Many patients comment regarding the use of a “clicky-device” by some chiropractors. It is called by these chiros, an “activator” or “adjustive-instrument”. What the patients routinely say is, “It doesn’t adjust me. I don’t feel the bones moving. I don’t get a real adjustment from that.” Working as an old-timey chiro, I understand what they are saying.
My colleagues in chiropractic who use the activator quickly defend it. They cite research studies by Dr. Arlan Fuhr (the promoter) that report positive results with the use of an activator instrument. They go on to share anecdotal stories of how forceful or painful traditional chiropractic methods can be. They continue to justify the use of the clicky-gun in place of simply using their own hands.
But it’s not chiropractic. Adjusting patients with an activator instrument is not chiropractic. The word chiropractic means, “done by hand”. If you use a tool instead of your hands to treat patients, you no longer are practicing chiropractic, it’s more like acu-pressure.
When I treat patients using my hands alone and traditional chiropractic techniques that unmistakenly move vertebrae, the patient knows it. They know, they can feel, the movement of bone & joint in their spine or extremities. There is no need to debate with the patient whether the bones moved. The patient gets the immediate clinical effect of opening up the stuck function (subluxation) of spinal vertebrae. They can feel the energy flowing immediately in their body. Furthermore, when I encounter patients that have been to chiros who only treat using the activator, these patients are surprised by real, dynamic movement of spinal vertebrae. They can feel the clinical effect of a real chiropractic treatment. These patients don’t have to keep coming back in over & over, “3x\week for 6 weeks”, like these activator chiros recommend. The patients are taught that real chiropractic adjustments involve obvious movement of bone & joint and expected improvement in their clinical symptoms very quickly. This is chiropractic.
The activator docs often say the regular chiropractic is “too rough” on the patient or that so many patients come in telling them the regular chiropractors are too aggressive. What that means to me is that those patients making that statement either did not have a good experience in a traditional chiros office, that chiro was not sensitive to the needs of the patient to be more gentle with them, or that the patient did not adequately communicate with the chiro doc that they wanted. Newbs to chiropractic are often surprised or startled by the sensation of the release of stuck vertebrae (subluxation) and the opening of nerve flow.
Frankly put, stuck bones in patients backs are often very difficult to move. Sometimes, it takes force to move stuck bones & joints. Relieving this deep-stuck condition of bone & joint by hands-on chiropractic adjustive forces is a skill and really, an art. It took many years of full-time practice to get good at it. Learning to work with patient’s reflexes and moving bones with the least amount of force necessary is the key to good chiropractic adjusting. Clicky-guns don’t even come close to this precision. Placing an inert metallic object between the doctor’s hands and the patient’s body removes that necessary bio-energetic feedback of hands on body, feeling the movement of bone & joint during the dynamic of the adjustive thrust. I can feel instantly during an adjustment if the joints moved enough and freed up the stuckness completely, or if more work needs to be done and get back into the spine for deeper adjusting to further free-up the stuck bones, opening nerve flow.
There is a palpatory feedback from a vertebral set of joints (motor unit) that can only be experienced at the moment of chiropractic adjustive thrust. Only chiropractors are feeling this and we sense this only in the instant we are moving bones & joints on patients. We can tell instantly if we got full movement back in spinal bones while we are treating patients. Activator chiros are not experiencing this, because they don’t have their hands on the spinal vertebrae at the time of manipulation. They barely move bones in the first place with their clicky-guns, so they don’t know what they are missing out on, in feeling this deep dynamic bio-feedback from vertebral joints at the moment a real spinal adjustment by hand only is performed. A sensitive chiro can feel the differences in anatomical health of the joints during the adjustive thrust only if he’s got his hands on the bones during the chiro adjustive treatment.
Chiros who are using the activator device on patients and calling that chiropractic are mis-communicating to patients the definition of traditional chiropractic. This mis-communication further perpetuates the public’s misunderstanding of what chiropractic health care involves. Chiropractic means “done by hand”. The activator is more akin to an acu-pressure device that attempts to move bones & joints in a very limited fashion, while advertising the gentleness of the technique. Hands on chiropractic can be just as gentle as adjusting a baby and we feel what we are doing.
page crow DC