Chiropractic Care
Evidence-based chiropractic treatment tailored to your diagnosis and your goals.
What Chiropractic Care Actually Does
Your central nervous system runs through your spine and branches out to every organ, muscle, and limb in your body. When vertebrae shift out of alignment due to injury, repetitive stress, or poor posture, they can irritate or compress surrounding nerves. The result is pain, reduced mobility, and diminished function, sometimes in areas far removed from the spine itself.
Chiropractic adjustments realign the spine, relieve pressure on nerve roots, and restore the body's natural ability to heal. The effects are not just structural. Research published in the Journal of Manipulative and Physiological Therapeutics has demonstrated measurable improvements in nervous system function following spinal manipulation.
Conditions Commonly Treated
- Neck pain and cervical disc problems
- Lower back pain and lumbar disc herniations
- Sciatica and radiating leg pain
- Headaches and migraines
- Shoulder, hip, and knee pain
- Carpal tunnel syndrome
- Scoliosis (mild to moderate)
- Chronic fatigue and restless leg syndrome
Who Is a Good Candidate for Chiropractic Care?
Dr. Mammales applies several specific adjustment techniques depending on what each patient's presentation calls for. The choice is not arbitrary. Each technique has a distinct mechanical profile suited to different patient types, joint conditions, and pain presentations.
Diversified Technique is the foundational chiropractic adjustment method. High-velocity, low-amplitude thrust applied precisely to a restricted spinal segment restores normal joint motion and relieves the mechanical irritation on surrounding nerves and soft tissue. The audible release that most people associate with chiropractic is the nitrogen gas cavitation produced when the joint opens. Diversified is appropriate for most adult patients with segmental fixation and no contraindications to high-velocity manipulation.
Thompson Drop Table Technique uses a specialized table with sections that drop a fraction of an inch as the adjustment is delivered. The drop mechanism allows Dr. Mammales to deliver a precise, controlled thrust with reduced force compared to Diversified. It is particularly well suited for lumbar and pelvic adjustments, and for patients who respond better to a lower-force input, including many patients recovering from acute injury or those with higher baseline pain sensitivity.
Activator Technique uses a handheld spring-loaded instrument to deliver a controlled, repeatable impulse to specific spinal segments or extremity joints. The force is precisely measured and consistent, which makes it the appropriate choice when a high-velocity manual thrust is not indicated. Cervical disc patients with acute nerve root irritation, elderly patients with osteoporosis concerns, and post-surgical patients often receive Activator adjustments. It is effective in the hands of a practitioner who knows when to use it.
Diversified Technique
High-velocity, low-amplitude thrust
Thompson Drop Table Technique
Reduced force compared to Diversified
Activator Technique
Handheld spring-loaded instrument
Digital X-Rays On Premises
Digital X-rays are taken in-house when the clinical examination indicates they are needed. Most new patient evaluations at Cobblestone include standing X-rays of the relevant spinal region. This matters because the decision about which technique to use, which segment to target, and what load is appropriate for a given patient depends on what the imaging shows. A patient with a significant degenerative spondylolisthesis at L4-L5 should not receive the same adjustment as a patient with a simple mechanical fixation at the same level. You cannot make that distinction without imaging.
Digital X-rays also allow Dr. Mammales to measure segmental angles, identify instability patterns, and track structural changes over the course of care. Taking the X-rays in-house means you get your diagnosis on the day of your first visit rather than being sent to an imaging center and waiting for results before treatment can begin.
Chiropractic and Your Long-Term Health
Many patients come to us in acute pain and leave as regular wellness patients. Once symptoms resolve, periodic adjustments help maintain spinal alignment, prevent recurrence, and support overall health. Think of it as maintenance for the most important structural system in your body.
If you have been living with pain, reduced mobility, or a condition you have been told requires surgery, we encourage you to come in for a second opinion. Many patients who were surgical candidates have found lasting relief through conservative chiropractic care.
What to Expect at Your First Visit
No two patients receive the same care at Cobblestone. Before any treatment begins, Dr. Mammales conducts a thorough consultation, orthopedic and neurological examination, and digital X-rays if indicated. Your diagnosis drives your care plan. The type of adjustments used, the frequency, and the duration of treatment all depend on what the exam reveals.