Chiropractic Treatment: How the Method Is Chosen

Why Integrative Spine and Joint Care?

CSC is a spine and joint care center in Malaysia. Our chiropractors and physiotherapists work together, so you do not have to choose between a chiropractor and a physiotherapist. Many of the people our physiotherapists see have already tried care elsewhere. Together, the team plans your care so that the methods used suit your condition.

Physiotherapy Combined with Chiropractic Care

Before any adjustment, your condition is evaluated. Chiropractors may use manual techniques such as the Gonstead technique, Thompson technique, or Diversified technique, or an instrument called the Activator. At CSC, we use Activator methods for the spine, joints, scoliosis and sports injuries, and each part of care is based on the examination.

Manual (Hands-On) Chiropractic Care, Used Since 1895

Manual adjustment remains the most common chiropractic method, although instrument-assisted adjustment has become more common as chiropractors see more complex spine and joint conditions.

For neck pain, manual adjustment is usually done seated, lying on the back or lying on the side, to mobilize the joints of the neck. Some methods, including the Diversified and Gonstead techniques, use rotational or twisting movements. Done correctly, the procedure should not be painful, though the popping sound that can occur may surprise people.

For lower back pain, manual techniques are applied lying on the back, face-down or on the side. The Gonstead and Diversified techniques are typically done side-lying, while S.O.T. (Sacral Occipital Technique) and the Meric technique are done face-down. The Activator can be used seated, face-down or side-lying, which helps people in severe pain, during pregnancy, or with more complex conditions.

The Gonstead Technique and Other Rotational Methods

The popping sound heard during some adjustments comes from gas bubbles released within the joint fluid. For lower back pain, the Gonstead method may be done face-down, on the side or seated, depending on the area treated. Properly performed, chiropractic care should not be painful.

The Gonstead method is widely used for general spinal mobilization. For a herniated, bulging, prolapsed or ruptured disc (a slipped disc), we avoid rotational methods such as Gonstead, because twisting an irritated disc may aggravate it. The Activator method is used instead, as its low force makes it better tolerated by older patients, people with a slipped disc, and during pregnancy.

Is Chiropractic Care Safe for Older Adults?

Chiropractic care is generally well tolerated at any age when appropriate techniques are used. Alongside spine and joint pain, older adults more often have high blood pressure, diabetes, arteriosclerosis (plaque buildup in the arteries) or reduced bone density. For older patients, we use low-force methods such as the Activator Method and S.O.T., and we avoid rotational techniques such as Gonstead and Diversified.

Chiropractic Care and High Blood Pressure

For people with high blood pressure, we avoid rotational chiropractic methods regardless of age and use non-rotational methods such as S.O.T. and the Activator Method. Chiropractic care is not a treatment for high blood pressure; that remains with your doctor.

Is Chiropractic Care Safe During Pregnancy?

Chiropractic care is generally considered safe for expecting and new mothers when appropriate techniques are used. Neck, upper back, mid-back and lower back pain are common during pregnancy, as are joint pain and swelling in the wrist, hand, foot and ankle during the prenatal and postnatal period. One common condition is De Quervain’s tenosynovitis, which causes pain and swelling at the wrist and thumb.

We avoid rotational methods such as Gonstead and Diversified during pregnancy. The hormone relaxin, which is elevated during pregnancy and breastfeeding, increases the flexibility of the joints and ligaments, which makes them more susceptible to strain from twisting techniques. Non-rotational, low-force methods such as the Activator Method are chosen for pregnant and breastfeeding patients because they avoid twisting the spine.

Comparing Chiropractic Techniques During Pregnancy

• Gonstead: Uses a knee-chest bench or a side-lying position for the lower back; the neck is treated seated or lying on the back. Because it involves rotation, it is less suited to pregnancy than the Activator Method.
• Diversified: Done lying on the back, face-down or on the side with the knee drawn toward the chest. Because of its rotational movements, we do not use it for older adults, people with disc problems, or during pregnancy.
• Activator Method: Low-force and non-rotational. It can be done seated, lying on the back, face-down or side-lying, which makes it adaptable during pregnancy and breastfeeding.

For prenatal and postnatal patients, CSC uses the Activator Method for its low force when addressing pregnancy-related pain and postpartum symptoms. If you are expecting, a new mother or breastfeeding, our chiropractic and physiotherapy teams can help with pregnancy-related aches and pain.

When General Rotational Methods Are Used

The Gonstead, Thompson and Diversified techniques are useful for general spinal adjustment when the main goal is to improve mobility. We reserve them for that purpose and do not use them for more complex conditions. They are classed as general spinal manipulation because they act on a region of the spine rather than a single segment.

In these methods, the patient usually lies on their side and a thrust is applied while the spine is rotated. Rotation can aggravate some conditions; applied to a herniated or ruptured disc, it may worsen the problem. For bulging, herniated, ruptured or extruded discs, we use non-rotational chiropractic and physiotherapy methods, because a compromised spinal disc is the wrong structure to twist.