Bone Out of Place Myth

Yes, this really is a myth. Your back does not go out. Part of the problem with this myth is that many chiropractors are directly or indirectly propagating it. Perhaps it is just easier to talk about back pain this way, but anyone who has studied anatomy and physiology understands that vertebrae do not simply go out of place. From a layman’s perspective, it feels like that is what is happening: you hear a pop in your back and it actually feels like a bone has moved out of place. Unfortunately, pain discrimination in our back is poor – in other words we have a hard time distinguishing between different types of sensory input in that area – that’s just the way our anatomy works.  So what we think we feel is not always what is actually happening.  A true bone out of place is called a dislocation. This does happen to fingers and toes and shoulders, and often requires a significant amount of force and traction to relocate the joint. This dislocation happens so rarely in the spine that we might as well say it DOES NOT happen at all. In ten years of practice seeing thousands of patients and tens of thousands of individual treatments, I have NEVER seen a spinal joint that was “out of place”.

The reality – a little less glamorous, but much more accurate – is that your spinal joints get stuck. They are still in the right “place”, but they are not moving as well as they should. This does indeed cause pain, and muscle spasm and so on. The chiropractic adjustment is very helpful not because it puts anything back in place, but because it restores mobility to an area that was previously stuck. I try to educate my patients about this more correct way of describing their pain, but I’m not sure that I’m making any headway! I still cringe every time someone tells me they threw their back out! Perhaps my efforts to change people’s pain descriptors are as futile as the Grammar Nazis attempting to maintain the purity of the English language… but I’m still going to try!

This entry was posted in Uncategorized. Bookmark the permalink.

1 Response to Bone Out of Place Myth

  1. Rob LaFreniere, DC says:

    Bravo, Doc:

    I was born and raised just east of you in the thriving metropolis of Castor. I have been a practicing chiro for 15 years now, having graduated from Palmer and moving to South Carolina. I am EXTREMELY pleased to see your focus on dispelling the “bone out of place” myth. Having worked in medical pain management with the benefit of floroscopy, MRI, and plain film as well as needle EMG/NCV, I can fully corroborate your notion as I, too, have never seen a “bone out of place” to the point where a typical chiropractic adjustment would restore it’s place and function. (One soccer player’s shoulder in Bolivia notwithstanding….but when there is no ambulance, no 911 and the nearest ER is several hours away on the back of the local MD’s motorcycle….well yeah, then a chiro can put a dislocated bone back.) But certainly not a vertebral bone. But restoration of motion, that is another matter. Proper function brings back proper proprioception and thus proper nociception. And no one does it better than us! Excellent work! Hope to stop by and say hello some time when I am back in the old stomping grounds.

    Rob LaFreniere, DC

Comments are closed.