Naturopathic manipulation is an "adjustment" of the movement of the spine from a restricted to a less restricted state. It is similar to chiropractic in that many of the same techniques are used, although the philosophy and practice of it varies on a few points.
A fixation, or restricted movement, in the spine or bones of the extremities is found
when movement of the part is asymmetrical without good reason: meaning that under
normal circumstances we would expect a joint to move symmetrically unless there were
underlying reasons for it not to do so. Such reasons might include a congenital deformity
that restricts movement, or a disease process. When, however, there is no such underlying
reason, and there are no contraindications, naturopathic manipulation may be used
to re-
Basically, an adjustment consists of a small but quick motion of the practitioner's
hands at the fixated point in the direction of normal motion. For example, say that
upon examination we determined that you could rotate your head much farther to the
left than to the right, and that in general you had much more freedom of motion to
the left of most neck movements. Say that when we examine your neck by palpation,
we find some points of tenderness along your spine at those vertebrae which have
some restricted motion. We would then conclude that you have a fixation of a particular
vertebra or vertebrae and we would, while supporting your neck and head, move the
vertebrae in question a small amount (maybe 1/8 of an inch) in the direction of the
restriction. Often when this is done, you hear a small pop, like a knuckle cracking,
and when it is done you find that once again your neck movement is symmetrical in
both directions and that there is reduced tenderness where you were feeling it before.
That is essentially the practice of manipulation -
How do joints become 'fixated'? There are many theories about this, but the truth is uncertain. It has been proposed that restriction could be caused by joint surface damage leading to impaired joint tracking, that it could be the result of the covering of the joint (the synovium) being sucked into the joint, that it could result from a small piece of cartilage being broken into the joint, or that lack of muscular support of a bony structure can cause fixation when a maladaptive pattern is adopted for a long period of time. Another theory which is interesting is that joint fixation might be caused by a change in the composition of joint synovial fluid. Joint fluid acts as a lubricant between the cartilage endplates of bones. It has been suggested that under compression, such as that found when a person has a muscular injury, the muscle contraction that serves to immobilize the injured area may compress an adjacent joint, causing the joint fluid to become gummy, restricting motion. It has been shown that when this pressure is released with manipulation, bubbles of nitrogen gas escape, and the synovial fluid again becomes liquid and stops restricting motion.
A person that might benefit from naturopathic manipulative treatment may complain of pain or restricted motion, they may have had an injury in the recent past where normal motion has not returned 100%, they may feel tingling in certain positions in an extremity, etc. Often a fixation can be determined from watching the walk of a patient. People make small adaptations to injury or fixation that are easily observable by a trained eye; for example, we may not swing both legs or arms equally, our heads might be carried forward or to the side, we may land differently on each foot. All of these clues are taken into consideration when evaluating a suspected dysfuntion.
Elimination of the root cause and treatment of the consequences are usually successful. Repeated manipulations should not be required providing that the cause of the restriction is addressed.
