Activator offers a controlled and direct low-amplitude high-velocity impulse to manipulate joint of tissues. The primary reason chiropractors prefer to use this technique has to do with the precision targeting and velocity of the treatment impulse.
We have provided additional factors why Gonstead and Diversified practitioners are turning to Activator Methods of care below:
- Non-Force: Activator’s higher velocity has replaced the need for force
- Depth Control: Activator allows better control over the depth of a given treatment. Depth control is critical to spine and sport injury patients
- Doesn’t aggravate or complicate condition: Flare-ups, aggravations, and complications are non-existent when treating patients with the activator
- Faster recovery: Better targeting and non-force features of the Activator have reduced recovery from pain or injury significantly
The manual hands-on methods provided in positions that may cause guarding or trigger an involuntary muscle tightening, especially with longer positioning time. Treatment of an acute patient by the manual method incorporates longer positioning time. Prolonged setup can lead to tears, aggravation, and general discomfort, which is why the activator method is adored. When the muscles aren’t tensing up, it’s easier to treat the underlying issue and get to the bottom of things as soon as possible. The Activator keeps treatment centralized without creating unwanted duress in the target area.
An Overview of the Gonstead Chiropractic Technique
Dr. Clarence Selmer Gonstead was born in 1898 and passed way in 1978. He founded the Gonstead chiropractic technique in the 1940s. In the 1960’s Chiropractic Universities started teaching the Gonstead technique. Today, it is one of the top three most utilized chiropractic treatment technique in the world. Dr. Gonstead developed several chiropractic concepts. These include primary and secondary subluxations, as well as the concept of compensation. According to Dr. Gonstead, there is a compensation for every subluxation. These theories are incorporated in all chiropractic methods including those delivered through the Diversified chiropractic techniques and the Activator. Dr. Gonstead is the most notable researcher on theories of spinal stability through chiropractic treatment.
According to the Gonstead method, the pelvis establishes the spine’s foundation. The pelvis is the part of the body where the hip bones attach to the lower back. Gonstead practitioners believe that slight misalignments of the pelvis cause structural instabilities in segments above. It is for this reason why Gonstead practitioners always require full spine x-rays that include the pelvis. Moreover, it is the primary reason why most Gonstead chiropractors treat the pelvis as the actual cause of all issues.
How the Gonstead Therapy of Pelvic Unleveling as Cause of Pain was Debunked by MRI?
According to this method, the misalignments put much pressure on the spinal discs, causing them to slip or herniate through. However, we must mention that this theory that has been debunked. With the advent of MRI assessment, researchers have proven the spinal disc degenerative changes as the primary reason for the slipped disc, joint pain, and misalignments of the spine as well as the pelvis. As the disc degenerates (wear out), it places undue stresses on spinal discs and spinal joints. Accumulated stresses result in minor alignment issues of the spinal bones and joints of the pelvis. The hallmark of a misaligned or subluxated joint is swelling or inflammation. In other words, a misaligned joint is an irritated joint. Irritated joints will always present with some degree of inflammatory process.
Analysis of the Diversified Chiropractic Technique
The Diversified method of chiropractic treatment is the most common type of chiropractic adjustment. It is the primary technique taught to chiropractic students. An estimated 95% of chiropractors are proficient in the Diversified methods of chiropractic treatment. In short, it is the technique most patients are familiar with. Diversified adjustment is somewhat similar to the Gonstead method as it entails a high-velocity, low-amplitude thrust, resulting in cavitation or “cracking” (popping sounds). Both have some degree of scissoring movements or rotations, but Diversified is reliant more on the rotatory or scissoring system of treatment.
Dr. D. D. Palmer developed the Diversified chiropractic technique. Dr. Palmer is the founder of the chiropractic profession. He was the first to coin the term subluxation. Dr. Palmer discovered the profession of Chiropractic in 1895. Diversified became the main chiropractic treatment methods with the emergence of Palmer School of Chiropractic in 1904. The reason why it is taught to all chiropractic students is that of the fact that the professions’ founder discovered it.
If you spend enough time in the chiropractic community, you hear many dos and don’ts. Some of the ‘rules’ that are taught to up-and-coming chiropractors make sense, but some are merely rules of thumb that get repeated without full understanding. All too often, newly qualified chiropractors accept rules as gospel and repeat them, not realizing why they were taught to avoid certain moves or why certain adjustments are performed in a given way.
How MRI Debunked the Gonstead Theory of Pelvic Misalignment as the Cause for the Subluxated or Misaligned Spine?
We mentioned that MRI had debunked the pelvis as sources of subluxations or misalignments; let’s see how? Review of pelvic and Lumbar MRI of patients with low back pain (subluxations or misalignments) has confirmed the existence degenerative changes and inflammatory changes in spinal joints in the absence of an inflammatory reaction in the sacroiliac joint (pelvis).
MRI is the gold standard for assessing spine and joint conditions. It debuted in 1982, three years after the passing of the dearly departed Dr. Clarence Gonstead. During his lifetime, the best means of assessing the spine was through the full spine x-rays. We are confident that much of Dr. Gonstead’s theories would have changed; had this modality been discovered during his lifetime. For starters, he would not have required the full spine x-rays or base his argument of subluxation on the pelvis. The contributions he has made are significant without a doubt. Every chiropractor is forever indebted to him regardless of the techniques they use.
Difference Between Gonstead and Diversified Chiropractic Techniques
Rotation is something that is taught as being dangerous, and young students are told to avoid rotational prestress, for fear of severe, adverse outcomes. Such outcomes are unlikely if the chiropractor is well trained, and provides the treatment carefully. However, scoliotic patients, moderately inflamed joints and those diagnosed with spinal disc damage such as tears or herniations may experience complications with Gonstead and Diversified methods.
As mentioned earlier, the “scissoring” move, especially for neck or low back treatments are the reasons for these complications. Dr. Gonstead advocated a non-scissoring move. However, performing Gonstead without scissoring hands is hard for new chiropractors. It takes at least a decade to master! So, most still incorporate the “scissoring” into the Gonstead method. The scissoring two-hand move is evident in the newly trained Gonstead practitioner.
Few Chiropractic Universities teach Gonstead techniques to students. The main reason being the time it consumes in becoming highly proficient. Those who are not taught during their studies will have a difficult time becoming proficient. Most have to rely on weekend courses to learn the method. Weekend courses offer limited training, yet another reason why many Gonstead practitioners are incorporating the Diversified scissoring moves into the Gonstead technique.
The two-hand ‘scissoring’ methods as provided through the Diversified and Gonstead produce an audible crack (popping sound). It may even feel good. Yes, the cracking sound is satisfying, and the patient may also enjoy a feeling of released pressure, but if the adjustment wasn’t the right one, then pain is going to return very quickly.
The Diversified, Activator and Gonstead techniques are the chiropractic treatment methods that have stood the test of time. In general, the non-force activator method provides all-encompassing control without further aggravation. This is essential in managing severe herniation and canal stenosis; otherwise, the condition can worsen over time. The process is efficient, safer, and better when weighing various pros and cons.
After thorough research, we choose the Activator method as our primary technique. Several factors looked at; we have listed some of them below:
- Proven research-backed method,
- The best method of care for sports injuries,
- Precision treatment for the spine spinal disc issues such as disc bulges, herniation, extrusions), sciatica, spondylosis, spondylolisthesis, and the scoliotic spine,
- Ability to target a single spinal segment,
- Non-rotatory method (no twisting or scissoring moves involved as it harms damaged or injured soft tissues or joints),
- High-velocity non-force method,
- Provides corrective care without aggravations,
- A tolerable system of by the injured, weak, young or elderly,
- Reproducibility time and again,
- Dependent on the practitioner’s knowledge, but not their size (Diversified or Gonstead methods are dependent on practitioner size and strength)
In our assessments of the Gonstead, Diversified and Activator techniques based on the criteria mentioned above; the Activator topped the list. If you are in pain and wondering which to chose, chose treatments via the Activator. We are not an Activator method only center. We hope you have found this article helpful. Contact our main center at 03 2093 1000 to learn more Gonstead, Diversified and Activator techniques today.