What is Chiropractic?
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic services are used most often to treat common musculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.
Through their whole-person, patient-centered approach, doctors of chiropractic (DCs) elevate the health and wellness of their communities by helping people of all ages live more fully and actively.

Why Choose Chiropractic?
Chiropractic is the third-largest primary health care profession, surpassed in number only by doctors of medicine and dentistry. Doctors of chiropractic treat about 35 million Americans annually.
- DCs are licensed to practice in all 50 states and the District of Columbia–and in many nations around the world–and undergo a rigorous education in the healing sciences at institutions accredited by the U.S. Department of Education.
- A growing list of research studies and reviews demonstrate that the services provided by chiropractic physicians are both safe and effective. The evidence strongly supports the natural, whole-body and cost-effective approach of chiropractic services for a variety of conditions.
- Chiropractic services are included in most health insurance plans, including major medical plans, workers’ compensation, Medicare, some Medicaid plans, and Blue Cross Blue Shield plans for federal employees, among others.
- Chiropractic is used extensively by amateur and professional athletes, professional dancers and others to prevent and treat injuries as well as achieve optimal health and functioning.
What is Spinal Manipulation?

One of the most common and well known therapeutic procedures performed by doctors of chiropractic is spinal manipulation (sometimes referred to as a “chiropractic adjustment”). The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for an individual. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, allowing tissues to heal.
Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours. Compared to other common treatments for pain, such as over-the-counter and prescription pain medications, chiropractic’s conservative approach offers a safe and effective option.
What is a Doctor of Chiropractic?
Doctors of Chiropractic (DCs) – often referred to as chiropractors or chiropractic physicians – practice a hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.
DCs may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate. Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other health care providers.
In many cases, such as lower back pain, chiropractic care may be a patient’s primary method of treatment. When other medical conditions exist, chiropractic services may complement or support medical treatment by relieving the musculoskeletal pain associated with the condition.
Like their medical colleagues, chiropractors are subject to the boundaries established in state practice acts and are regulated by state licensing boards. Their education in four-year doctoral graduate school programs is nationally accredited through an agency that operates under the auspices of the U.S. Department of Education. After graduation, they must pass national board exams before obtaining a license to practice, and then must maintain their license annually by earning continuing education (CE) credits through state-approved CE programs.
Is chiropractic effective?
The cost of spine-related pain in the United States is estimated at $134.5 billion. Spinal pain patients have multiple options when choosing healthcare providers, resulting in variable costs. Escalation of costs occurs when downstream costs are added to episode costs of care. The purpose of this review was to compare costs of chiropractic and medical management of patients with spine-related pain.
A Medline search was conducted from inception through October 31, 2022, for cost data on U.S. adults treated for spine-related pain. The search included economic studies, randomized controlled trials and observational studies. All studies were independently evaluated for quality and risk of bias by 3 investigators and data extraction was performed by 3 investigators.
The literature search found 2256 citations, of which 93 full-text articles were screened for eligibility. Forty-four studies were included in the review, including 26 cohort studies, 17 cost studies and 1 randomized controlled trial. All included studies were rated as high or acceptable quality. Spinal pain patients who consulted chiropractors as first providers needed fewer opioid prescriptions, surgeries, hospitalizations, emergency department visits, specialist referrals and injection procedures.
Patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management.
Farabaugh, R., Hawk, C., Taylor, D. et al. Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review.Chiropr Man Therap 32, 8 (2024). https://doi.org/10.1186/s12998-024-00533-4