What Is Tonal Chiropractic and How Can It Help Chronic Pain?
Image courtesy of Gilbert Beltran via Unsplash.
The core idea that chiropractic was built upon is that there are things in life (acute injuries, chronic insults, lack of movement) that can disrupt communication between our the central nervous system and the rest of the body. In the early iterations of this idea, the disruption was thought to be more mechanical in nature (a bone out of place physically pinching a nerve and impeding its function—AKA a subluxation).
As research and our knowledge of the electrical, chemical, and physical complexities of the human body have advanced, this model has received a few big updates, leading to major changes in the way chiropractic can be practiced.
The first types of techniques are the more manual, alignments-based ones that chiropractors are most widely known for and the ones taught in chiropractic schools. But I want to dive into tonal chiropractic, which incorporates some of the least common techniques practiced today. What makes these techniques stand out is that they treat the human body as less of a static skeleton and as more of a dynamic and ever-changing body. Here’s how tonal chiropractic has evolved.
The Manual Chiropractic Model: Spinal Alignment Reigns
As the chiropractic profession was developing over the past century, the primary theory of how chiropractic worked was that we were applying a force to correct mechanical misalignments of the spine. These misalignments (that we dubbed subluxations) put pressure on the nerve roots that exit the spine between the vertebra at that level, decreasing the ability of that nerve to function.
The idea was that any tissue innervated by that nerve would then function at less than peak efficiency. This could present itself as pain, but could also mean decreased organ function to the associated viscera (aka the heart from a T2 subluxation, the large intestine form an L1 subluxation, etc.).
Under this mechanical model, the spinal misalignment comes first, puts pressure on the nerves, and then causes dysfunction down the line in the muscles and organs.
This model is based on the concept that chiropractic adjustment must be a manual force that pushes the affected bones back into alignment and allows for proper function to be restored. It also assumes that there is a proper biomechanical position for all bones and joints to be in, and a static evaluation of the spine can reveal misalignments that affect the whole body in motion.
This theory hasn’t quite stood up to the test of scientific study. As our ability to measure function of the human nervous system has improved in recent decades, we’ve been able to get a much clearer (yet ironically more diffused) picture of what’s really going on with chiropractic adjustments. None of the manual chiropractic tenants are inherently wrong, but they are incomplete—simplified to the point of no longer being accurate.
The Chiropractic Subluxation Complex: Mechanical and Chemical Stress Contribute to Pain
The first wave of new research caused the profession at large to expand our model from simple bone-out-of-place-pinching-a-nerve, to something we call the “chiropractic subluxation complex.” In this currently-taught-in-chiropractic-schools model, the dysfunction associated with spinal misalignments is expanded upon to include mechanical stresses from misaligned joints, chemical stresses associated with the inflammatory processes in and around the misaligned (and subsequently irritated) joint complex, and the myofascial (muscular and connective tissue) distortion that is caused and made worse by spinal misalignments.
It is understood in this newer model that the mechanism of the chiropractic adjustment is not what we previously thought it to be. We as chiropractors do not in fact apply a force that manually sets a misaligned bone into place. It turns out that when we apply an adjustment to a joint complex, what we’re really doing is applying a quick and jarring stimulus to a part of the body that is densely packed with mechanoreceptors (nerve endings that sense movement) and proprioceptors (nerve endings that sense joint and body position).
When we rattle all of those nerve endings at the same time, the brain lights up and starts paying more attention to that area. That increased attention allows the brain to tune the muscles and connective tissue around the joint and hold it in a more efficient (and usually less painful) position. (This again assumes that there is an ideal position for each bone to be in, though.)
Recent studies have revealed to us that people with chronic pain do not have an accurate awareness of where parts of their body are in space. The brain’s map of the body is literally distorted, sometimes to the point that people can’t tell what part of their body is being touched or how that body part is moving. Stimulating the mechanoreceptors and proprioceptors in such an area is a great way to prompt the brain to pay attention and re-evaluate its map of that area.
It is through this re-evaluation that the brain makes shifts in muscle and connective tissue tone to set the joint in a more efficient position. Same-ish end result, VERY different mechanism.
Tonal Chiropractic: Evaluating the Whole Body
It’s at this point that tonal chiropractic begins to emerge. If the core function of chiropractic work is to reconnect the brain to the body, do we need an abrasive manual adjustment to make that happen? Or, do we maybe just need to find ways to stimulate the nervous system to prompt the brain to make whatever shifts best suit the person?
By that same token, is “proper alignment” what’s most efficient for every person? Is the textbook standard spinal posture, with a completely straight spine in the coronal (left to right) plane and three smooth, even curves (four, if you count the sacral curve) in the sagittal (front to back) plane, really most efficient to EVERY human?
We do, after all, have asymmetrical bodies as a standard. We have organs like the liver, gallbladder, and spleen that are only on one side, several others like the lungs, heart, and stomach that are significantly asymmetrical, and a dominant side that typically has greater coordination and muscle development. We also build up injuries, scars, anomalies, and habits that shape each of our individual bodies in unique ways.
On top of that, we’ve found that all humans have variations in bone structure from side to side (a pair of femurs found in the same human will never be exactly the same length!). In fact, the more we study human beings, the more dynamic and varied we find ourselves to be.
Add to that the fact that the human body has to make changes every second of every day to keep itself upright, moving, breathing, healing, digesting, and thinking, and we need chiropractic treatments that are flexible for every body.
After all, should the person with a congenital hemi-vertebra (a partially formed, wedge-shaped vertebra) have no curve in their spine? Should an amputee who is walking on one prosthetic leg have symmetrical movement and position of his S.I. joints? I would argue not.
What Is Tonal Chiropractic?
Full disclosure—I practice tonal chiropractic techniques. The doctors who have helped me create the most prominent and long-lasting changes in my health have all been tonal chiropractors.
Tonal techniques are among the most gentle in chiropractic and often include very light adjustments to the body (though some of us do still use manual adjustments). Doctors who practice tonal techniques also tend to also incorporate cranial, visceral (meaning organs and guts), and in some cases, energy work into their practice.
Ultimately what a tonal chiropractor is looking for are signs of stress (activation of the sympathetic nervous system) and signs of ease (activation of the parasympathetic nervous system). Tense muscles and connective tissues; shallow, tense breathing patterns; and restricted movement patterns are all signs of stress. A decrease in (or evening out of) tissue tone; slower, more relaxed breathing; more fluid movement patterns; and in some cases, a change in demeanor are all signs of more ease.
Tonal chiropractic also takes into account that bodies change from moment to moment, day to day, and year to year. Changes in patterns and areas that need help are a sign of a healthy, adaptive body. Patterns that don’t change and adapt over time are often signs of pathology.
That’s why we will rarely, if ever, do the same adjustments from one appointment to the next. In fact, one of the core tenants of most tonal techniques is that if you do the same thing with the same person for three visits in a row, then you’re missing something and need to re-assess.
Each body is also different, which tonal chiropractic acknowledges by tuning into what the individual needs. For some people, big manual adjustments that are associated with traditional chiropractic work are the most effective way to communicate with their system. But for many, the input can be a light, but intentional touch, the smooth passive movement of a joint, or even an instruction to breathe slowly and deeply that helps create the most relief.
Take a married couple that I work with: Who would you think needs very intense muscle work and forceful manual adjustments? The 6’-2”, 300-pound, male power-lifter or his 5’-5”, 160-pound wife? (She’s also a powerlifter, but I usually leave that part out to serve my point better.)
I bet you guessed wrong: He responds best to feather-light adjustments (we often joke that I only have to think hard enough about one of his joints to make it shift), and his more petite wife needs forceful manual adjustments and deep muscle work to feel any benefit at all.
That’s why tonal chiropractic can be so effective. Not only does it take into account the evolution of our understanding of the body over decades, but it also observes what each individual needs in each individual session to get the most ease in movement and pain relief possible.
Interested in learning more or about how tonal chiropractic could be beneficial for you or your patients? Contact me to learn more.