A patient case from today. A 70 year old woman on six-weekly maintenance care, booked in a week early after a fall that jarred her neck, middle back and right shoulder.
Presenting complaint
She came in a week ahead of her scheduled six-weekly visit. She had fallen forwards last week and jarred everything. Neck pain, middle back pain and right shoulder pain. No headaches.
What the assessment showed
Nothing nasty. Nothing sinister. No sign of fracture or other bony pathology. The pain pattern was musculoskeletal locking consistent with the fall, concentrated through the mid thoracic, lower neck and right shoulder.
The clinical thinking
When an older patient falls, the first job is to rule out fracture before anyone touches them for treatment. Only after that comes the technique choice, and in older patients neck work is where technique matters most. A lot of our older patients, kids, babies, and anyone who simply does not like a manual neck adjustment do not want their neck twisted. We do not force it. We use an instrument called an activator, which is a small spring-loaded mechanical device that delivers a very light mechanical impulse directly into the joint. The bone moves, the joint position releases, but the neck itself does not get rotated. For Vicky’s demographic that is the right tool.
Care plan today
A towel-contact sitting adjustment through the mid back. Activator adjustments through the neck. A mobilising shoulder adjustment on the right.
How she is now
Walking out feeling a lot better. Booked in for next week ahead of a flight she is taking, to make sure she is tuned up for travel.
Rebates at the counter
Normally a Bupa Member First Provider rebate. Her Bupa cover has run out for the year, which is common toward the end of the calendar year even for patients on regular care. She paid the full $71 adjustment fee on credit card. Cover resets in the new year.
If you are still deciding
If you are an older patient and the thought of a manual neck adjustment puts you off, that is not a reason to avoid chiropractic. The activator and other gentle techniques exist for exactly this situation and are what we use most often with older adults. Book an initial consultation.
Patient name has been changed. Individual results vary. This case study is shared for educational purposes and does not constitute a clinical recommendation for anyone else.
Frequently asked questions
Can older patients still receive chiropractic adjustments safely?
Yes. Technique is matched to the patient. For older adults we typically use an activator or gentle mobilisation rather than high-force manual adjustments. We also screen for fracture risk before adjusting after any fall.
What is an activator and when do you use it?
An activator is a small spring-loaded instrument that delivers a very light mechanical impulse directly into a joint. We use it for older patients, children, babies, and anyone who prefers not to have manual rotation of the neck. It is one of several technique options we select from based on the patient.
Related patient cases
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A 74 year old maintenance patient came in stiff and sore all over. Here is what we did and how she pulled up. - Patient case: pelvic joint pain in a 66 year old traveller
A 66 year old patient came in for a pre-flight check after left pelvic joint pain the week before. Here is what we did and why pelvic joints tend to lock up on long travel. - Patient case: acute neck pain and headache in a 45 year old maintenance patient
A 45 year old regular patient hurt his neck lifting on Monday and came in with headaches by Thursday. Here is how we worked through it.
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