What Is a Subluxation?
In order to understand what a subluxation is, we should first discuss the movable joints in your body. Fully movable joints are known as synovial joints. A synovial joint is the area where two bones that articulate, or when two bones meet with each other, form the movable joint. Synovial joints contain structures that allow the joint to move while reducing friction and stress. These include very slippery articular cartilage, synovial fluid (which you can think of as the WD40 of your joints), and a joint space that prevents the bones from rubbing on each other. Synovial joints are the most frequently injured joints in the body and may suffer from sprains, dislocations, arthritis, and subluxations.
While a dislocation is a complete disunion, or separation, between the two articulating bones of the synovial joint, a subluxation is an incomplete disunion of the two articulating bones. In the case of a subluxation, the two bones that meet up will partially separate from each other and return to their normal position. This process is called spontaneous reduction. The bones continue to touch each other along the articulating surfaces but not in the same nature as if they were not injured. In contrast, in a dislocation the two bones completely separate from each other and remain apart.
The partial disunion of the two bones can cause damage to the surrounding tissues associated with the synovial joint. These structures may include the articular cartilage (or the cartilage on the surface of the bones that are meeting up), the joint capsule (or the connective tissue that surrounds the joint), or the ligaments surrounding the joint (which include the connective tissue that connects bone to bone).
Likely Subluxation Scenario
During a pick-up game of basketball, one of the players goes up for a rebound and has his arm ripped back by someone on the other team. Immediately, he feels something strange happen in his shoulder, and he grabs his shoulder with his opposite arm. His friends see this happen and watch as he shakes his arm. It takes a few minutes but he gets back into the game, but just doesn't play the same for the rest of the day. The next day the player decides to get his shoulder checked out by his doctor.
Now that we understand the technical aspects of synovial joints and an actual injury, we can understand what a patient may present with that would indicate that he or she has suffered from a subluxation. While complete dislocations result in a visible deformity, subluxations don't.
Since a subluxation will spontaneously reduce, the symptoms are going to depend on what the patient tells you, the doctor. Patients will say that they felt their joint slide in and out at the time of injury. They'll likely complain of pain and discomfort. They may state that initially they felt some type of grind or pop and couldn't use their joint at all. However, after it spontaneously reduces, they'll tell you that there's still pain and discomfort associated with the joint.
Upon examining the patient, you may also note that the patient may have decreased strength and be apprehensive to move the joint through the full range of motion. Clinicians who test the integrity of the joint will see this apprehension in the patients while they're undergoing these special exams.
All first-time subluxations should be referred to an orthopedic physician. There is a chance that, due to the force of the subluxation, damage to other structures could be present. The physician will most likely check the integrity of the joint, check the alignment of the joint, and typically obtain some type of diagnostic imaging (X-rays, MRI tests, etc.) in order to rule out other injuries.
Treatment of a first-time subluxation also includes ice and immobilization of the joint, followed by exercises that will strengthen the muscle surrounding the joint. If the condition becomes a chronic condition, the physician may decide that some type of surgical option to stabilize the joint is needed in order for the patient to return to his or her previous level of activity.
Let's take a few moments to briefly recap what we've learned about subluxation. Subluxations are partial disruptions of the articulating surfaces of two bones that make up one joint. These are usually in fully moveable joints, known as synovial joints. Remember that a synovial joint is the area where two bones articulate, or where two bones meet.
A subluxation differs from a dislocation because the two bones will spontaneously reduce or, in other words, return to their normal position. Subluxations should be referred to the appropriate physician, who will prescribe rehabilitation to strengthen the joint in the case of first-time subluxations, while chronic conditions may require some type of surgical intervention followed by extensive rehabilitation to return the joint to full function.
Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.
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