From Dr. Natalie Meiri’s Clinical Pearl Stories:

This was a 34 year old male patient with a chief complaint of pain which he described as “stiffness” and dull in his neck and back. To be HIPAA compliant, I will call him Ted instead of his real name. Ted was an active duty military/law enforcement officer who was currently working on a boat for a few weeks.  He stated the rocking and constant motion of the boat made his gait unnatural.  Recently, he started experiencing “stiffness” and decreased range of motion.

In the past, Ted had also injured his left glenohumeral (shoulder) joint.  So this had happened 5 years ago and he had physical therapy for it.  Furthermore, he stated from time to time it seemed to “act up”.  Ted was an avid long distance runner and had to exercise/train regularly for his military career. He stated he came to see me before “things got really bad”.

Ted’s Examination

Upon examination Ted had decreased range of motion in his cervical (neck), thoracic (mid back), lumbar (low back) and left glenohumeral (shoulder) joint. Although there were no positive orthopedic or neurological tests, Ted definitely had areas of chiropractic subluxations (joint restrictions).  These subluxations were found by inspection/observation and palpation (static and motion) which revealed tender intersegmental dysfunction.  Additionally, soft tissues/muscles needing manipulation were located via deep digital palpation. Indeed, Ted’s condition was diagnosed as the Joint Subluxation/Dysfunction Syndrome (JSDS).


Ted’s Treatment

Firstly, Ted received chiropractic adjustments/ manipulation to his neck, spine and left shoulder along with soft tissue work (myofascial release, pressure point and various post-isometirc relaxation procedures).  Secondly, recommendations were made on nutrition and posture. Thirdly, therapeutic exercises for stretching and strengthening were given.

Ted responded to his chiropractic treatment.  Moreover, he had increased range of motion and less stiffness immediately following his first visit.  He was to return in 2 weeks for a follow up.


What is the Chiropractic Subluxation/ Joint Subluxation/Dysfunction Syndrome (JSDS)?

A Joint Subluxation/Dysfunction Syndrome (JSDS) diagnosis is defined by a combination of signs and symptoms for dysfunction of spinal, pelvic, or peripheral (limb) joints. It is a functional (biomechanical) diagnosis, not a structural (pathoanatomic) diagnosis. If you have JSDS, your spinal and peripheral motion segments and associated soft tissues are the source of your symptoms.

The chiropractic subluxation is the alteration of the normal dynamic, anatomic, or physiologic relationships of contiguous (neighboring) articular (joint) structures. It is a motion segment in which alignment, movement integrity, or physiologic function is altered.  However, the contact between the joint surfaces remains intact.  So the ORTHOPEDIC SUBLUXATION term which means a partial or incomplete dislocation, is different from the chiropractic subluxation.

And this aberrant relationship between two adjacent articular structures may have functional or pathologic sequelae (consequence of disease). The chiropractic subluxation can ultimately cause an alteration in the biomechanical or neurophysiologic changes to occur not only to your articular structures, but also your entire body systems.


Meiri Chiropractic in
West Palm Beach, FL

Meiri Chiropractic serving West Palm Beach, Jupiter, Palm Beach Gardens and North Palm Beach offers chiropractic treatment for  various ailments and maintenance/wellness care. Your chiropractor will examine, diagnose and determine your best course of chiropractic treatment for your condition and goals. Call us in West Palm Beach at 561-253-8984 to schedule an appointment or to find out more about The Chiropractic Subluxation and Adjustments for Athletes and Active People. Start getting the relief you need and the wellness you deserve!





A common source of pain and disability is soft tissue injury with its resultant fibrosis and loss of elasticity and strength. Soft tissue injury and fibrosis may result from acute or repetitive trauma to muscular, tendinous, myofascial, or ligamentous tissue.  Therefore,  adjustments of the joint without attention to the supporting and controlling effects of the soft tissues (i.e. muscles, tendons, ligaments, fascia) will likely result in recurrence of joint dysfunction (misalignment of joint).  The reason being, abnormal soft tissue patterns and presentations may persist after joint function has been restored.  Accordingly, any soft tissue problems need to be treated along with the joint dysfunction. 

Soft Tissue Manipulation (STM) techniques are defined as those physical methods applied to muscles, ligaments, tendons, fascia, and other connective tissues with the goal of therapeutically affecting the body. This post is about Instrument Assisted Soft Tissue Mobilization (IASTM) which is a form of soft tissue manipulation technique.

What is Instrument Assisted Soft Tissue Mobilization (IASTM)?

Instrument Assisted Soft Tissue Mobilization (IASTM) is a specialized manual therapy technique that involves the use of handheld instruments to diagnose and treat soft tissue dysfunctions. For instance it helps chronic postural related problems, neck/back pain, carpal tunnel syndrome, shoulder pain, sciatica, foot pain/ plantar fasciitis, hip/knee problems, tennis elbow, hand pain and many other soft tissue injuries.  It is a non-invasive procedure that aims to improve musculoskeletal function, mobilize adhesions/scar tissue, reduce pain, and enhance the body’s natural healing processes.

IASTM may have come from gua sha, an ancient Chinese medicine therapy. This therapy used common items, such as spoons, coins, or pieces of bamboo to scrape across the affected soft tissue. Additionally, this was meant to create sha (chi energy and/or petechiae), which helped overcome blood stagnation by improving circulation.

IASTM- Benefits and Goals


  1. Stimulates tissue healing and regeneration– By increasing blood flow IASTM promotes the body’s natural healing processes. IASTM brings oxygen, nutrients, and immune cells to the tissues, accelerating the healing process and reducing inflammation.
  2. Improves tissue extensibility and flexibilityBy breaking up collagen cross-links, scar tissue, and decreasing adhesions IASTM restores proper tissue extensibility and flexibility. Furthermore, this improves range of motion and enhances joint function.  Ultimately, it alleviates pain associated with restricted movement.
  3. Modulates pain perceptionBy stimulating sensory nerve receptors in the skin and underlying tissues it helps modulate pain signals. So IASTM provides pain relief and provides a sense of relaxation.
  4. Breaking down scar tissue and adhesionsChronic overuse, injury and surgery can cause Scar tissue and adhesions. Next these can restrict mobility, reduce circulation and cause pain. Similarly, IASTM breaks down and remodels scar tissue. Finally, improved tissue mobility and function occur.

What to Expect?

Firstly, contemporary IASTM utilizes ergonomically designed stainless steel instruments that have various curves.  These instruments have smooth edges and come in different shapes and sizes to accommodate different areas of the body.

Secondly, the intention is to find areas of scar tissue and break them up. 

Thirdly, gentle pressure to the affected area is applied while gliding the instrument over the skin. The unique design of the instrument allows for precise targeting of specific tissues, including muscles, tendons, ligaments, and fascia. The outcome is a smoother muscle contraction, decreased tension, pain relief and healing.


Soft Tissue Manipulation Procedures and Chiropractic Adjustments at Meiri Chiropractic in West Palm Beach, Florida

Probably the most well known soft tissue technique is massage (methodical, friction and kneading of the body upon bare skin). Subsequently, some chiropractors do not use manual therapy (non thrust techniques) and refer their patients for massage (i.e. Swedish, deep tissue) because of their exclusiveness  to adjustments (thrust techniques). And in the chiropractic practice, one of the functions of massage is to relax your muscles.  This prepares the irritated region for adjustments. However, they are NOT the same procedure. It fact, massage and manual therapy are a different code in insurance billing ( e.g. medicare)

What’s the Restrictive Barrier Difference?

First, massage is great for pain reduction, relaxation, improved circulation and even softens superficial fascia. However, massage is not soft tissue manipulation therapy which crosses the restrictive barrier. Many conditions require the restrictive barrier to be found and accurately engaged to provide  functional improvement.  Moreover, the barrier concept provides an important distinction between massage procedures and other Soft tissue manipulation techniques.

Second, you cannot get whichever therapy (massage) you prefer and expect the same  outcome.  Some soft tissue injuries/conditions may require a soft tissue manipulation technique beyond massage for restoration of full functional and/or structural improvement.  Also, when considering the use of treatment of certain soft tissue conditions a working knowledge of the fundamental principles behind them is necessary and helpful.  

Third, indeed, at Meiri chiropractic, we are specialists rendering our own services (adjustments along with manual therapy) after examining and diagnosing you. And Instrument Assisted Soft Tissue Mobilization Along with Chiropractic Adjustments are utilized at Meiri Chiropractic!


Call your West Palm Beach Chiropractor at 561-253-8984 to find out more about Instrument Assisted Soft Tissue Mobilization Along with Chiropractic Adjustments or to make an appointment.





From Dr. Natalie Meiri’s Clinical Pearl Stories: Chiropractic Helps You Overcome Addiction


Author: Natalie Meiri, D.C.           Posted: 8/9/23


This was a 25 year old male patient with a chief complaint of acute right sided cervical (neck)/thoracolumbar (mid/lowback) spine and right shoulder pain. To be HIPAA compliant, I will call him Kenny instead of his real name. Currently, Kenny was in an alcohol and drug rehab facility. He stated there had been a “chiropractor at the facility yesterday who gave him a 15 second crack which did nothing for him”.


Kenny had a history of multiple car accidents and falls over the years. He even had an injury last year where he had to have stitches to his right shoulder when he fell off a roof.  Kenny had been to a chiropractor in the past who combined the adjustment with soft tissue techniques and physiotherapy which gave him some relief.  Furthermore, being a recovering alcoholic, he couldn’t take any drugs for the pain. This was why he presented to my office.


Kenny’s Examination and Imaging

Upon examination he had painful spasmed muscles and tenderness all around the right shoulder, thoracolumbar (mid/lowback) spine, and cervical (neck) spine. Also, Kenny’s range of motion was limited. He wasn’t able to raise his arm past his head and could not bend forward at the waist due to pain.

His sensory examination showed a pattern of numbness and pain down his arms and legs in multiple dermatomes (areas of skin on your body that rely on specific nerve connections in your spine). Kenny had positive tests to indicate he had sprained and strained his neck, back and right shoulder.  Then he remembered during the exam he had recently been in yet another car accident. Additionally, he had chronic neuropathy in his neck and back.

His cervical (neck) x-rays showed loss of cervical lordosis (straightening) consistent with cervical myospasm for a sprain.  His thoracic x-ray showed a curvature with a  right convexity (abnormal curve) consistent with thoracic myospasm. If he wasn’t responding to care in a month, I would order a M.R. I. (magnetic resonance image).


Substance abuse, addiction and Chiropractic

Firstly, substance abuse and addiction are universally recognized as diseases that disrupt and damage neurotransmitters in the brain, causing a disturbance to production levels of chemicals.  Misalignments (chiropractic subluxation/fixation) in the spine interfere with normal functioning of neurotransmitters, such as serotonin and dopamine. Chiropractic adjustments correct and normalize functioning in the nervous system.  Moreover, chiropractic care eases stress, and anxiety. Ultimately, chiropractic affects an addict’s thoughts and emotions to improve positively.  Without improvement, the feelings of anxiety, depression, and mood swings results in an uncontrollable compulsion to consume the substance of addiction.


Secondly, Chiropractic can help addicts work through pain holistically and learn healthy alternatives for pain management.  Indeed, pain is especially common in those suffering from prescription drug addiction, and often leads people to abuse medications in an attempt to control discomfort.  In fact, for many individuals suffering from addiction, physical pain is one of the primary causes of substance abuse. Developing a rehabilitation plan that treats the physical and mental dependence on drugs or alcohol is important.


Thirdly, many addicts report that, in an attempt to manage pain, they began misusing prescription pain medication.  A tolerance often builds in people who suffer from long-term pain. Therefore, they start taking more of the medication to manage discomfort. So identifying and relieving pain without the use of prescription medications is key.  Alternative therapy programs have shown to support and enhance the outcome of treatment for substance abuse and chemical dependence. In conclusion,  detox, counseling, and physical rehabilitation (chiropractic care) are all necessary elements of addiction recovery programs. 

Dr. Natalie Meiri adjusts the neck of a patient


Kenny’s Treatment at Meiri Chiropractic

It is common to have pain and neuropathy in your shoulder and spine after a car accident. 

Chiropractic manipulative treatment techniques rendered to Kenny’s right shoulder and spine treated the sprain/strain.

Our other therapies, such as soft tissue techniques, therapeutic exercise, electric muscle stimulation, ice/ heat therapies and homeopathic consultations provided additional relief. It took a few months of care, but Kenny was pain free and got his range of motion back.  Kenny is continuing his chiropractic care in his hometown following his discharge/graduation from the addiction facility.


 Chiropractic Helps You Overcome Addiction

At Meiri Chiropractic we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have.  Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.  We have been offering effective chiropractic care in Palm Beach county since 2006.  Many of our patient reviews note our excellence.  Call us today at 561-253-8984 to make an appointment or to find out more about Chiropractic Helps You Overcome Addiction.



Chiropractic physicians are “primary contact providers” which means you can go directly to your chiropractor for an examination, diagnosis and treatment. In Florida, there is a large scope of practice besides from spinal and extremity (limb) adjustments (chiropractic joint manipulation): various manual therapies, physiologic therapeutics, exercise, nutritional/dietary counseling, and natural medicine (e.g. homeopathy).  Although there is a great difference in each chiropractor’s practice, nearly all utilize manual therapy with an emphasis on adjusting techniques.


What is Manual Therapy?

Manual therapy includes all procedures that use the hands to mobilize, adjust, manipulate, create traction, or massage the somatic (joint or soft tissue) or visceral structures of the body.

The aim is to get joint motion through either nonthrust techniques (mobilization) or thrust techniques (chiropractic adjustment/ thrust manipulation). Furthermore, these procedures improve range of motion as well as the quality of motion.  So by normalizing function, the pain goes away. Indeed, manual therapy is a treatment for Neuromusculoskeletal disorders with joint pain and dysfunction. 


Dr, Meiri adjusts a patient


The Chiropractic ADJUSTMENT


Central to the practice of chiropractic, it is the chiropractor’s specialty. Moreover, adjusting procedures are a key distinguishing feature of chiropractic practice. Chiropractors commonly use such procedures to influence joint and neurophysiologic function.

However, most chiropractors do not limit their practices to solely adjustments. Many conditions require additional therapy (e.g. electric muscle stimulation, soft tissue techniques, therapeutic exercise, ice/heat therapy, lifestyle/nutritional/ergonomic counseling, homeopathy).


Chiropractic Technique


More than 100 different named chiropractic technique systems have been developed within the chiropractic profession. These systems are a wide variety of diverse procedures: thrust and nonthrust joint manipulation/adjustment, soft tissue manipulation, manual or motorized traction, etc. And they all involve force, leverage, direction, amplitude, and velocity.

Many chiropractors do not equate an adjustment with a thrust. In fact, some chiropractic technique systems do not incorporate thrust procedures at all.  However, it is the thrust attribute that is a central distinguishing feature of the chiropractic adjustment. What’s more, the amplitude and velocity of the adjustive thrust vary depending on the patient’s need and condition (e.g high velocity–low amplitude (HVLA) force of controlled velocity, depth, and direction).

Certainly, the adjustment is a specific form of direct articular manipulation, using either long-or short-leverage techniques with specific contacts characterized by a dynamic thrust of controlled velocity, amplitude, and direction.


Some Techniques


Flexion Distraction (COX) Technique/Motorized Lumbar Distraction/ Manual or Motorized Cervical Traction


First, Flexion-distraction is a mechanically assisted form of joint mobilization or distraction. It has been advanced in chiropractic by the work of chiropractor James Cox.

Second, Motorized Lumbar (low back) Distraction can be used to assist in the production of lumbar traction. Traction to the lumbar spine is applied in the prone (face down) position while the pelvic section of the table produces continuous passive motion in the long axis of the spine.

Third, Manual Cervical (neck) traction can be applied manually or with mechanical assistance. Manual cervical traction is generally accomplished with the patient in the supine (face up) position.

Fourth, Traction and Distraction techniques restore normal physiological range of motion to the cervical (neck), thoracic (mid back) and lumbar (low back) spinal joints. The manipulation is a gentle, non-force adjusting procedure that works with the body’s natural design to aid in healing.

Finally, these techniques transfer metabolites into the spinal disc, decrease intradiscal pressure and decompress inflamed or compressed spinal nerve roots.


Diversified Chiropractic Technique

This is one of the most commonly used techniques in chiropractic. It involves application of “a short (low-amplitude), quick (high-velocity) thrust over restricted joints (one at a time). Of course the goal is to restore normal range of motion in the spine and extremity joints.

Musculoskeletal disorders, Migraine headaches, Pregnancy-related issues, ​inward curvature of the neck are all conditions which respond to this technique. 


Thompson Technique

Thompson Technique uses an adjusting table with a pneumatically driven, segmented drop system.  Next using minimal force, the doctor thrusts at high speed, allowing the fast drop to carry the joint through its range of motion. It is a gentle and effective technique.


Sacro Occipital Technique (SOT)

It was developed by Bertrand DeJarnette, DC. SOT believes adjusting one segment of the spine can cause change in another.

Dr. DeJarnette theorized that structural changes of the cranial bones could affect the movement of cerebrospinal fluid. Thus, SOT addresses the positioning of the cranial bones using a method called craniopathy.

SOT addresses pelvic subluxations by blocking. This involves blocks placed beneath the pelvis with the patient lying face-up. Above all, SOT integrates with other chiropractic systems, allowing for use of a variety of techniques within the SOT system.


Instrument Adjusting

A small handheld spring-loaded adjusting instrument is used.  It delivers a controlled and reproducible impulse to the spine and extremities.  This is an alternative to manual manipulation of the spine or extremity joints. Surely, Instrument Adjusting has grown to become one of the most commonly used in today’s practice (National Board of Chiropractic Examiners Survey, 2000). Similarly, this technique offers the flexibility to perform a chiropractic adjustment on a variety of patients, regardless of age or condition.



Chiropractic in West Palm Beach: Various Adjustments and Techniques


Dr. Natalie Meiri is a graduate of New York Chiropractic College (NYCC).  And all the techniques above are part of the NYCC curriculum.   In addition to joint manipulation and adjustment to the spine and peripheral joints, at Meiri Chiropractic, we use soft tissue procedures, hot and cold modalities, stretching exercises, rehabilitation exercises, and homeopathic consultations.

At Meiri Chiropractic in West Palm Beach we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have. Through regular chiropractic visits, you can get pain relief and improve function. Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.  Meiri Chiropractic has been offering effective chiropractic care in Palm Beach county since 2006.  Many of our patient reviews note our excellence.  Call us today at 561-253-8984 in West Palm Beach to make an appointment or to find out more about Chiropractic in West Palm Beach: Various Adjustments and Techniques.