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The Neurology and Physiology of Chiropractic: An Overview
A vertebral subluxation, by definition, demonstrates a number of signs and symptoms as effects of Dysafferentation Syndrome. These may manifest themselves in multifarious means. Patients may experience diverse forms of neuropathophysiology – walking ability may be compromised, some may experience numbness and/or tingling in the arms and/or legs, headaches, difficulty swallowing, arm and/or leg weakness, dizziness, bowel or bladder incontinence, neck and/or back pain, etc.
It is important to understand the pathophysiology of patients who are thus affected. Their central integrative state is driven toward potassium equilibrium potential, or is said to be hyperpolarized, largely due to a lack of sensory afferent input from the large diameter axons of the zygapophyseal and joint mechanoreceptor system. Since 90% of the information proceeding into the central neuraxis is a product of mechanoreceptor afferentation, it is relatively fundamental to understand why a patient may experience various tiers of difficulty performing activities of daily living.
In these circumstances, not only will the patient’s neuraxis be dispossessed of potentiation from the large diameter fibers, but information carried by the small diameter nociceptive unmyelinated C fibers, as well as the small diameter myelinated A Delta fibers, will not be modulated either pre- or post-synaptically. The result is the conspicuous articulation of neurologic malfunction – symptomatology.
It is also important to realize that when such a patient loses input to their central neuraxis provided by these large diameter mechanoreceptive fibers, there is paucity of input through the thalamus to the cerebral cortex; and furthermore, a decrease in activity through the thalamic-hypothalamic-reticulospinal pathway. Hyperpolarization of this pathway impedes bombardment at the basal spinal nucleus to post-synaptically inhibit the second order neuron of the nociceptive system from reaching threshold – while simultaneously preventing a patient from receiving proper blood and oxygen supply to these tissues, causing further nociception and cellular compromise.
In order to correct, minimize, or allay these well documented effects, patients affected with such syndromes absolutely need and should receive chiropractic care. High velocity, fast-stretch chiropractic adjustments depolarize Type 1b afferents which then di-synaptically inhibit the alpha motor neuron to muscle spindle receptors, as well as Type I and Type II joint mechanoreceptors. These joint mechanoreceptors fire into the apical internuncial pool at the posterior horn of the spinal cord, and then send an axon collateral to pre-synaptically inhibit nociceptive afferents.
This type of adjustive regimen also releases a transmitter substance with a terminal amino acid of methionine, causing endorphin release at the basal spinal nucleus. Furthermore, through the re-establishment of normal and proper joint movement parameters, a patient will continue to depolarize the basal spinal nucleus, thus continuing to alleviate pain and/or discomfort through normal movement.
Normal joint movement further stimulates large diameter fibers which fire an afferent bombardment through the thalamus to the cerebral cortex, further affecting the thalamic-hypothalamic-reticulospinal pathway. This chain of events leads to further oxygenation and activation of the cells at the end of the pathway.