In order for the body to function optimally, a number of systems are working together, including the bones and muscles that facilitate healthy movement patterns. Subluxations can cause pain, swelling, mobility changes, and common causes include injury and underlying conditions like scoliosis.
Subluxations are misalignments of bones and joints in relation to one another; they are common in the spine, shoulders, and knees. but can also occur in fingers and elbows. Nature favors symmetry, and asymmetrical changes to the axial and appendicular skeleton can cause a number of effects felt throughout the body including postural changes and pain.
Let’s take a look at the three most common types of subluxations: those involving the shoulders, knees, and spine.
What is Subluxation?
A subluxation is a partial dislocation of a joint, where the bones remain in partial contact with one another but are misaligned.
A full dislocation is known as luxation where there is no contact between the bones of the joint (full separation).
Joints are structural points where bones meet, and their role is to facilitate healthy movement and flexibility.
Joints are made of connective tissues (ligaments, cartilage, and bursas) and are classified as moveable, partially moveable, or immovable, and while joints are designed to facilitate a certain degree of movement, if there is too much movement within a joint, it can become unstable and shift out of position.
When joints are misaligned, balance and healthy movement is disrupted, and common symptoms of subluxation include swelling, pain, joint instability, numbness, popping sensations in the joint, and a reduced range of motion in the affected joint and area.
Common causes of subluxations include an overuse injury, trauma, strenuous movement such as a sudden twist, trauma from a fall, altered muscle tone, impaired proprioception, overstretching, ligament damage, and/or the presence of an underlying condition like Ehlers Danlos Syndrome or scoliosis.
Injury/Trauma and Subluxation
For people without an underlying condition causing joint hypermobility, injury and trauma is the leading cause of subluxation.
When a joint comes out of place due to injury and/or trauma, excessive force pushes and/or pulls bones beyond their natural range of motion.
A direct blow to the shoulder or knee, for example, or a sudden strenuous twisting motion can cause a bone to shift out of its socket.
Damage to ligaments and tendons can also contribute to subluxation because joints need support from surrounding muscles and supportive structures. Repeated overstretching, over time, can cause increased laxity in ligaments and tendons surrounding a joint and instability in the joint as a result.
Repeated stress from overuse can also cause joints to gradually weaken and misalign. Shoulder subluxations, for example, are common sports injuries.
Muscle strain can also contribute to a subluxation if an injured muscle spasms or tightens to support a joint, but ends up pulling the joint into an unnatural position.
Conservative nonsurgical treatment options include RICE (rest, ice, compression, and elevation), immobilizing the joint for stability through the use of a sling or brace, and medication prescribed for pain relief.
Rehabilitation through physical therapy can also help improve a patient’s range of motion, muscle strength and support around an affected joint, and can include proprioception training.
Ehlers Danlos Syndrome and Subluxation
Ehlers-Danlos Syndrome and hypermobility spectrum disorders are genetic conditions that affect the connective tissues and cause ligaments/tendons to become lax to the point of instability.
A lack of support from lax ligaments and tendons causes joint instability and makes them vulnerable to frequent recurrent subluxations without injury or trauma. Ehlers Danlos patients can experience subluxations caused by simple movements.
Some subluxations are painful, but many are described as more uncomfortable than painful and can happen repeatedly throughout the day, becoming disruptive and chronic.
Some subluxations will correct themselves, while others require treatment to realign the joints.
Ehlers Danlos has no known cure, so treatment focuses on symptom management for improvements to quality of life; physical therapy focuses on improving joint stability through increasing the strength of surrounding muscles for more support.
Orthopedic support can counteract hypermobility and minimize dislocations, while pain medications can further help with pain relief.
Scoliosis and Subluxation
Scoliosis is a highly-prevalent asymmetrical spinal condition and is the leading spinal condition amongst school-aged children.
Scoliosis causes vertebral subluxations through the development of an unnatural sideways spinal curvature with rotation, meaning certain vertebral bodies are curving unnaturally to the side and twisting.
Scoliosis can cause spinal subluxation through disruptions to the spine’s proper position and spinal alignment.
Structural Changes
The underlying nature of scoliosis is structural, so it directly affects the health and position of the spine’s bones and joints through uneven pressure.
The spine needs its natural and healthy curves in place to maintain its balance and stability. A vertebral subluxation means a vertebral body has shifted out of alignment in relation to other vertebrae, causing a misaligned spine, and the rotational component means vertebrae at the apex of the curve are also twisting, further affecting their position and alignment.
Once a subluxation occurs, increasing instability can become an issue, particularly in older adults also experiencing age-related degenerative changes in the spine.
Because scoliosis is progressive, the subluxations are likely to get worse over time, and common symptoms of scoliosis include postural changes, mobility changes, pain, and disruptions to nerve function.
Nervous System Function
A role of the spine is to protect the spinal cord within; containing 31 pairs of spinal nerves, the spinal cord and brain work in tandem to form the central nervous system, and if the spine’s vertebrae aren’t aligned, the uneven pressure can cause nerve interference through compression.
Compression is more closely associated with adult scoliosis; the condition becomes compressive once skeletal maturity is reached, and pain that radiates into the extremities due to nerve compression is the main symptom of adult scoliosis.
Nerve involvement can also mean a disruption in brain-body communication.
Muscular Imbalance
Scoliosis can also cause muscular imbalance due to the spine’s unnatural curve and rotation causing the muscles on one side of the spine to work harder as they struggle to support and counteract its unnatural position, while muscles on the opposite side can become weak due to lack of use.
A muscle imbalance can cause muscle tension and muscle spasms. A lack of strong and/or balanced muscular support can further contribute to vertebral subluxation and poor posture.
Proprioception
Another effect of scoliosis is an impaired sense of proprioception: the body’s ability to orient itself in space and sense joint position and movement without visual cues. The disruption can affect muscle mechanisms, healthy posture, and cause improper muscle loading.
When there is a disconnect between the brain and its ability to detect a joint’s position in space, surrounding muscles aren’t activated to stabilize the joint, leading to instability and potential subluxation.
The first line of scoliosis treatment involves conservative nonsurgical methods that combine a number of scoliosis-specific treatment disciplines for the best potential results.
Scoliosis-specific chiropractic care can involve manual chiropractic adjustments of affected vertebrae to improve their position and alignment, while physical therapy and rehabilitative scoliosis-specific exercise addresses the strength and balance of surrounding muscles for more support and stability for the joints.
Corrective bracing can further improve the spine’s position and stability and works towards neurological retraining while wearing the brace; the connection between the brain, the spine’s surrounding muscles, and the spine’s healthier position is strengthened over time.
Conclusion
A joint subluxation involves the bones of a joint shifting out of alignment while remaining in partial contact.
Symptoms of joint subluxation can include pain, discomfort, inflammation, swelling, unhealthy movement patterns, and stress, and the most common causes include injury and trauma, strenuous movement, altered muscle tone and balance, impaired proprioception, and underlying conditions such as Ehlers Danlos and scoliosis.
Treatment for subluxation has to address the underlying cause and generally includes chiropractic care, physical therapy, activity modification, and use of orthotics for support, stability, and pain relief.
Here at the Scoliosis Reduction Center®, scoliosis is treated proactively in an effort to prevent increasing vertebral subluxation over time and related effects, including postural changes, mobility changes, instability, and pain.
