Your First Spinal Adjustment–What To Expect

Chiropractic care is a great addition to your personal health practices that can enhance your spine’s health, and give you a more comfortable back and body. Not every chiropractor accepts health insurance, so if you would need your appointments to be covered, check for a chiropractor in your network. For your first spinal adjustment, most reputable chiropractors will require an appointment ahead of time, so that they can hear about the issue that brought you to their office, introduce the techniques they might use to adjust your spine, assess your spine, and formulate a treatment plan. Many chiropractors will take x-rays of your spine as part of this assessment, especially if your problem is severe, or if you have been referred by a physician or physical therapist.


The chiropractor’s assessment is to determine where you have subluxations in the spine. A subluxation is what you might perceive as a “crick” in your neck, or as your back going “out,” or you might not perceive them at all until they create an injury or inflammation. Each vertebra has multiple facets that are supposed to align with its neighbors’ bony facets. The entire length of the spine bears weight, and the compression from weight-bearing, plus movements and use of the body, can cause the facets of different vertebrae to misalign and become stuck. Subluxations can be very painful, sometimes pinching nerves or injuring muscle tissue, depending on location and severity. The exact sensations you will experience at your first spinal adjustment will depend on several factors, including how tight or inflamed the spine is, and where it requires the most work to adjust.


It can be a good idea to take an over-the-counter NSAID pain reliever before a chiropractic appointment. This can help decrease inflammation at the site of adjustment, and help relieve muscles and soft tissue that sometimes feel painful if they have been trapped by a subluxation for a long time. Some chiropractors will begin your spinal adjustment by having you lie on a massaging table, and they might use electro-stimulation, to bring circulation to the spine and begin the process of relieving pressure in the back. Some chiropractors might include a little bit of traditional massage therapy for the same reason. Warming up the spine for adjustment usually takes 10-15 minutes.


A good chiropractor will let you know where their hands will be, and what to expect during the adjustment. They will typically have you lie face down on a massage table, with fresh paper over it, and use their hands close to your spine to identify how to apply pressure to create proper alignment. The table might have a height adjustment under your hips, to help align your sacrum, ilium, and lumbar spine. If the adjustment is in any part of the ribcage, the chiropractor will ask you to inhale, then apply specific pressure as you exhale. The application of pressure on the spine is when you will feel or hear “popping” or “cracking”. This is the sound of the vertebrae facets moving into proper alignment. The adjusted area should not feel painful, although you might experience a momentary strong sensation during the adjustment.


The chiropractor might have you lie on your back to adjust your low back. A common technique for the ilium and lumbar spine involves twisting the hips to one side to apply pressure. You might lie face up, or be seated to adjust your neck. Neck adjustments can create an intense sound because those vertebrae are closer to the eardrums.


After your adjustment, the chiropractor will check in on how your spine is feeling and how you are doing. You might feel extremely relieved or even light-headed after your first spinal adjustment, or it might not feel like your problem is resolved. The chiropractor will finalize your treatment plan based on their assessment, experience of treating you, and your response to treatment.

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