We are always trying to find ways to find or confirm the level of subluxation. Here are a few found through digital palpation. Dr. Gonstead stated that he put a lot of weight on digital palpation findings.
Another procedure is to rub the tissues over the spine. Normally, there is a slight hyperemia or redness. If the hyperemia persists, one must closely examine the segment as the persistent hyperemia often signifies a subluxation at that level.
A well-known finding used by many chiropractors is digital palpation of edematous “pitting.” This is usually felt over the transverse process and/or spinous process. It is usually tender to palpation. This can be found, along with taut and tender muscle fibers, over compensations as well as subluxations.
Dr. Alex Cox teaches percussion of the spinous processes. This works well in the thoracic spine and fairly well in the lumbar spine, but is difficult in the cervical spine due to the small size of the spinouses. In this procedure, upon percussion with one or two fingers, the normal vertebra has a hollow sound and the tissue over the spinous process is taut. A unisegmental dull sound, and often a spongy feel, is percussed over the spinous at the level of subluxation.
In some patients who are not sweaty, one can find a one or two segmental region of sudomotor hyperactivity over the spinous(es). As you lightly slide your palpating finger along the spinouses, you will feel a slight tackiness. This tends to be over the area of a subluxation. It does not occur in everyone and is nullified by general sweating.
Dr. Gonstead relied heavily on palpation of edema and tenderness in the interspinous space when determining the level of subluxation.