Gonstead vs. Mainstream Chiropractic Adjustments

Chiropractic Therapy / April 2, 2024
Hands applying a nervoscope to patient's spinal area.

If you weren’t aware of different types of chiropractic techniques, you’re not alone. Few people outside the chiropractic field understand the subtle but distinct discrepancies in different types of chiropractic methods.

This article will clarify some of the key differences between the Gonstead and Mainstream chiropractic adjustments and will review the advantages and disadvantages of each.

Understanding the Gonstead Chiropractic Technique

The Gonstead technique was developed by Clarence S. Gonstead in 1923. At the time, the relatively new field of modern chiropractic medicine (which often traces its origins to Daniel Palmer in 1895) was in a constant state of evolution. Clarence Gonstead had an extensive 55-year chiropractic career,  and his practice claimed to have completed 4 million chiropractic adjustments. Gonstead’s system was the result of this extensive experience.

The Gonstead system uses five techniques to diagnose patients:

  1. Visual Inspection – The chiropractor will look for subtle changes or spots of concern along your spine.
  2. The Nervoscope – This instrument detects subtle differences in heat along the spine. Inflamed spots tend to be hotter, which alerts the chiropractor to potential problem areas.
  3. Static Palpation – You’ll stand or sit in a normal manner (more or less straight) while the chiropractor will feel along your spine to find swollen spots, knots, tight areas, and asymmetry.
  4. Motion Palpation – Unlike static palpation, the chiropractor will instruct you to bend or twist at different points as they feel along your spine.
  5. X-rays – Being able to see your spine in its entirety allows your doctor to notice areas of inflammation, misalignment, fractures, and other irregularities.

Gonstead chiropractors believe that this enhanced scrutiny helps them pinpoint subluxation and allows them to treat areas of concern with greater accuracy.

A General Overview of Mainstream Chiropractic Medicine

Many patients would read the section on Gonstead chiropractic medicine and come away with the impression that it’s the best or only way to approach chiropractic care. However, the truth is that many practices have chosen different approaches to chiropractic medicine to treat patients with various conditions.

Most of the differences between Gonstead and Mainstream chiropractic are from the chiropractor’s decision not to use some of the tools that are part of the Gonstead approach. For instance, many chiropractors will forgo the use of the Nervoscope. Others are reticent to expose their patients to X-rays if they believe the images are unnecessary. Overall, mainstream chiropractors have greater freedom in selecting the diagnostic tools and treatments that they can employ.

A typical visit to a chiropractor’s office that does not use the Gonstead method might involve the following:

It’s important to remember that there are many different chiropractic techniques. Just because a doctor is not Gonstead certified does not mean that they aren’t using an approach from a different school of thought. It’s important to ask questions when going to a new chiropractor. Also, review the documentation on their website. Most reputable practices will disclose the techniques they use.

Differences Between Mainstream and Gonstead Chiropractic Methods

For a patient, the similarities between Gonstead and Mainstream chiropractic are more apparent than the differences. However, you should be aware of the points of divergence between the two approaches.


The Gonstead approach uses five specific techniques for diagnoses: visual inspection, nervoscope analysis, static palpation, motion palpation, and x-ray results. Mainstream chiropractors will use some or all of these diagnostic tools, but they are more free to modify the tests. For example, the motion palpation portion of the Gonstead exam is heavily regimented. Mainstream chiropractors may ask patients to perform additional motion tests to determine subluxations.


Gonstead chiropractors attempt to target the specific areas of subluxation with adjustments. These adjustments are almost always performed with their hands. Mainstream chiropractors may employ broader techniques, even when they’ve identified the exact point of the subluxations. Mainstream chiropractors may also use tools to assist in adjustment, like drop tables or an activator.

Philosophical Approaches

As you may have perceived, the Gonstead approach to chiropractic medicine has a rigid structure. It focuses specifically on spinal biomechanics and maintaining the health of the spine. While this is also at the core of mainstream chiropractic medicine, practitioners often take a more holistic approach to healing. For example, a chiropractor may also incorporate massage or physical therapy into a patient’s treatment plan. Or they may recommend adjustments to diet and daily activity to improve the patient’s outcome. These suggestions would generally be considered to be out of bounds for the Gonstead method.

Body Positioning

The Gonstead method mandates specific body positions for various adjustments. For example, a Gonstead chiropractor will use a cervical chair for neck adjustments. Mainstream chiropractors will pay a great deal of attention to positioning, but they can vary it a bit more.

Training and Education

As you’ve probably surmised, all Gonstead clinicians are chiropractors, but not all chiropractors are trained in the Gonstead method. Gonstead chiropractors must undergo additional training to achieve certification. This includes:

All chiropractors are expected to continue their studies even after they’re practitioners. Many mainstream chiropractors study the Gonstead method to expand their base of knowledge, even if they do not choose to adhere to the strict tenets of the system.

Individual Care vs. Standard Protocols

Proponents of the Gonstead system will argue that the extensive standardization and research of the rigid system allows them to better predict patient outcomes. Opponents may argue that it’s too narrowly focused on individual subluxations and that a greater amount of good can be accomplished from a more general approach.

Research and Scientific Support

There is extensive research indicating that both the Gonstead approach and mainstream chiropractic are effective for certain conditions.

With regard to Gonstead, a paper entitled Gonstead Chiropractic Technique, filed by Robert Cooperstein, MA, DC, and published in the National Library of Medicine, found that the Gonstead diagnosis techniques were efficacious. The paper cited several independent studies. Additionally, the narrow focus of the Gonstead technique also benefits from research showing that mainstream chiropractic adjustments are effective since GCT is a subset of this broader category.

There are similar studies that show that mainstream chiropractic is also effective, particularly for back pain. One JAMA study showed improvements in acute lower back pain at about the six-week mark.

Understanding Gonstead vs. Mainstream Chiropractic

It’s important to understand that the two approaches to chiropractic medicine are not necessarily at odds with one another. Most mainstream chiropractic clinics utilize Gonstead techniques, even if they aren’t considered a Gonstead practice.

Mainstream chiropractic gives practitioners the freedom to explore options that may not be indicated using the Gonstead method. On the other hand, true Gonstead practices are supposed to limit their approach to proven techniques within the curriculum. Many practices have staffs that mix chiropractors from varying disciplines. This allows them to take the best approach for individual patients.

South Florida Chiropractic Centers

If you’ve been in an accident or have developed a condition that chiropractic medicine can treat, you owe it to yourself to go to a practice with a solid reputation. ChiroCare of Florida has treated thousands of patients. Make an appointment at an office near you.

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