Chiropractic + Naturopathic Doctor

Technique Toolbox: Certainty in the Adjustment

By John Minardi BHK DC   

Features Clinical Techniques

A 35-year-old female real estate agent presents to the clinic complaining of persistent headaches and occasional back pain.

A 35-year-old female real estate agent presents to the clinic complaining of persistent headaches and occasional back pain. She informs the doctor that she works very long hours, and attributes her headaches to stress at work. She also informs the doctor that she spends much of her time driving in her car, which aggravates her back pain. When the doctor asks the patient if she suffers from any other health issues, she answers no; however, she notes that she has been trying to become pregnant for several months and has been unable to conceive to this point. Physical examination reveals palpable subluxations present at C1 on the right and S1 on the left, with concurrent muscle hypertonicity of the quadratus lumborum bilaterally and the bilateral scalenes. Radiological analysis is unremarkable. The patient begins a chiropractic care regime and within a few months relays to the doctor that she is symptom-free and has never felt better in her life.

Dr. Minardi contacts the patient’s spine for a prone cervical adjustment.



Experiencing the power of the chiropractic adjustment first-hand, the patient elects to continue with regular adjustments to optimize her overall health and well-being. Within six months, she informs the doctor that she has exciting news – she and her husband are expecting their first child.

How many of us in our clinics have seen individuals become pregnant under chiropractic care, where they were never able to become pregnant before? How many of us have seen individuals with depressed immune systems suddenly become well by being adjusted? How many children have we seen whose ear infections, colic or behaviour issues dramatically improved with chiropractic? How was this possible? In this edition of Technique Toolbox, we will explore these questions and more as we look at the power of the chiropractic adjustment on the nervous system.

What’s really going on?
As chiropractors, we have claimed to have a direct influence on a patient’s nervous system through the chiropractic adjustment, and further claim that patients who remain subluxated will have some form of neurological dysfunction.

However, if we asked most chiropractors how the adjustment directly influences the nervous system to create these global health changes in the body, few would be comfortable explaining how this happens. What results is a decreased certainty in the power of what we do. Many of us graduated from “scientific” schools. Although, that often meant that we learned a great deal of science, we have little idea how most of it relates to being a chiropractor. Furthermore, the primary neurological explanation that had been presented was the classic nerve pressure theory. But, if all we understand about our influence on the nervous system is removing pressure off of a peripheral nerve, then we are focusing on a very small piece of the puzzle.

How is it possible that a chiropractor who only adjusts the atlas discovers that (s)he can significantly decrease an individual’s hypertension?1 There is no peripheral connection, and therefore, the nerve pressure theory cannot be the only explanation. In fact, I contend – and research is underway to demonstrate – that it is a very small piece of what is actually occurring and that the connection of these global health changes is the central nervous system’s response to the adjustment. We have to embrace that adjusting subluxations in our patient’s spine produces a direct neurological effect to the patient’s brain and central nervous system. I would suggest that this, in turn, could lead to global changes in a patient’s health and well-being.

By understanding that a spinal subluxation acts as both a physical stressor – due to the strain of the supporting structures connecting to that vertebra – and a chemical stressor –  due to the accumulation of inflammation inside the facet joint – we then can embrace the possibility that the subluxation has a neurological connection to the limbic system and launches the stress response to occur in the brain. When the stress response is initiated, this activates two systems: The sympatho-adrenal system (SAS), and the hypothalamic pituitary adrenal axis (HPA).2 The SAS activates the sympathetic nervous system, which in turn releases norepinephine into the circulation. Once norepinephine reaches the adrenal glands, the adrenal glands release epinephine into the blood stream. Epinephine supplies energy to the muscles and heart to prepare for the stress; however, it takes this energy from reproductive organs and the gastrointestinal tract. The HPA axis activates the hypothalamus to release specific hormones to the anterior pituitary gland, which in turn releases adrenocorticotropic hormone (ACTH) into circulation. Once ACTH reaches the adrenal glands, the adrenals release cortisol.3 Again, cortisol supplies energy to the muscles; however, it takes this energy from reproductive organs and the immune system.4 This stress response is a normal response provided that the stressor is removed in a short period of time. However, when the stressor is not removed quickly, this chronic hormonal release negatively alters the immune system, reproductive system and gastrointestinal system, triggering a cascade of disease and illness.5 By removing the stressor (the subluxation) through the chiropractic adjustment, we stop the chronic stress response and allow energy to be reallocated back to the centres that promote growth, expansion and health.

Even this is a small piece of the puzzle, and much more work needs to be done in the chiropractic community to research and better understand the mechanisms behind the adjustment. But by understanding this stress mechanism, practising chiropractors will increase their certainty that each chiropractic adjustment they deliver has a profound neurological effect on the central nervous system, which has global effects on a patient’s health.

Do I recommend that we all start advertising that we can create pregnancy, cure colic and rid patients of hypertension by adjusting them? Of course not.

However, we as chiropractors must accept that our work is part of a bigger picture when it comes to an individual’s health and well-being. And by adjusting an individual’s subluxations, we can and will have a bigger effect on the patient’s health. If you have any questions or concerns, please contact me at

Until next time… adjust with confidence!


  1. Bakris, G, Dickholtz M Sr, et al. Atlas vertebrae realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J. of Human Hypertension, May 2007, 21(5): 347-52.
  2. Hardy K, Pollard H. The organization of the stress response, and its relevance to chiropractors: a commentary. Chiropractic & Osteopathy. 2006 (14) 25.
  3. Ibid.
  4. Kent C. Models of Vertebral Subluxation: A Review. JVSR. 1996. 1(1): 1-7.
  5. Hardy, op. cit.

Dr. John Minardi is a 2001 graduate of Canadian Memorial Chiropractic College. A Thompson-certified practitioner and instructor, he is the creator of the Thompson Technique Seminar Series and author of The Complete Thompson Textbook – Minardi Integrated Systems. In addition to his busy lecture schedule, Dr. Minardi operates a successful private practice in Oakville, Ontario. E-mail, or visit www.ThompsonChiropractic

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