Instrument adjusting has become one of the most commonly used techniques in today’s chiropractic practice.

It is second only to diversified-type manual spinal manipulation, according to the National Board of Chiropractic Examiners Survey of 2000.

From ease of use to providing added safety to a patient encounter, adjusting instruments have provided a new dimension to the chiropractic practice. Likewise, instrument adjusting has expanded the range of conditions and patients that can now be more easily managed with chiropractic care.

Following are the top 10 most popular reasons why you should incorporate instrument adjusting into your practice.

10. A mechanical advantage.Biomechanically speaking, chiropractic adjustments are delivered to move the bones of the spine. Newton’s Second Law is force equals mass times acceleration (F = ma). Adjusting instruments take advantage of the acceleration part of the equation in providing large accelerations with a substantially smaller mass.

In contrast, force manual adjustments require the use of more mass (weight) because of our physical limitations in achieving accelerations. Increasing the speed component of chiropractic thrusts has been found to be associated with the elicitation of neuromuscular reflexes thought to be related to the mechanisms underlying successful treatments. (1-3)

Instrument adjustment speed also allows you to deliver the thrust faster than the patient’s natural tendency to tighten up and resist the adjustment.

Stress is another consideration among the mechanical advantages of instrument adjusting. In continuum mechanics, stress is a measure of the average amount of force exerted per unit area, where stress equals force divided by area (? = f/a).

When you contact the spine with your hand (pisiform), the surface area over which the force is produced is relatively large compared to the stylus of an adjusting instrument. Thus, the resultant stress felt by the tissue with manual adjustments are appreciably less with force being the same.

Adjusting instruments can achieve an appreciable stress to the spine, while keeping forces relatively low due to their small contact area with the patient — thereby less force is required to achieve the same stresses imparted to the spine with manual adjustments.

Appreciating the concept of stress with the understanding of the high accelerations achieved with instrument adjusting and its easy to explain how studies have shown that the same amount of intersegmental bone movement can be achieved with instrument adjusting as manual techniques. (4,5)

9. Safety.There are instances where you may have a concern of manually adjusting a particular patient. Low force instrument adjusting techniques can be delivered in the prone neutral position, thus enabling you to administer care with peace of mind in some situations that you may feel uncomfortable applying manual techniques.

For instance, you may not want to provide higher forces of manual adjustments to an elderly patient with osteoporosis. Likewise, you may not impart rotatory cervical spine adjustments to a patient with dizziness or signs of cerebrovascular disease.

8. Easy incorporation.Instrument adjusting can be easily incorporated into your existing technique repertoire. You may want to adjust the upper cervical spine and TMJ of a headache patient with an instrument, yet perform manual methods on their thoracic and lumbar spine. Alternatively, you may want to adjust the shoulder in a rotator cuff syndrome patient with an instrument instead of using a drop piece.

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