Non-specific adjusting procedures, whether employed with short or long levers, is used to increase mobility in a number of motion segments at the same time. In theory, the procedure involved passive movement of joints through their physiological range without exceeding their passive end range (e.g., no cavitation produced). Like most adjustive procedures, there is a lack of data to provide a basis for decision making, leaving room for opinion on the use of these procedures. This brief discussion will outline what I feel are important considerations in the practice of non-specific contact adjusting.
While non-specific adjusting has received an established rating at the Mercy Conference, non-specific procedures such as the anterior thoracic adjustment and lumbar roll, and the master cervical are often accompanied by multiple audible releases indicating caviation has occured. In these instances, the lines are blurred between manipulation and mobilization. A major question remains to be studied: Are specific lesions present which warrant specific procedures, or will general mobilization create movement that will effect all areas of putative hypomobility and are thereby justified? Who are suitable candidates for these procedures? Several additional questions are also of interest:
a. Are these procedures safe? Biomechanical modeling data suggest that forces generate during lumbar side posture rotary adjustments may exceed safe ranges in some individuals.
- In the cervical region vertebral artery syndrome is a concern; the risk of which may or may not be detectable by provocation tests.
- In the thoracic spine rib fractures are also a concern. We need to develop ways to carefully select the procedures are used.
b. What are the long term effects of repetitive treatment over time?
Reference: Arlan W. Fuhr,DC. Proceedings California Chiropractic Foundation’s 7th Annual Conference on Research & Education, Palm Springs CA, June 19-21, 1992, pp. 256-7.