A critical look at the subluxation hypothesis

Historically, manipulation has been applied to manage spinal and extremity joint lesions that produce pain. The cause of this local or referred joint pain often has been attributed to subluxation or partial dislocation. This paper looks at the historical roots of the subluxation hypothesis, and reviews the literature to see if any valid research exists supporting the hypothesis that slight subluxations correlate with local or referred pain or is a cause of fixation. Also examined is whether proof exists that manipulation reduces subluxation. Associations between subluxation and the manipulable lesion are outlined, and suggestions for use of the word subluxation are addressed. The term somatic dysfunction is forwarded as an appropriate descriptive diagnosis of the manipulable lesion.