Chiropractic is a regulated health profession centered on the diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, with a focus on the relationship between the spine and the nervous system. While all doctors of chiropractic complete the same core training, practitioners adopt varied philosophical approaches and distinct clinical methods. Understanding the differences among these approaches is the first step for anyone seeking the type of care best suited to their individual health goals.
The Philosophical Divide in Chiropractic
A fundamental ideological split exists within the profession, which broadly divides practitioners into two groups: “Straight” and “Mixer” chiropractors. The “Straight” approach adheres closely to the founding principles, maintaining that the primary purpose of care is the detection and correction of the vertebral subluxation. This traditional philosophy views subluxation—a misalignment interfering with the nervous system—as the root cause of health issues, disrupting the body’s innate intelligence. Straight chiropractors generally limit their practice to manual spinal adjustments and exclude supplementary treatments like physical therapy modalities or nutritional counseling.
The “Mixer” camp constitutes the majority of modern practitioners and adopts a broader, more integrated approach to patient care. Mixer chiropractors still perform spinal adjustments, but they view joint dysfunction as only one potential factor contributing to a patient’s condition, alongside muscle tension, poor posture, and lifestyle factors. This group integrates a wide array of evidence-based modalities, such as therapeutic exercise, soft tissue work, and nutritional advice, into their treatment plans.
Major Adjustment Techniques
Beyond philosophy, chiropractors are often defined by the specific hands-on techniques they use to deliver an adjustment.
Diversified Technique
The Diversified Technique is the most widely utilized method and is commonly associated with traditional chiropractic care. It is an entirely manual technique characterized by a high-velocity, low-amplitude (HVLA) thrust applied directly to a restricted joint to restore normal movement. The quick, specific force often produces the audible release, or cavitation, that many patients recognize as the sound of an adjustment.
Activator Method
The Activator Method utilizes a small, handheld, spring-loaded instrument to deliver a precise, low-force impulse. This instrument-assisted technique is favored for its gentleness and speed, as the impulse is delivered so quickly that the body’s muscles are less likely to tense up in resistance. This method is suitable for patients sensitive to manual manipulation, such as the elderly, young children, or those with certain bone density conditions.
Upper Cervical Specific
This approach focuses almost exclusively on the alignment of the first two vertebrae: the atlas (C1) and the axis (C2). Techniques like NUCCA and Atlas Orthogonal rely on detailed imaging, such as specialized X-rays, to calculate the exact degree of misalignment. The resulting adjustment is a precise, low-force correction, often delivered by a specialized instrument or a gentle hand contact, without the twisting or cracking motions associated with full-spine techniques.
Gonstead Technique
The Gonstead Technique is a highly detailed method that relies on a comprehensive five-point analysis before any adjustment is performed. This analysis includes visualization of posture, motion and static palpation, full-spine X-rays, and the use of a Nervoscope—an instrument that detects uneven heat distribution along the spine. Gonstead practitioners often use specialized tables to position the patient in a way that isolates the segment to be adjusted.
Focus Areas and Specialized Care
Many chiropractors pursue advanced training to specialize in treating specific patient populations or complex conditions, often culminating in the achievement of Diplomate status. These advanced credentials require extensive post-graduate education and practical experience:
- Diplomate of the American Chiropractic Board of Sports Physicians (DACBSP): This credential signifies the highest level of training in sports chiropractic. It involves practical experience in areas like emergency procedures, extremity injury assessment, performance enhancement, and on-field care.
- Diplomate in Clinical Chiropractic Pediatrics (DICCP): This specialization requires extensive coursework covering infant development, prenatal and perinatal care, and modified adjustment techniques for children and pregnant women.
- Diplomate of the American Chiropractic Rehabilitation Board (DACRB): This advanced certification focuses on therapeutic exercises, movement analysis, and functional restoration to manage chronic pain, post-surgical recovery, and movement disorders. These specialists integrate active patient participation, such as strengthening and flexibility programs.
- Diplomate of the American Board of Chiropractic Occupational Health (DACBOH): These practitioners focus on ergonomics, injury prevention, and workplace accommodations to reduce occupational strain and injury risk.