A critical look at the subluxation hypothesis.

Area of Science:

• Orthopedics
• Chiropractic Medicine
• Manual Therapy

Background:

• Joint manipulation is historically used for pain management, often attributed to subluxation.
• The subluxation hypothesis links joint pain and fixation to partial dislocations.

Purpose of the Study:

• To investigate the historical basis of the subluxation hypothesis.
• To review literature for evidence supporting subluxation's role in pain and fixation.
• To assess if manipulation effectively reduces subluxation.

Main Methods:

• Literature review of historical and current research.
• Analysis of studies investigating subluxation, pain, and joint fixation.
• Examination of evidence for manipulation's effect on subluxation.

Main Results:

• No valid research supports the hypothesis that subluxations correlate with local or referred pain.
• Evidence is lacking to confirm subluxations cause joint fixation.
• Proof that manipulation reduces subluxation is not established.

Conclusions:

• The subluxation hypothesis lacks scientific validation.
• The term "somatic dysfunction" is suggested as a more appropriate descriptor for manipulable lesions.
• Clinical terminology should reflect evidence-based understanding of joint dysfunction.