Inflammation is the body’s natural and protective response to injury, irritation, or infection. A Doctor of Chiropractic (DC) is trained to identify and localize this response, particularly when it affects the musculoskeletal system, using a combination of detailed patient history, hands-on physical assessment, and structural imaging. This multi-faceted approach allows the chiropractor to determine the source of mechanical irritation or dysfunction that is driving the inflammatory process.
Gathering the Subjective Evidence
The initial step in identifying inflammation involves a thorough intake of the patient’s reported symptoms and medical background. The chiropractor specifically inquires about the mechanism of injury (MOI), the date of onset, the duration of symptoms, and any prior treatments the patient may have received.
Detailed pain description is a significant component of this subjective assessment. Patients are often asked to use a standardized scale, such as a 1-10 pain intensity scale, but to describe the quality of the pain using words like burning, throbbing, aching, or sharp. A deep, throbbing, or constant ache often suggests a more generalized inflammatory state, while sharp pain may indicate direct nerve or joint irritation.
The discussion also centers on functional limitations and how the inflammation impacts activities of daily living (ADLs). Reports of morning stiffness, pain that worsens with rest, or difficulty performing simple tasks like lifting or bending offer clues about the severity and nature of the underlying issue.
Hands-On Physical Assessment Techniques
The hands-on examination serves to objectively confirm the presence and location of inflammation suspected from the patient’s subjective report. This process uses the chiropractor’s trained sense of touch and movement observation to analyze tissue changes and functional limitations.
Palpation, the act of feeling with the hands, is central to this technique, as the chiropractor assesses for the classic signs of inflammation in the tissues. These signs include localized heat, known as calor, which is detected as an increase in skin temperature over the affected area. The chiropractor also feels for subtle swelling, or tumor, which may present as tissue boginess or edema.
Furthermore, static palpation is used to assess tissue texture abnormalities, such as muscle guarding or hypertonicity, which are often protective responses to an inflamed joint or nerve root. Pain upon pressure, or dolor, is noted as the chiropractor gently probes specific anatomical landmarks and soft tissues. These tactile findings help differentiate between acute inflammation, characterized by tenderness and warmth, and chronic irritation, which may present as fibrosis or hardened tissue.
Range of Motion (ROM) testing provides objective data on how the inflammation is affecting joint function. The chiropractor performs both active (patient-initiated) and passive (doctor-initiated) ROM movements to observe movement patterns and pain provocation. Restricted or painful movement, particularly at the end range, frequently indicates an underlying inflammatory process, such as joint capsule swelling or muscle splinting.
Specific orthopedic tests are utilized to confirm the involvement of particular structures. These provocation tests involve placing stress on a specific joint, nerve, or ligament to reproduce the patient’s pain. For example, a straight leg raise test can isolate an inflamed nerve root, while compression tests can indicate inflammation within a spinal joint. Reproducing the pain with these targeted movements helps the chiropractor pinpoint the precise anatomical driver of the inflammatory symptoms.
Using Structural Imaging to Confirm the Cause
While the physical exam can identify the presence of inflammation, structural imaging is often used to visualize the underlying mechanical or degenerative cause. X-rays are the most common imaging tool employed, primarily to assess the alignment and integrity of the bony structures.
The images allow the chiropractor to identify spinal misalignments, or subluxations, and degenerative changes like osteoarthritis or disc space narrowing. These structural issues can create chronic mechanical stress on nerves and joints, which in turn leads to a persistent inflammatory response over time.
In cases of significant trauma or when ruling out more severe pathology, a chiropractor may refer a patient for advanced imaging such as a Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scan. These studies provide a detailed view of soft tissues, including discs, ligaments, and nerves, helping to confirm the source of the inflammatory pain when it is not clearly bony in origin. The findings from all imaging studies are then correlated with the subjective history and the objective physical assessment to create a comprehensive understanding of the patient’s condition.