Before I do that let me refresh your memory about TSV (Total Subluxation Value). This is that number that I use as a measure of spinal subluxation. It is by no means the only measure of subluxation that chiropractors use, but it is easy to measure, accurate, and reproducible. In scientific circles it would be called sensitive but not specific. The TSV can vary from a low of zero to a high of 304. It is a measurement of the health of the spine. The smaller it is the better the spine works. Like golf scores, bigger is badder.
Now let us pretend that we have two different patients, Patient Low and Patient High. Patient Low has a lower pain threshold than Patient High. This is not to say that Patient Low is weaker or lesser than Patient High in any way. This is just the genetic programming of our two patients. We all have our strengths and weakness, and when it comes to our genes we can accept no more credit for our strengths than we can take blame for our weaknesses. They just are.
Both of our patients have headaches on a daily basis along with neck and upper back pain. They have a history of recurring lower back pain and have had sciatica too. In other words, when it comes to their pain, they are exact twins. But when it comes to their TSV Patient Low measures 60 while Patient High is 120. THEY HAVE THE SAME AMOUNT OF PAIN BUT CLEARLY PATIENT HIGH HAS A SICKER SPINE. It takes more damage for him to feel it. Even though these two patients are made up, I see this kind of thing all the time.
The conclusion has to be that the TSV is a measure of spinal damage, while the amount of pain is a measure of the patient’s genetic threshold for pain. TSV is cause. Pain is effect. Should we treat the cause or the effect, the subluxation or the pain? This is the basic question dogging chiropractic and medicine. Drugs treat effects and chiropractic treats cause.
Let’s go back to our patients. After observing thousands of patients over my 26 years I have concluded that in the absence of complicating factors (see article #100) that most people will feel much better and be reasonably stable once their TSV is reduced by half. Patient Low needs to get to 30 from 60. Patient High to 60 from 120. Think about that, this means that Patient High will feel good at the exact same TSV (60) that Patient Low was at when he/she first came to my office! This is pain threshold at work.
The only logical process once at the half-way point is reached is to continue to try to reduce the TSV to as low as possible, but that is a different discussion for a different article involving Reconstructive Care.
If your only goal is to treat the effect and you don’t care about cause and you don’t care about side-effects, take a drug. Drugs will numb better than an adjustment. But if you care about cause then there can be only one conclusion, forget about the effect – the pain – and focus on the TSV (and any complicating factors), so we can truly measure the health of your spine.