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Dr. Ana KnollaApr 17, 2023 4:16:13 PM12 min read

How Do Chiropractors Know Where to Adjust? Exploring the Science Behind Chiropractic Care

Have you ever wondered what a chiropractor is doing when adjusting your body? How on earth do they know which joints to adjust and why?

Let's explore the science and technology chiropractors use to determine where and how to adjust your body. Want to be pain-free? Click the link below to schedule a free consultation with Arrowhead Clinic.

Quick Summary of Key Question

Chiropractors rely on their experience and training to identify areas in the body that need adjustment. They assess the patient's posture, range of motion, muscle tension, and joint movement while also considering their medical history.


Table of Contents


What Does a Chiropractor Examination Look Like?

Chiropractic Adjustment Methods

Manual Techniques to Identify Adjustment Points

Posture Analysis and X-Rays

Other Types of Techniques Used by Chiropractors

What is the Role of Physical Signs?

How Effective is Chiropractic Treatment?


Frequently Asked Questions


What Does a Chiropractor Examination Look Like?

If you've ever been to a chiropractor, you know that a thorough examination is a key part of the experience. It's more than just a routine check-up - it's a comprehensive assessment that helps the chiropractor understand what's happening with your body and how to address it best.

The examination aims to locate areas of spinal dysfunction or injury while ruling out other causes of pain, such as nerve entrapment or degenerative joint disease.

The chiropractic physical exam is much like an exam done by a medical doctor—the difference is that the chiropractor looks for changes in joint motion and strain patterns rather than signs of infection or inflammation.

The chiropractor will also use specialized equipment such as orthopedic tests, thermography, and vibration testing to assess changes in nervous system function. During the examination, the chiropractor may feel along your spine, checking for tenderness and mobility. The chiropractor might ask you to do various movements when lying down or standing.

Chiropractic physical exams remain an important part of modern chiropractic care—providing valuable insight into a patient's health, range of motion, limitations, neuromusculoskeletal concerns, and ruling out other possible causes of pain. These exams may serve as a starting point for any treatment plan the chiropractor suggests.

Chiropractic Adjustment Methods

Chiropractic care focuses on musculoskeletal and neurological health and is considered one of the safest forms of alternative medicine. Chiropractors use two primary approaches when locating joint dislocations: manual palpation and imaging-based location techniques.

The manual palpation technique uses the chiropractor's hands to feel or "palpate" different body areas to determine which areas are restricted in mobility or tissue tone. They then manually adjust these areas. This approach requires specialized knowledge about the musculoskeletal anatomy of a patient, which a chiropractor will gain over years of practice.

The imaging-based approach uses various imaging modalities, such as X-rays and MRI scans, to locate areas of restriction in muscle tissue or joint function. Imaging can assist with a more accurate diagnosis, further develop treatment plans, and provide ongoing feedback on a patient's condition. 

Research indicates that manual palpation and imaging-based methods are effective tools for diagnosing musculoskeletal issues encountered in chiropractic practice and finding areas of joint dislocation. 

Manual Techniques to Identify Adjustment Points

Manual techniques are an essential part of a chiropractic doctor's arsenal for identifying points for the adjustment.

While manual techniques may not be as accurate or precise as other technologies available, the hands-on approach allows practitioners to feel for subtle changes and irregularities in tissue texture and mobility that can indicate underlying issues.

One such technique is palpation, which involves feeling the spine, muscles, and ligaments to identify any tightness or tension. This manual method can help chiropractors detect and adjust areas where spinal misalignment may occur.

Manual muscle testing is another commonly used technique in which specific muscles associated with corresponding spinal segments are engaged to assess if they function correctly.

Similarly, range-of-motion testing allows chiropractors to detect subtle changes in mobility or limited range of motion that can indicate underlying misalignment or pain.

Although manual techniques tend to be less precise than technologies like thermography or imaging, they have been regularly employed by practitioners for centuries due to their reliability and sensitivity in helping to detect minor issues that could otherwise be overlooked with more advanced methods.

Having explored how manual techniques are used by chiropractors to identify points for adjustment, the next section will look at what role physical signs have in the evaluation process.

Posture Analysis and X-Rays

Posture analysis and X-rays are other two techniques chiropractors use to help identify the source of musculoskeletal pain. X-ray imaging helps provide a clearer picture of the underlying skeletal structure, while posture analysis focuses on body movement and positioning.

During a posture analysis, patients are asked to stand before a wall and observe their posture profile.

The chiropractor looks at how the head is positioned and the curvature of the spine and shoulder location. Based on this information, they can create an orthopedic evaluation and study any deformities or changes in joint range of motion (ROM).

An X-ray exam gives an even more precise indicator of what may be causing pain. With an x-ray, chiropractors can look for misaligned bones, wear patterns on areas such as facet joints, and swelling or inflammation in soft tissues like ligaments or muscles.

However, due to X-ray's limited view, there has been some debate amongst chiropractors about the effectiveness of using X-rays for assessing musculoskeletal pain. In some instances, deeper levels of tissue are affected and cause pain.

This leads some to argue that relying too heavily on X-rays alone could result in missing important conditions or overlooking root causes.

By combining postural analysis with X-ray imaging, chiropractors can better understand their patients' conditions and adjust accordingly.

Other Types of Techniques Used by Chiropractors

Chiropractors approach spinal manipulation and adjustment differently, depending on the type of injury being treated and individual preferences.

Some forms of chiropractic care involve physical adjustments performed with manual force, while others use devices or controlled pressure to adjust the spine manually. A few other forms of treatment are available as well.

The most traditional form of chiropractic care is high-velocity low, amplitude thrusts (HVLAT). This technique involves very brief and rapid joint movement to move it beyond its range of motion.

It is often used to create a new joint position and correct vertebral subluxation or misalignment. HVLAT can also help relieve muscle tension, spasms, and other conditions caused by poor posture or prolonged sitting.

Another type of technique is called non-thrust or low-force manipulations, which uses slow, repetitive movements to stretch tight muscles and promote increased joint mobility.

These manipulations may include massage therapy, stretching, reflexology, ultrasound therapy, transcutaneous electrical nerve stimulation (TENS) therapy, and manipulation of soft tissues such as ligaments and tendons around the spine.

Non-thrust techniques are generally more gentle than HVLAT manipulations.

In addition to these manual techniques, some chiropractors use devices such as handheld instruments or chairs, making adjustments much easier for the patient and practitioner. These devices often utilize vibration or oscillating movements to help release muscle tension or reduce joint pain. They can benefit patients who have difficulty lying still during manual adjustments due to extreme pain or mobility issues.

Each technique has its benefits, but there is some debate about whether one is superior. Proponents of traditional manual HVLAT cite its ability to quickly realign joints that have become misaligned due to injury or uneven wear on the spine over time.

Others argue that HVLAT places too much pressure on joints and can increase the risk of injury when performed incorrectly by an experienced practitioner. In contrast, proponents of non-thrust techniques argue that their gentle approach can be just as effective at realigning joints without unnecessary pressure; proponents also point out that these techniques can be beneficial for addressing musculoskeletal pains unrelated to spinal problems.

Ultimately it comes down to personal preference between patients and practitioners when deciding on the best course of treatment.

Leading into a future section about "How Effective is Chiropractic Treatment?", it's important to note that although clinical trials have suggested chiropractic care may provide relief from a variety of back pain conditions, more research is needed on its long-term effectiveness before definitive conclusions can be made about its potential health benefits.

What is the Role of Physical Signs?

Physical signs are crucial in a chiropractor's ability to adjust a patient accurately. Muscle strength and tone, joint mobility, posture, balance, coordination tests, and tenderness to palpation are just some of the physical factors that help chiropractors determine where to apply their technique.

Those in favor of using physical signs assert that they provide evidence of areas that need adjusting. Tell-tale signs include muscle spasms or joint stiffness around the area, which needs to be manipulated. It helps chiropractors identify areas that require attention, thus allowing them to make precise adjustments.

On the other hand, some doubt the efficacy of physical signs as guides for proper adjustment techniques. They argue that such external indicators can be misleading and force practitioners to ignore critical underlying causes.

They see this approach as needed to be more comprehensive and suggest considering other assessments like lab tests and imaging scans to get an overall picture of a patient's condition.

Despite these criticisms, most researchers suggest that physical signs remain important in helping chiropractors know where to adjust their patients.

By carefully studying the body's cues, practitioners can ensure they target the right areas and deliver more effective treatment plans in the long run.

Now that we have discussed the importance of physical signs in chiropractic care let's explore chiropractors' different techniques in more detail.

How Effective is Chiropractic Treatment?

The effectiveness of chiropractic treatment is a widely debated topic. Advocates of chiropractic care consistently report positive results from their treatments, citing relief of pain, improved mobility, and better overall health. Research studies have supported their claims, showing that adjustment can improve chronic back pain, headache, and osteoarthritis symptoms.

On the other hand, many skeptics point to the lack of scientific evidence regarding specific spinal adjustments as proof that chiropractic care is ineffective. They might also cite reports of rare but severe side effects of adjustments, such as increased pain.

It's important to note that most research has demonstrated at least some benefit of chiropractic care in managing musculoskeletal conditions such as low back pain, neck pain, and headaches. More research is necessary to entirely understand the efficacy and risks associated with chiropractic care.

While some may be hesitant to try chiropractic treatments due to perceived risks or lack of evidence, many individuals have seen substantial benefits from visiting a chiropractor for musculoskeletal problems.

With so much conflicting information regarding the effectiveness of chiropractic treatment, it's difficult to draw any definitive conclusions about its value in patient care.

Whether you decide to give it a try or not, it's always wise to speak with your doctor before embarking on any form of treatment and discuss any potential risks or benefits associated with it.


Chiropractic care is a unique form of health care that involves adjustments to restore joint functioning, reduce nerve interference, and improve overall body function. Effective chiropractic care relies on the practitioner's ability to identify areas in the spine that are out of alignment or restricted and then deliver a precise manipulation to correct these areas.

The question of "How do chiropractors know where to adjust?" has become increasingly studied in recent years as more evidence is gathered about the efficacy and safety of chiropractic treatments.

Studies show that expert chiropractors use a combination of their own experience and objective assessments to determine areas of spinal dysfunction.

During an exam, a chiropractor looks for neuromuscular irregularities such as tension, tenderness, muscle spasm, limited range of motion, asymmetry in joint movements, or poor posture patterns.

Further assessments, such as X-rays or MRIs, can be used to detect potential structural issues and misalignment.

With years of study and clinical practice, skilled practitioners develop an acute awareness that helps them hone in on which areas require adjustment.

Despite many studies supporting the efficacy of chiropractic treatments for various musculoskeletal conditions, there remains controversy over whether chiropractic adjustments are safe and effective. Some criticize the method of adjustments and argue that more research is needed before it can be fully endorsed as a viable treatment option for patients suffering from chronic pain or other musculoskeletal issues.

Supporters counter this argument by pointing to well-documented records showing how successful specific spinal adjusting techniques have been used to treat pain syndromes associated with multiple nerve entrapments and dysfunctions.

Ultimately, both sides agree there is more work to better understand how and why chiropractic treatments work. However, they also acknowledge its importance in providing relief for individuals unable to find it through conventional medical treatments alone.

If you are looking for relief from pain, look no further than Arrowhead Clinic. Yes, you can be pain-free! Fill out the form below to get a free consultation with Arrowhead Clinic.


Frequently Asked Questions

Chiropractors use several techniques to assess where to adjust, such as palpation (feeling with their hands) to identify areas of tension and restriction. They may also use motion palpation testing to determine if there are areas with limited mobility. Additionally, chiropractors often incorporate X-ray imaging into the assessment process to identify structural imbalances or misalignments that may be disrupting their patient's health. Finally, specific chiropractic techniques may employ subtractive diagnostics, wherein a series of tests are conducted, which help pinpoint the precise area(s) that need to be adjusted.


Chiropractors determine where to adjust by studying a patient's spinal anatomy and performing tests. They use palpation and palpatory skills to locate areas of misalignment or restriction. By feeling for misalignments, known as subluxations, chiropractors can narrow in on the vertebrae that need adjusting. Many chiropractors will also take X-rays or MRI scans to get a clearer spine picture before changing. Other forms of assessment, such as postural analysis, range-of-motion testing, orthopedic testing, and neurologic tests, are also used to help identify areas in the spine that could benefit from adjustments. Once these tests have been completed, the chiropractor can decide which vertebrae need adjusting and provide relief to the patient!

The amount of force a chiropractor uses when adjusting particular vertebrae depends on the patient's individual condition. Generally, chiropractors use a combination of experience and analysis to determine the amount of pressure that should be applied.

Chiropractors will assess the patient's posture and flexibility before utilizing their manual skills to determine which areas need adjustment. Based on this assessment, they'll evaluate the range of motion and muscle tone to decide how much force should be used for an effective adjustment.

Finally, skilled chiropractors consider the patient's risk level for injuries and their levels of comfort with more vigorous treatments. By applying all these criteria, chiropractors can accurately determine how much force should be used when adjusting.



Dr. Ana Knolla

I graduated from Life University in Marietta and I've been practicing for almost 20 years. I started at Arrowhead Clinics in 2001 and have continued in either a part-time or full-time status ever since. I love working with injured patients and having the gratification of seeing them get well! I'm born and raised in North Florida/South Georgia...I've traveled extensively but always enjoy coming home to the South! I have 5 dogs...from chihuahuas to pit bulls... and 4 cats... and we all live in a farmhouse out in the country.