Cause of Curvatures
Without entering here into a discussion of those disturbed metabolic processes—themselves the result of subluxation—which result in curvature by general softening of the bone, as in rachitis or spondylitis deformans, we will simply state the general proposition that almost all curvatures which are in any degree angular result from a single subluxation to be found at the point of the angle. It has been demonstrated in such cases that adjustment at that point will correct the curvature in time but it is usually wiser to hasten matters by selecting other points of attack by a method to be presently suggested.
Long, regular, but not pronounced, Scoliosis, usually in the Dorsal, may be an example of occupation curvature, following the continued use of muscles in a fixed position and not due to subluxation. Another example is the mailman’s Lordosis. These in themselves are not detrimental to health and are negligible unless some special point of impingement through individual subluxation exists within them.
The sharp, angular kyphosis of Pott’s Disease, tubercular caries of the vertebrae, the curvature involving three or four vertebrae which are extremely tender to palpation, should warn against adjustment unless one can be very certain that the vertebrae are sufficiently intact. Fracture of a decayed vertebra is easily possible under adjustment. The cause of Pott’s Disease is usually at the angle point, most frequently the tenth Dorsal but possibly any Dorsal from fifth to twelfth.
Record on Curvatures
If it is the purpose of the examiner to straighten the curvature he should choose for adjustment a series of non-adjacent vertebrae which are most prominent in the direction of the curvature; thus in a right scoliosis he should choose only those vertebrae most prominently out to the right, and in a kyphosis only posterior ones. A lordosis as such cannot be properly adjusted except in the Cervicals, but lordosis is usually a compensating curvature (see below) and can be otherwise corrected.
If the patient suffers from some disease which assumes more importance than the curvature and demands attention, select the one vertebra which is causing the disease, without reference to its position in the curvature, and adjust that vertebra into a proper relation with the adjacent ones, even though you adjust directly toward the convexity of the curvature. Disease may often be relieved by making a curvature regular more quickly than by eliminating the entire curvature. Sometimes both considerations may influence the selection of vertebrae.
In a curvature there is not necessarily pressure on nerves at every foramen. In fact, such pressure is the exception rather than the rule in curvature and a careful study of the spine must be made in order that adjustments may be accomplished without causing temporary impingement here and there.
A foot-note describing curvature may be appended to the record of palpation. It should contain the special name of the curvature, whether simple or compound, and the numbers of the first and last vertebrae in it. For instance, note may read: “Right rotary scoliosis from D 3 to L 1 inclusive.”