Chiropractic adjustments, matched to the body in front of him.
The word "adjustment" covers a lot of ground. Dr. Augello is trained in nine techniques, from the very low-force Activator instrument to precision hands-on Diversified. The right technique depends on your age, your injury, your comfort level with manual work, and what the exam reveals.
Signals that make an adjustment the right call.
Spine-driven pain
Back, neck, or mid-back pain where movement makes it worse and sustained postures make it ache. Restricted joint motion is usually palpable on exam.
Referred nerve symptoms
Pain, tingling, or numbness radiating into a limb along a nerve-root pattern. Sciatica is the classic example; cervical radiculopathy is its neck-and-arm counterpart.
Post-injury stiffness
After whiplash, a fall, or a hard lift, soft tissue has healed but the joint has not returned to full motion. Adjustment restores that motion safely.
Chronic headaches
Cervicogenic (upper-neck-origin) headaches respond especially well. Tension headaches often respond to adjustment plus soft-tissue work.
How a first visit flows.
Nothing gets adjusted before an exam. That is non-negotiable. What differs case-to-case is the technique Dr. Augello chooses once he has the findings.
History and intake
What happened, what hurts, what you have tried. Medications. Surgical history. Previous imaging.
Orthopedic and neurologic exam
Range-of-motion, palpation, reflex testing, motor and sensory screen. If nerve-root symptoms are present, specific tests isolate the level.
Digital x-ray if indicated
Imaged only when the exam calls for it. Typically for recent trauma, red flags, or persistent symptoms that have not been worked up.
Adjustment matched to findings
Manual technique for most, Activator or drop-table for patients who prefer low force or need it. Soft-tissue work where the muscle is driving the joint.
Nine approaches in one toolkit.
Most patients do well with two or three. Knowing the full range matters because the right technique for a 20-year-old weightlifter is rarely the right technique for a 75-year-old with osteoporosis.
Diversified
The classical hands-on adjustment. Specific, high-velocity, low-amplitude thrust to a single spinal segment.
Activator (Advanced Proficient)
Spring-loaded hand instrument. Precise, very low force. Good for first-visit patients, older patients, or cases where manual thrust is contraindicated.
Sacro-occipital technique (SOT)
Wedge-shaped blocks positioned under the pelvis, using body weight and time to correct pelvic imbalance.
Thompson drop
A segmented drop-table absorbs the force, delivering the adjustment without a manual thrust through the doctor's body.
Gonstead
Hands-on adjustment guided by specific postural and radiographic analysis. High specificity, historically one of the most studied techniques.
Cox flexion-distraction
A specialized table gently distracts the disc space. Primary technique for lumbar disc protrusion cases that respond to flexion.
Pierce
A low-force, highly specific approach used in sensitive regions or for patients who have had poor experiences with manual adjustment elsewhere.
Impulse adjusting
A second instrument option. Different frequency and feel than Activator. Useful where one instrument is better tolerated than the other.
Logan basic
Light, sustained contact primarily at the base of the sacrum. Good pediatric and elderly option.
Two doctors, two adjusting toolkits. Both Dr. Augello and Dr. Maurer are trained in low-force techniques including Activator and instrument-assisted adjustments, the right call for older patients, recent injuries, or anyone new to chiropractic. Dr. Maurer brings additional sports-chiropractic adjustment training developed working with athletes at the Philadelphia Union, Eagles, and Flyers. The front desk routes new patients to whichever doctor's toolkit best matches the case.
Common questions about adjustments.
What is a chiropractic adjustment?
A chiropractic adjustment is a controlled application of force to a specific joint, most often in the spine, intended to restore normal motion and reduce nerve irritation. Adjustments can be performed manually by hand or with a hand-held instrument such as the Activator, depending on the patient and the joint.
Does a chiropractic adjustment hurt?
Most adjustments are not painful. A hands-on thrust may produce a brief pop, which is gas releasing from the joint. Patients in acute muscle spasm may feel a moment of stretch. If you prefer no thrust at all, Dr. Augello can use the Activator instrument or drop-table techniques for the same therapeutic effect with far less force.
How many adjustments will I need?
It depends on the problem. A minor strain may respond in three to six visits. A long-standing chronic pattern may need a longer corrective phase followed by periodic maintenance. Dr. Augello gives you a written plan with specific visit counts and re-evaluation points before you commit.
Can you adjust older patients or patients with osteoporosis?
Yes, with care. Patients with osteoporosis, recent fracture risk, or general fragility should not receive high-force manual adjustments. Dr. Augello is Advanced Proficiency Rated in Activator methods specifically because instrument adjusting and drop-table techniques make chiropractic care safe for this population.
What is the Activator instrument?
The Activator is a small spring-loaded, hand-held instrument that delivers a precise, low-force impulse to a specific spinal segment. It allows Dr. Augello to adjust without manual thrust and is a good fit for patients new to chiropractic, older patients, recent injuries, and pediatric cases.
Start with an exam, not an assumption.
Book a first visit, describe what is going on, and Dr. Augello will tell you honestly whether chiropractic is the right next step.