The Vertebral Subluxation Complex

For over one hundred years chiropractors have fought to protect their unique identity. In 1987, Judge Getzendanner concluded that the American College of Surgeons and the American College of Radiology had participated in a conspiracy with the medical association to make it difficult for chiropractors to work in the US.

This should have been a watershed moment for the chiropractic profession as I was planning to begin studying chiropractic. The enemy is no longer those in the medical profession but those among the ranks who want to force all chiropractors to take the biomedical path they are on. The chiropractic profession stands on the shoulders of giants who based their practice on the relationship between the structure of the spine and the function of the nervous system, to achieve wellbeing, without the use of “drugs or surgery”.

in 1910 chiropractors came up with a term to describe the “spinal joint dysfunction” they were adjusting. A “Vertebral Subluxation” was the name given to the spinal lesion being palpated that needed “correcting”. Another play on medical terminology was used to describe what was being affected by the adjustment; “dis – ease”, this may have sounded very clever in 1920, but became a stick for critics to beat chiropractors with in later year, by deliberately removing the hyphen stating chiropractors claimed to cure all “disease”. Worse still chiropractors, not able to get into medical school, began doing the same as they sought to make chiropractic a branch of “manual medicine”.

In the 90s Meredil Gatterman wrote what I believe, is the most authoritative book on chiropractic theory for the 21st century. She sets out the tone early on by stating “When it comes to communicating the language of “vertebral subluxation theory” chiropractors struggle  Adopting the approach of Humpty Dumpty in Lewis Carrols Through the Looking Glass “…..when I use a word, Humpty Dumpty said in a rather scornful tone, “it means what I chose it to mean- neither more or less….”

Subluxation is a medical term for joint hyper mobility a contraindication for an adjustment as is joint fusion at the other end of a joint’s range of motion. There are recognised grades of joint dysfunction across the board so for the purpose of chiropractic terminology “subluxation” is a good word. However “dis – ease” is not. This is what I came up with slightly adapted from Gattermans definition, that I believed the vast majority of chiropractors would accept, when I was a member of the GCC.

” A theoretical model of vertebral motion segment dysfunction, that incorporates the complex interactions (homeostasis / innate), of pathologic changes in nerve, muscle, ligamentous vascular and connective tissues that affects adaptability to physical, chemical and emotional stresses and compromises general wellbeing”

Ultimately, debates about whether the subluxation complex is associated with pain and debates about the existence of the subluxation complex illustrate that our profession has not adequately applied the principles of pathology and neuroscience to the spine.  

Pain is a symptom that is considered a component of subluxation syndromes, but it need not be present for the subluxation complex to exist. Similarly, heart disease, cancer, diabetes, alzheimer’s disease, cirrhosis, osteoporosis, and all other chronic diseases are known to exist long before symptoms appear. Why should this be any different for the subluxation complex?

Research has clearly demonstrated that pathologic changes of the spinal column, which we call the subluxation complex, may exist without symptoms. Consider that significant disc herniations can be present in individuals without back pain and that atrophic changes and fatty infiltration of spinal muscles exist in 45% of asymptomatic individuals.  

and biomechanically stressed tissues will release chemical mediators of inflammation that constitute the biochemical changes of the subluxation complex. It is known that the cells of injured discs and joint tissue release chemical mediators, such as proinflammatory eicosanoids (prostaglandin-E2, leukotriene-B4, thromboxane-A2) and proinflammatory cytokines such as interleukin-1 and tumour necrosis factor.

These biochemical changes that we associate with the subluxation complex can stimulate spinal nociceptors and generate the back pain we commonly encounter. Initially, such biochemical changes can occur without obvious signs of degeneration, inflammation, and nociception and without the generation of symptoms – the way that every chronic disease begins. 

Considering the fact that nociceptive input reaches subcortical areas, such as the brainstem and hypothalamus, it is also likely that a wide variety of neuroendocrine responses and seemingly unrelated symptoms could develop in response to a sensitised nociceptive system (or a system with decreased mechanoreception to inhibit nociception). In other words, pain may not be the symptomatic outcome of nociceptive stimulation of spinal structures.

Chiropractic is based on the scientifically proven hypothesis that proper structure of the spine is required for proper function of the nervous system as it relates to the control and regulation of global physiology and health. Traditional Chiropractic has never been and should never be defined as manipulation to reduce symptoms of back pain.

Infants & Children

We see many children from infants who may have experienced neck trauma during the birth process, colic, children with growing pains, ear problems, asthma and other childhood disorders and those developing postural problems carrying school bags.

Richard Lanigan DC. MSc. has four children who have been getting chiropractic care since birth. A spinal adjustment on a child is very light compared to how its performed on an adult and can have amazing results. It is important to remember, the purpose of chiropractic is to find and reduce stress and interference to the nerve system, allowing the child to experience greater function and an overall improved quality of life. 

The International Chiropractic Paediatric Association has put together a comprehensive collection of chiropractic case studies clinical research studies and other published papers which suport the efficacy of chiropractic care for children and pregnant women.

Richard Lanigan DC. MSC., has had many years of experience treating infants and children, In 2018 Richard was invited on ITVs “Good Morning Britain” to explain why he believed his children’s lifestyle meant they have never needed antibiotics or medicine of any kind.

Make an appointment before those niggles you feel each morning become chronic and much harder to treat. After the first visit all children appointments are classified as maintenance and cost £35

General Joint & Muscle Injuries

If Mrs Jones sprains her ankle or wrist it’s a sprain, if she is wearing running shoes it’s a sports injury. The physiology of an injury is the same regardless of the activity, the difference is the speed the athlete may want to return to activity and the intensity of the rehabilitation program. Scroll down for information on various extremities.

In most cases, “sports injuries” are often due to overuse or acute trauma of a part of the body when participating in a certain activity. For example, runners knee is a painful condition generally associated with running, while tennis elbow is a form of repetitive stress injury at the elbow. Other types of injuries can be caused by a hard contact with something, which can often cause a broken bone or torn ligament or tendon

Sports injuries can be broadly classified as either traumatic or overuse injuries. Traumatic injuries account for most injuries in contact sports  because of the dynamic and high collision nature of these sports. These injuries range from bruises and muscle strains, to fractures.

A bruise  is damage to small blood vessels which causes bleeding within the tissues. A muscle strain is a small tear of muscle fibres and a ligament strain is a small tear of ligament tissue. The body’s response to these sports injuries is the same in the initial period immediately following the traumatic incident – inflammation.

The inflammatory stage is therefore the first phase of healing. However, too much of an inflammatory response in the early stage can mean that the healing process takes longer and a return to activity is delayed. 

The first thing to do after an injury occurs, is to get ice/cold on the damaged tissue to constrict blood vessels, reducing blood supply and inflammatory chemicals going to the injured tissue and start the healing process.

Hip, Leg & Sciatica Pain

The hip joints are formed where the head of the femur (thigh bone) attaches to the acetabulum of the pelvis (on both the left and right of the body). The hip joint fits like a ball in a socket called a ball and socket and strong capsule, strong ligaments surround the joint. There are also a large number of muscles that attach to the hip from the lumbar spine, pelvis and thigh. The thigh contains the femur bone and the groups of overlying muscles known as the quadriceps, hamstrings, adductors (groin) and abductors. 

Allthough similar in design to the shoulder, the hip is designed for stability for standing, while at the same time allowing movement to occur. It is the first joint from the solid base of the pelvis that takes part in the gait cycle, allowing us to walk and run. For this reason the hip joint experiences much wear and tear and is prone to osteoarthritis as you get into you get older.

Common leg conditions that patients present with at the Spinal Joint.

  • Osteoarthritis 
  • Sciatica
  • Bursitis 
  • Tendonitis 
  • Muscle strain, especially groin and hamstring 
  • Hip problems 

The hip joints, as well as having their own conditions, can be a source of referral for back and knee pain or can be where back and knee pain is referred to. It is important to have hip pain assessed to determine if it is true hip pain or referred from other parts of the body. Through testing at your initial assessment we will try to determine the cause of your hip pain and construct a treatment plan to help with your problems. Contact Spinal Joint, Kingston, to arrange for your initial assessment.


The knee is formed where the femur of the thigh meets the tibia of the leg. It has two strong ligaments attaching its inner centre (ACL and PCL) and another two on either of the outer sides (MCL, LCL). The joint surfaces are covered with cartilage and then cushioned by a medial and lateral meniscus. The patella (knee cap) sits on the anterior surface of the joint. Many muscles of the thigh and leg connect to different aspects of the knee.

The knee, like the elbow, allows the longer limb (in this case the leg) to bend so as to increase the number of tasks we can undertake using it. It also provides a further place of shock absorption from the weight of the upper body 

Common knee conditions that patients present with at the Spinal Joint.

  • Ligament strain/tear especially ACL and MCL 
  • Meniscus tear 
  • Osteoarthritis 
  • Patella tendonitis 
  • Cartilage issues
  • Bursitis

Knee pain can arise from any number of reasons. Ligament and meniscus damage is often caused by traumatic incidents such as sporting injuries while tendonitis can come about due to biomechanical inefficiencies in your gait cycle or foot posture.

Osteoarthritis is often the result of years of injuries and wear and tear on the cartilage and joint space. Knee pain can also be referred from the hip, ankle and even lower back so be sure to come in and see us at Spinal Joint to have your knee pain assessed.

As well as helping with your pain we can also advise on rehabilitation. If you have a knee injury due to trauma get some ice on it as soon as possible, to reduce swelling.

Ankle and Foot

The leg, sitting between the knee and the ankle consists of the tibia and fibular bones. The calf muscles make up the posterior portion of the leg. The ankle is formed at the base of the tibia and fibular with the talus (a foot bone). Like many of the other major joints listed it is surround by a joint capsule and many ligaments. It is these ligaments that are damaged when you sprain your ankle. The rest of the foot is made up of 26 individual bones joined together by ligaments and muscles.

If you have injured your foot the first thing to do, even before seeking professional advice is to get some ice on the injury to prevent increased inflammation.

Common conditions of the leg, ankle and foot that are presented at Spinal Joint.

  • Calf strain/tear 
  • Ankle Sprain/strain
  • Achilles tendon strain/tear 
  • Compartment syndrome 
  • Medial ankle sprain 
  • Plantar fasciitis 
  • Heel spurs
  • Metatarsal fracture
  • Pronation/supination
  • Gout 

Conditions of the lower leg, foot and ankle have a habit of reoccurring as few people allow them to resolve completely before returning to activity, nor do they often complete all of the necessary rehabilitation.


The shoulder is a complex very mobile joint, made up of the glenoid of the scapula and the humerus of the upper limb. The joint is surrounded by a capsule and ligaments and then connected by a large number of muscles to the trunk and upper limb to allow for its diverse range of movement. 

The shoulder connects the upper limb to the thoracic cage (rib cage) of the axial skeleton, enabling us to do things such as catch and throw, write, hold hands and wave goodbye. 

Common back conditions that patients present with at the Spinal Joint.

  • Dislocation and instability 
  • Rotator cuff tear/strain 
  • Tendonitis 
  • Bursitis 
  • Frozen shoulder 
  • Impingement syndromes 
  • Clavicle fracture 

We can help identify the cause of your shoulder pain as well as assist with the recovery and rehabilitation of your shoulder injuries. Due to the complex nature of the shoulder, recovery from injury can often be slow and tedious but generally worth the effort in the end.

Arm and Elbow

The elbow is made up of the humerus of the arm and the ulna and radius of the forearm. It is surround by a joint capsule and overlying ligaments. Most of the muscles that allow movement of the wrist and hand, as well as those from the arm, attach to the elbow. It is a hinge joint that allows for greater use of our upper limb; without it our arm would not bend. 

Common elbow conditions that patients present with at the Spinal Joint.

  • Tennis elbow 
  • Golfers elbow
  • Tendonitis 
  • Bursitis 
  • Fracture 
  • Radial head dislocation in children

The elbow often goes unnoticed when considering injuries as problems in the muscles attaching to the elbow are often felt in the wrist or hand. Our computer driven society has our hands on a keyboard or mouse for most hours of the day. As it is the muscles that begin at the elbows that drive the finger taping to occur, it is important to ensure that the health of these muscle and their joint of origin are in good working order. Come and see us at Spinal Joint Kingston to keep that mouse clicking, pain free!

Hand and Wrist

The wrist and hand is a complex part of our anatomy due to the dexterous natural of the nerves, ligaments and muscles that allows our hands especially to do all that is required of them. The wrist is formed by the ulna and radius of the forearm and the first row of carpal bones in the hand, while the hand itself contains 27 bones. 

Common hand & wrist conditions that patients present with at the Spinal Joint.

  • Carpal tunnel syndrome 
  • Fracture 
  • Osteoarthritis
  • Rheumatoid Arthritis 
  • Lunate dislocation 
  • Wrist sprain 
  • Finger Ligament sprain
  • Pins and Needles/numbness 

We often underestimate how much we use our hands and wrists until they are injured. We also tend to ignore pain in this area, unless the onset is traumatic, hoping that the niggle will go away. While are hands and wrists are not as commonly injured as our backs or necks, it is important to take care of them.

Richard Lanigan DC. MSC., has has many years of experience providing chiropractic care sucessfully to people with Sports Injury and extremity problems . Make an appointment before those niggles you feel each morning become chronic and arthritic.

Headache & Migraines

The skull and facial bones house and protect the brain and sensory organs such as the eyes. The brain gives rise to the nerves of the body via the spinal cord and requires a large blood supply. The head and the brain it contains is the master of our physiological system we require for life, enabling us to interact with the world. 

Common head conditions that patients present with at the Spinal Joint.

  1. Headaches e.g. tension, referred from neck & cluster 
  2. Migraines 
  3. Concussion 
  4. Ear, nose and throat pain 
  5. Temperomandibular joint issues (jaw)
  6. Facial pain, neuralgia. 

Due to the important role that the head plays it is essential that anything disturbing its function is rectified. Most major issues involving the head will often need to be refered out for medical investigation. However headaches are a very common ailment of society and depending on their cause, can be helped with manual therapy.

Head pain can also sometimes be referred from neck and jaw problems, or rebound headaches caused by taking too many painkillers to deal with headaches.

Chiropractic through the use of spinal manipulation (adjustments) and soft tissue work, can help improve neck function and nerves controlling soft tissue on head. It is also important that neck muscles are strong to support the back.

Mid Back & Rib Pain

The thoracic spine is made up of twelve vertebra and protects spinal nerves. The rib cage attaches to the thoracic spine, providing protection for the heart, lungs and autonomic nervous system. Therfore this part of the spine is generally the most rigid and pain often manifests between the shoulder blades due to poor posture at the work station.

The most common conditions related to the thoracic spine which are presented at Spinal Joint are: 

  1. Vertebral Subluxation
  2. Muscle Spasm 
  3. Rib sprain or fracture 
  4. Pain referred from organs 
  5. Thoracic outlet syndrome 
  6. Ankylosing spondylitis 
  7. Scheuermann’s disease 

For the health of the neck and lumbar spine it is important for the joints of the thoracic spine and ribs to maintain their range of motion. As most people spend a lot of time at computers working in awkward positions, straining their upper back and shoulders the thoracic spine is a common source of pain and stiffness.  It is also important your core muscles are strong to support the back. Richard Lanigan has had many years of experience treating back pain as well as extensive knowledge of exercises that will help strengthen your core and back to prevent future episodes.

Make an appointment below before those niggles you feel each morning become chronic and much harder to treat. 

Back Pain During Pregnancy

Low back pain is by far the most common complaint experienced by pregnant women, but mid-back and foot discomfort is also common. The source of low back pain is most often the pelvis (sacroiliac joints) or lumbar spine.. The pelvis is affected due to the combination if increased body weight and relaxation of the pelvic ligaments associated with pregnancy. In effect, the pelvic girdle expands and this leads to all types of mechanical imbalances.

A characteristic feature of normal pregnancy is a progressive increase in the curve of the low back. The increased forward weight of the enlarging uterus and its contents shifts the centre of gravity considerably forward from the norml. The result is a big change in posture that increases the low back curve, thus placing an increased amount of stress on the lowback and low back pain.

Mid-back discomfort is usually described as an annoying ache. This area is stressed due to the enlargement and increased weight of the breasts, as well as the result of the forward shift of the centre of gravity. In order to help maintain balance, a pregnant woman will tend to hold the shoulders back and move the head forward. This altered position places greater stress on the mid-back joints and muscles and tends to worsen already existent postural changes. The result is that mid-back joints become locked and muscles tighten, causing a deep aching sensation.

During the first trimester, most treatments can be utilised as with any patient and exercise is regarded as safe. During the second and third trimesters, some additional alterations may need to be made, because of the inability to lie face down. The only contra indications to treatment during pregnancy are when the patient presents with conditions such as excessive bleeding, premature labour, placenta previa, placenta abruptio, ectopic pregnancy, and the incidence of ruptured amniotic membranes without labour.

For many pregnant women, spinal care is probably the best option for back pain as we don’t rely of pain medication for results. There is no need to suffer for nine months and spinal manipulation and soft tissue work is worth a try, there are many benefits. In addition to helping control aches and pains during pregnancy, spinal care has been demonstrated in studies to reduce the mean labor time and reduce the likelihood of back pain during labour.

Neck, Shoulder & Arm Pain

The cervical spine consists of seven vertebra and eight spinal nerves, which forms the brachial plexus controlling the muscles of the neck shoulder and arm and why cervical spine dysfunction (subluxation) often refers into the shoulder, arm and hand. The role of the cervical spine is to support the head and protect the spinal cord. The spinal joints allow movement of the head in different directions. You may be reading this because you can no longer turn your head fully when reversing the car., It’s been building up for years and only now you are doing something about it.

The most common neck problems patients present at Spinal Joint with are: 

  1. Vertebral Subluxation
  2. Whiplash 
  3. Cervical disc 
  4. Cervicogenic headache
  5. Muscle spasm 
  6. Ligament strain/sprain 
  7. Osteoarthritis

The cervical spine can be a major source of pain and health problems for people because of its relationship with spinal nerves and the autonomic nervous system. The cervical spine is greatly affected by things such as poor posture, stress, lifting akward loads and sitting at a computer. Problems in the neck can refer to the head and well as into the shoulder and arm. 

Chiropractic through the use of spinal manipulation (adjustments) and soft tissue work, can help improve neck function, It is also important that neck muscles are strong to support the back.

Richard Lanigan DC. MSC., has has many years of experience providing chiropractic care sucessfully to people with neck problems . Make an appointment before those niggles you feel each morning become chronic and arthritic.

Low Back Pain & Sciatica

The lumbar spine consists of the bottom five largest spinal vertebra and sits on the sacrum bone and pelvis. Between each vertebra are discs that act like shock absorbers. Five large lumbar and sacral nerves exit the spine and join together to form a plexus, which forms the sciatic nerve sometimes the source of referred leg pain for people with back and pelvis problems. 

The lumbar spine supports the upper body and spine and transfers the weight from the spine into the pelvis and lower limbs as we perform activities such as sitting, standing or walking. When the spine has to alter shape for prolonged periods, during pregnancy, sleeping on front, or sitting at work, the soft tissue elements around joint get irritated, producing muscle spasm, stiffness and pain.

Common back conditions that patients present with at the Spinal Joint.

  1. Sacroiliac joint problems
  2. Disc prolapse (slipped disc) 
  3. Facet Joint Syndrome
  4. Vertebral Subluxation
  5. Muscle strain/Sprain 
  6. Spinal stenosis 
  7. Osteoarthritis 
  8. Spondylolithesis 

The lumbar spine is one of the greatest sources of pain in our society. Most people will experience some form of lower back pain in their lifetime, which can be very debilitating so it is important to seek treatment before the problem becomes chronic and harder to treat. 

It is also important your core muscles are strong to support the back. Richard Lanigan has had many years of experience treating back pain as well as extensive knowledge of exercises that will help strengthen your core and back to prevent future episodes. The sad truth is back pain is caused by every day activities, its not something you cure, self management is the key, using information and exercise as first step and you may need some chiropractic adjustments to get you on your way.

Most of the scientific studies that have been done on chiropractic have been for low back pain and are generally favourable. A 2018 study published in the Journal of The American Medical Association, looked at the pros and cons of chiropractic care for treating low back pain. Researchers enrolled 750 active-duty military personnel who complained of back pain. Half were randomly assigned to receive usual care (including medications, self-care, and physical therapy) while the other half received usual care plus up to 12 chiropractic treatments.

After six weeks of treatment, those assigned to receive chiropractic care:

  1. reported less pain intensity
  2. experienced less disability and more improvement in function
  3. reported higher satisfaction with their treatment
  4. needed less pain medicine.

While no serious side effects were reported, about 10% of those receiving chiropractic care described adverse effects (mostly stiffness in the joints or muscles). Those receiving usual care had similar complaints

In 2017 the American College of Physicians (ACP) updated its guidelines for the treatment of acute and chronic low back pain to recommend first using non-invasive, non-drug treatments before resorting to drug therapies. ACP’s guidelines, published in the Annals of Internal Medicine and based on a review of randomised controlled trials and observational studies, massage, and spinal manipulation (a centrepiece of chiropractic care) as possible options for non-invasive, non-drug therapies for low back pain ( This is similar to UK NICE guidelines which includes exercise as a central part of management). Only when such treatments provide little or no relief, should patients move on to medicines such as ibuprofen or muscle relaxants, which research indicates have limited pain-relief effects.

Richard Lanigan has had many years of experience adjusting spinal joints of people with back pain as well as extensive knowledge of exercises that will help strengthen your core and back to prevent future episodes.

Make an appointment before those niggles you feel each morning become chronic and much harder to treat.