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A critical look at the subluxation hypothesis.

J W Brantingham

    Journal of Manipulative and Physiological Therapeutics
    |April 1, 1988
    PubMed
    Summary

    This review examines the historical subluxation hypothesis for joint pain, finding no valid research supporting its link to pain or fixation. The term "somatic dysfunction" is proposed as a more accurate diagnosis for manipulable lesions.

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    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.

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