• Homect_img
  • Health Information

Health Library

Back

What Is Chiropractic Treatment?

Image for chiropractor article Chiropractic is a medical system founded in 1895 by Canadian Daniel David Palmer. It is based on the theory that many illnesses originate in the spine, and for this reason it focuses on spinal manipulation. Chiropractic physicians may also utilize physical therapy techniques, as well as methods drawn from other branches of alternative medicine, such as herbs and supplements.

Uses

Most visits to chiropractor physicians are for back pain, but it is also commonly used to treat:

  • Headaches
  • Neck pain
  • Pain in other areas, such as the shoulders, knees, and jaw
  • Colic

How It Works

Chiropractic theory has based itself on “subluxations,” or vertebrae that have shifted position in the spine. These subluxations are said to affect nerve outflow and cause disease in various organs. A chiropractic treatment is supposed to "put back in" these "popped out" vertebrae. For this reason, it is called an “adjustment.”

However, no real evidence has ever been presented showing that a given chiropractic treatment alters the position of any vertebrae. In addition, there is no real evidence that impairment of nerve outflow is a major contributor to common illnesses, or that spinal manipulation changes nerve outflow in such a way as to affect organ function.

Other theories suggest that chiropractic manipulation may relieve pain by “loosening” vertebrae that have become relatively immobile rather than by changing their position. In addition, the sudden movements of manipulation may alter the response patterns of nerves in the spine, again relieving pain.

What Do Studies Show About Chiropractic Treatment?

Does It Work?

While many people seek chiropractic treatment for back and neck pain, the current research suggests that chiropractic may offer just a modest benefit. As with most other alternative therapies, more high-quality studies are needed before researchers can come to any definitive conclusions about the effectiveness of chiropractic treatment. The strongest evidence so far seems to be in the treatment of migraine headaches—with chiropractic treatment offering long- and short results (fewer and less severe migraines).

Chiropractic has also been studied as a treatment for numerous other conditions, like asthma, menstrual pain, colic. Thus far, the results of studies have been inconclusive.

Is It Safe?

Chiropractic manipulation appears to be generally safe, rarely causing significant side effects. The most common reaction is local discomfort following therapy, which generally disappears within hours of treatment. Other side effects include temporary headache, tiredness, and discomfort radiating from the site of the adjustment.

Stroke is a reported rare side effect of chiropractic treatment on the neck. Other rare side effects include:

  • Worsening of disc herniation
  • Increased sensation of nerve pinching

Because of these rare risks, talk to your doctor before you undergo chiropractic manipulation of your neck.

If You Decide to Visit A Chiropractor

A chiropractor must have a four-year Doctor of Chiropractic (DC) degree and also must have a state license. To find a doctor in your area, websites like the American Chiropractic Association offer searchable databases. You can also ask your doctor for a recommendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Copyright © EBSCO Publishing
All rights reserved.

RESOURCES

  • American Chiropractic Association

    http://www.acatoday.org/

  • National Association for Chiropractic Medicine

    http://www.chiromed.org/

CANADIAN RESOURCES

  • College of Family Physicians Canada

    http://www.cfpc.ca/Home/

  • Health Canada

    http://www.hc-sc.gc.ca/index%5Fe.html

References

  • Assendelft WJ, Bouter LM, Knipschild PG. Complications of spinal manipulation: a comprehensive review of the literature. J Fam Pract. 1996;42:475–480.

  • Astin J, Ernst E. The effectiveness of spinal manipulation for the treatment of headache disorders: a systematic review of randomized clinical trials. Cephalalgia. 2002;22:617–623.

  • Aure OF, Hoel Nilsen J, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine . 2003;28:525–531.

  • Carey TS, Garrett J, Jackman A, et al. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors and orthopedic surgeons: the North Carolina back pain project. N Engl J Med. 1995;333(14):913-917.

  • Cherkin DC, Deyo RA, Battie M, et al. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. N Engl J Med. 1998;339(15): 1021-1029.

  • Chiropractic. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated August 2011. Accessed August 1, 2011.

  • Chiropractors. Occuplational Outlook Handbook website. Available at: http://www.bls.gov/ooh/Healthcare/Chiropractors.htm. Published March 29, 2012. Accessed April 16, 2012.

  • Considering complementary and alternative medicine. American Medical Association website. Available at: http://www.medem.com/ . Accessed September 19, 2003.

  • Cooper RA, McKee HJ. Chiropractic in the United States: trends and issues. Milbank Q . 2003;81(1):107-38.

  • Coulter ID. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, CA: Rand Corporation; 1996.

  • Dabbs V, Lauretti WJ. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. J Manipulative Physiol Ther. 1995;18:530–536.

  • Ernst E. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage. 2001;21:238-242.

  • Frisoni GB, Anzola GP. Vertebrobasilar ischemia after neck motion. Stroke. 1991;22:1452-1460.

  • Frumkin LR, Baloh RW. Wallenberg's syndrome following neck manipulation. Neurology. 1990;40:611-615.

  • Giles LG, Muller R. Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine . 2003;28(14):1490-1502.

  • Gross A, Kay T, Hondras M, et al. Manual therapy for mechanical neck disorders: a systematic review. Man Ther. 2002;7:131.

  • Haldeman S, Kohlbeck FJ, McGregor M. Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy. Spine. 2002;27:49–55.

  • Haynes MJ. Stroke following cervical manipulation in Perth. Chiropr J Aust. 1994;24:42-46.

  • Homola S. What a rational chiropractor can do for you. Chirobase website. Available at: http://www.chirobase.org/07Strategy/goodchiro.html . Accessed September 24, 2003.

  • Hondras MA, Long CR, Brennan PC. Spinal manipulative therapy versus a low force mimic maneuver for women with primary dysmenorrhea: a randomized, observer-blinded, clinical trial. Pain. 1999;81:105–114.

  • Hufnagel A, Hammers A, Schonle PW, et al. Stroke following chiropractic manipulation of the cervical spine. J Neurol. 1999;246:683-688.

  • Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005;30:1477–84.

  • Jarvis WT. Chiropractic: a skeptical view. Chirobase website. Available at: http://www.chirobase.org/01General/skeptic.html . Accessed September 24, 2003.

  • Jarvis KB, Phillips RB, Morris EK. Cost per case comparison of back injury claims of chiropractic versus medical management for conditions with identical diagnostic codes. J Occup Med. 1991;33:847–852.

  • Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002;27:1835–1843.

  • Kaplan AP. Chiropractic for asthma: placebo effect. Complement Med Physician. 1999;4:75–76.

  • Klougart N, Leboeuf-Yde C, Rasmussen LR. Safety in chiropractic practice, Part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988. J Manipulative Physiol Ther. 1996;19:371-377.

  • Lee KP, Carlini WG, McCormick GF, et al. Neurologic complications following chiropractic manipulation: a survey of California neurologists. Neurology. 1995;45:1213-1215.

  • Low back pain. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/ . Accessed September 24, 2003.

  • Michaeli A. Reported occurrence and nature of complications following manipulative physiotherapy in South Africa. Aust J Physiother. 1993;39:309-315.

  • Ofman JJ. Chiropractic spinal manipulation for treatment of acute low back pain. Altern Med Alert. 1998;1:45–46.

  • Nielsen NH, Bronfort G, Bendix T, et al. Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial. Clin Exp Allergy. 1995;25:80–88.

  • Nelson CF, Bronfort G, Evans R, et al. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. J Manipulative Physiol Ther. 1998;21:511–519.

  • Olafsdottir E, Forshei S, Fluge G, et al. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child. 2001;84:138–141.

  • Peterson KB. The effects of spinal manipulation on the intensity of emotional arousal in phobic subjects exposed to a threat stimulus: a randomized, controlled, double-blind clinical trial. J Manipulative Physiol Ther. 1997;20:602–606.

  • Reed WR, Beavers S, Reddy SK, et al. Chiropractic management of primary nocturnal enuresis. J Manipulative Physiol Ther. 1994;17:596–600.

  • Rivett DA, Milburn P. Complications arising from spinal manipulative therapy in New Zealand. Physiotherapy. 1997;83:626-632.

  • Schiller L. Effectiveness of spinal manipulative therapy in the treatment of mechanical thoracic spine pain: a pilot randomized clinical trial. J Manipulative Physiol Ther. 2001;24:394–401.

  • Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22:435-441.

  • Senstad O, Leboeuf-Yde C, Borchgrevink CF. Side-effects of chiropractic spinal manipulation: types frequency, discomfort and course. Scand J Prim Health Care. 1996;14:50-53.

  • Shekelle PG, Coulter I, Hurwitz EL, et al. Congruence between decisions to initiate chiropractic spinal manipulation for low back pain and appropriateness criteria in North America. Annals of Internal Medicine . 1998;121(1):9-17.

  • Stevinson C, Honan W, Cooke B, et al. Neurological complications of cervical spine manipulation. J R Soc Med. 2001;94:107-110.

  • Vernon H. Qualitative review of studies of manipulation-induced hypoalgesia. J Manipulative Physiol Ther. 2000;23:134–138.

  • Walsh MJ, Polus BI. A randomized, placebo-controlled clinical trial on the efficacy of chiropractic therapy on premenstrual syndrome. J Manipulative Physiol Ther. 1999;22:582–585.

  • Wiberg JMM, Nordsteen J, Nilsson N. The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physiol Ther. 1999;22:517–522.