Subluxation refers to a dislocation in which the bones of a joint have shifted against each other. The articular surfaces are partly still together. Subluxations can still be very painful and severely impair the function of the joint. Here you can read all about the different forms of subluxations and their possible symptoms.
What happens with the subluxation?
A joint on the body is the area in which bones are more or less movably connected. The parts of the bones which lie against each other are called joint surfaces. They are covered with a lubricious cartilage layer. Almost always, ligaments, an articular capsule, and muscles keep the bones of the joint in place.
However, external forces can cause their stabilizing function to be insufficient and the articular surfaces to move against each other. If this does not happen completely, but they still have some contact with each other, it is called a subluxation.
Which joints are affected?
In principle, a subluxation can occur at every joint. However, just like the dislocation, it mainly affects those joints that are particularly susceptible to injury due to their anatomy or position on the body (shoulder, elbow, hip). At certain joints, the bone fractions almost never completely slip, making subluxation much more common. An example is the dislocation of vertebral bodies.
Chassaignac palsy (Pronatio dolorosa)
A special form of subluxation that occurs only in children is the Chassaignac palsy. It is a special case of subluxations as it only occurs in children up to the age of six. Chassaignac’s paralysis is named after French surgeon Charles Chassaignac and is one of the most common injuries of that age. Because the affected children are hardly able and willing to move their forearms, one speaks of a paralysis – medically not exactly precise.
What causes Chassaignac palsy?
The (bony) arm consists of the humerus and the two forearm bones, ulna and spokes. At the elbow, three joints are created by these three bones: The ulna forms a hinge joint with the humerus and allows the flexion and extension of the forearm. The spoke simultaneously forms a joint with the ulna and a ball joint with the humerus. So the forearm can be rotated in and out of the upper arm.
A typical mechanism of causing Chassaignac’s paralysis is this: The child is standing by the roadside with an adult and suddenly starts running, the adult pulls the child jerkily back at the hand because a car is coming. The resulting forces can lead to dislocation of the spit head. For smaller children, the ligamentous apparatus holding the spinal head in its two joints is not yet very stable. The head of the spoke can thereby slip out of the ball joint with the humerus. Even with the popular “angel flying”, an unfavorable force is exerted on the elbow joint.
The children then hold their arms slightly bent and turned inwards. In this condition, they have little pain.
Treatment of chaissaignac palsy
This type of subluxation is good to treat. Ideally, the spine head will jump back into the annular tether and the pain and movement restrictions will be resolved as quickly as they occurred. After reinserting the arm usually does not need to be spared.
Complications of chaissaignac palsy
Although the pronation dolorosa is very painful for the child, it is rarely associated with accompanying injuries. As soon as the spine head is retracted, the symptoms abate and the arm can be moved freely again. However, if the elbow joint is not quickly retracted, it usually takes a few days after restraining until the child can move the arm again without pain.
As with any subluxation and dislocation, there is an increased risk of re-dislocation following injury of this nature. If the spine head slips out of the ring band shortly after reduction, a humeral gypsum can help. This is put on for about two weeks and holds the arm in outward rotated position. In this way you prevent a renewed subluxation.
Subluxation to the vertebral bodies
If the first (top) cervical vertebra slips over the second cervical vertebra, it is called an atlanto-axial subluxation. Neurological symptoms to paraplegia may be the result.
How does an atlanto-axial subluxation develop?
The first cervical vertebra has the structure of a ring on which the head rests. From the second cervical vertebra grows a bony projection (dens axis) from below through this ring. In this way, the first and second cervical vertebrae form the atlanto-axial joint, which allows the lateral rotation of the head.
In malformations, such as a badly grown bony prominence or weakened connective tissue, the atlanto-axial joint may dislocate. Chronic inflammations of the atlanto-axial joint, such as occur in the context of polyarthritis, also represent a risk for subluxation. In external trauma, for example in a traffic accident, the bony prominence may even break off and thus cause a subluxation.
Symptoms and treatment of atlanto-axial subluxation
The greatest danger of an atlanto-axial subluxation is that the spinal cord, which also runs through the cervical vertebral ring, is damaged. In addition to pain in the neck area, especially when bending the neck, motor or sensory disorders may occur on the limbs. In severe cases, all limbs may be paralyzed (“high paraplegia”, quadriplegia).
In the case of a subluxation due to malformations, the symptoms usually appear creeping in the first months of life, but very suddenly in an acute subluxation. An atlanto-axial subluxation must be confirmed by an imaging procedure. If the spinal cord is damaged, an operation is usually unavoidable.
Subluxation in chiropractic
Subluxation plays a relatively important role in chiropractic treatment, whereby it refers exclusively to the displacement of two dorsal vertebrae. It is believed that not only accidents and other injuries can move the vertebrae, but also everyday stress and even mental stress can cause subluxations. By the subluxation The eddies are irritated by the exiting nerves, which not only leads to nerve damage, but can also cause malfunction of the organs.