Spinal Palpation of the Neck

Palpation is the process of examining by means of touch. The art of spinal palpation is the first procedure a chiropractor learns in school. It is an art the chiropractor continues to perfect throughout his or her career. Palpation is not the only way a chiropractor determines where and how to adjust or manipulate the spine. It is however, the chiropractor's central diagnostic technique.

There are two types of palpation; static palpation and motion palpation.

Static palpation involves palpation of the tissue surrounding the spine for pain or tenderness, as well as feeling for lack of tissue compliance or tightness. With experience, a chiropractor can gain vital information through direct touch.

In motion palpation, the chiropractor examines each complex spinal joint to analyze the degree to which it may lack proper motion. This highly skilled maneuver requires the examiner to have a mental picture and tactile knowledge of a spinal joint's normal motion. Normal motion is compared with the feel of the joint being examined as it is moved through its range of motion.

End Play
As a joint goes through its range of motion, there is extra play to that motion called the end play. An easy way to illustrate end play is to demonstrate using wrist motion.

For example, straighten your wrist with the palm up. Draw your hand forward to flex the hand toward the wrist. At about 90-degrees, you reach a normal stopping point. Now make the wrist move just a little more toward you. You will reach an absolute stopping point where the wrist cannot move any farther. That little extra distance you have made your wrist move is called the joint's end play.

When the muscles of your wrist work to bring the hand toward you, they depend on end play in the joint. If your wrist was locked or fixated, the muscles would tug against the fixed joint and become inflamed.

Spinal Joint Subluxation
In examining a patient with neck pain, the chiropractor asks the patient to sit on the adjusting table. The chiropractor stands behind the patient. Using both hands in a series of gentle motions, the chiropractor examines the neck joints one by one, taking each joint through its five ranges of motion to determine if any joint has become locked or fixated. Specific lack of spinal joint motion is one important aspect of what chiropractors call a subluxation.

If you have been to a chiropractor, you have probably heard the term subluxation. When the chiropractor reports his findings to the patient, he explains an injury or lack of proper function to a particular spinal joint as a subluxation of the spine.

A subluxation is a disturbance in the spinal joint's function. The term subluxation describes a set of abnormal spinal joint inter-relationships that is not yet fully understood. These inter-relationships include the structural, mechanical, chemical, neurological, hormonal, and circulatory spinal joint components. While not an identifiable 'thing', like a fracture or a wound, it is a useful organizing principle for chiropractic research and clinical practice.