How I measure progress, and why I do not only ask how you feel
You may have noticed that I do not ask you how you feel at the start of every single session. Some people find that surprising, so I wanted to explain it properly.
Pain is not my guide.
Let me be very clear about what I am and what I am not. I am not a doctor. In Spain I am not even legally a healthcare professional, because chiropractic is not a regulated profession here. I do not diagnose anything and I do not replace anyone. Chiropractic is something else entirely, and it is for people who are open to trying a different route alongside whatever else they are doing.
So what am I actually looking at, if not the pain? That is the whole point of this article. 🙂
You stop noticing what got better
Here is something I find genuinely fascinating about the human brain: it is very good at noticing what hurts, and very bad at noticing what stopped hurting.
Your brain is built to flag what is new, unexpected or potentially threatening, and to quietly filter out everything that is running smoothly. That is why you feel your shoe when there is a stone in it, and not for the rest of the day.
Think about the last time you had a cold. For four days it was all you could think about. Then it faded, and you almost certainly cannot name the exact day you stopped feeling unwell. You just did, and then you thought about other things.
The same happens with the body more broadly. Someone stops waking up stiff and, three weeks later, has genuinely forgotten that they used to. Someone stops thinking about their neck at their desk, and the absence of that thought is invisible by definition. You cannot notice a thought you are no longer having.
This is just how attention works. Improvements are quiet. Problems are loud. Which makes "how do you feel" a very unreliable place to measure from, in either direction.
The same tests, repeated over time. That is the only honest way to compare where you started with where you are now.
This is part of why we fill in a detailed questionnaire at the very beginning, and why we come back to it later with the same questions. The functional tests work the same way: we repeat the same ones, under the same conditions, so that any comparison is at least comparing like with like.
No single test tells the whole story, and each one has its limits. But taken together, and repeated over time, they help us see trends rather than snapshots. That is really what we are looking for.
Why sensation is not my reference point
A paper cut is one of the most painful things that can happen to a finger, and it is medically insignificant. Meanwhile, spinal restrictions can be present for a long time without producing any sensation at all, because the body compensates around them quietly.
Pain is a signal produced by the nervous system, not a direct readout of what is happening in the tissue. Sometimes the system stays in the habit of producing that signal long after there is much left to protect.
So sensation is useful information, but it is one input among several. What I am actually paying attention to is how the body is functioning. Which is why I ask questions that can seem unrelated: how you are sleeping, whether you feel clearer during the day, how you are handling stressful weeks, whether you move without thinking about it. Those are not small talk. They are markers of how the nervous system is adapting, and they do not always move at the same pace as pain does.
Your situation did not begin last month
Almost everything I see in practice started silently, long before it was ever felt. A restriction appears. The body compensates. That compensation creates load somewhere else, and that area adapts too. This goes on quietly for years, until something ordinary like lifting a box becomes the moment it finally surfaces. This is also one of the reasons I check children's spines, so that we are looking at things before patterns have had decades to build.
Which means expecting one month of care to undo a decade of adaptation is, honestly, quite optimistic. I have the same impatience with my own body, so I understand it completely.
The nervous system also adapts through repetition rather than intensity. Five minutes of Spanish every day takes you further than one intensive weekend, and a muscle responds to consistent load rather than a single hard session. Your spine works the same way, which is why adjustment sessions are short and frequent rather than long and occasional. It also means a plateau is not necessarily a sign that nothing is happening, since adaptation tends to move in steps rather than in a straight line.
This is also why the recommendations I give in the second part of your initial care plan matter. The adjustments are inputs, but what you do between visits is where your body spends most of its time.
Depending on the situation, that might be specific exercises, moving every thirty minutes rather than sitting for three hours, changing how your desk is set up, breathing work, or seeing a physiotherapist or a psychologist alongside what we do here. None of it is filler. It is the part that runs while I am not there.
I wrote more about the logic of consistency in my post on why I go to the chiropractor when I am not in pain.
What we actually compare
Postural analysis gives us something memory cannot: the same measure, taken twice.
- Your questionnaire: the same questions, side by side with your original answers
- EMG: muscle activity and tension patterns along the spine
- Thermography: temperature symmetry along the spine
- HRV: a marker of how the nervous system is adapting
- Postural analysis: how the body is organised in space
- Functional tests, range of motion and palpation: where movement is available and where it is not
Sometimes the measures and the sensation agree. Sometimes the measures show change that had not been registered. And sometimes very little has moved, which is equally useful to know.
Common questions
What if I do not feel any different?
Tell me, because it genuinely changes what I do next. Sometimes more time is simply needed. I regularly see situations where nothing is visible on the tests early on and something appears considerably later. I would like that to be faster, and it is a fair frustration, but that is the nature of a natural, non invasive approach that depends on the body adapting rather than on something being imposed on it.
What I do need to see at some point is movement, either on the functional tests or in how you feel. If neither is changing, we stop, and I refer you to someone who may be better placed to help.
How long does adaptation usually take?
It varies enormously, depending on how long the pattern has been present and what your daily load looks like, so I cannot predict it for any individual. What I can say is that the timescale is generally counted in months rather than weeks.
Is it normal for progress to plateau?
It is common. Adaptation tends to happen in steps rather than in a straight line. Plateaus are worth discussing rather than worrying about, because they are also sometimes a signal to change something in the approach.
Is stopping a valid choice?
Of course. It is your body, your time and your money, and an informed decision to stop is a perfectly reasonable one. My only ask is that it is an informed one rather than one made on a vague impression. That is really the whole point of measuring.
Our perception of our own body is far less reliable than we assume. That is not a flaw, it is simply how attention is built. It is also the reason I would rather look at measures with you than ask you to trust an impression. 💙
Questions about your own results? Bring it up at your next visit, or send me a message. I would always rather talk it through than have you wondering.
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