Many states also require applicants to pass a background check and state-specific law exams, called jurisprudence exams. All states require a practicing chiropractor to take continuing education classes to maintain his or her chiropractic license. Check with your state’s board of chiropractic examiners or health department for more specific information on licensure.

There is a wide range of ways to measure treatment outcomes.[91] Chiropractic care, like all medical treatment, benefits from the placebo response.[92] It is difficult to construct a trustworthy placebo for clinical trials of spinal manipulative therapy (SMT), as experts often disagree about whether a proposed placebo actually has no effect.[93] The efficacy of maintenance care in chiropractic is unknown.[12]
Neck pain is just that – pain in the neck. Pain can be localized to the cervical spine or may travel down an arm (radiculopathy). All age groups are at risk of developing neck pain. People who sit in one location staring at computer screens for long periods of time may be at an increased risk. About 30% of the population has an episode of neck pain each year. Neck pain may occur slightly more frequently in women than men.
Although mixers are the majority group, many of them retain belief in vertebral subluxation as shown in a 2003 survey of 1100 North American chiropractors, which found that 88% wanted to retain the term "vertebral subluxation complex", and that when asked to estimate the percent of disorders of internal organs (such as the heart, the lungs, or the stomach) that subluxation significantly contributes to, the mean response was 62%.[38] A 2008 survey of 6,000 American chiropractors demonstrated that most chiropractors seem to believe that a subluxation-based clinical approach may be of limited utility for addressing visceral disorders, and greatly favored non-subluxation-based clinical approaches for such conditions.[39] The same survey showed that most chiropractors generally believed that the majority of their clinical approach for addressing musculoskeletal/biomechanical disorders such as back pain was based on subluxation.[39] Chiropractors often offer conventional therapies such as physical therapy and lifestyle counseling, and it may for the lay person be difficult to distinguish the unscientific from the scientific.[40]
Your neck and shoulders contain muscles, bones, nerves, arteries, and veins, as well as many ligaments and other supporting structures. Many conditions can cause pain in the neck and shoulder area. In fact, neck pain is the third most common type of pain according to the American Pain Foundation. It is estimated that 70% of people will experience neck pain at some point in their lives.
Analysis of a clinical and cost utilization data from the years 2003 to 2005 by an integrative medicine independent physician association (IPA) which looked the chiropractic services utilization found that the clinical and cost utilization of chiropractic services based on 70,274 member-months over a 7-year period decreased patient costs associate with the following use of services by 60% for in-hospital admissions, 59% for hospital days, 62% for outpatient surgeries and procedures, and 85% for pharmaceutical costs when compared with conventional medicine (visit to a medical doctor primary care provider) IPA performance for the same health maintenance organization product in the same geography and time frame.[163]
The neck contains muscles and ligaments that connect to the head, shoulders and back.  Because the neck is so interconnected with other muscle groups, pain in this area can result from an array of issues, including poor posture, stress, or injury. Neck pain can begin to inhibit your movement and way of life if left untreated. Learn more about how Airrosti helps patients recover rapidly from neck and other upper body pain, quickly. We eliminate pain at the source so you can get back to living the life you love.
What is cervicalgia and how is it treated? Learn all about cervicalgia, a pain in the neck. It involves a sharp pain in the neck area when certain movements are made. Poor posture, traumatic injury, and stress are some of the common causes. Symptoms include stiffness and difficulty moving the neck. Find out more about neck pain and how to treat and prevent it. Read now
Low back pain. A 2013 Cochrane review found very low to moderate evidence that SMT was no more effective than inert interventions, sham SMT or as an adjunct therapy for acute low back pain.[94] The same review found that SMT appears to be no better than other recommended therapies.[94] A 2016 review found moderate evidence indicating that chiropractic care seems to be effective as physical therapy for low back pain.[95] A 2012 overview of systematic reviews found that collectively, SM failed to show it is an effective intervention for pain.[96] A 2011 Cochrane review found strong evidence that suggests there is no clinically meaningful difference between SMT and other treatments for reducing pain and improving function for chronic low back pain.[97] A 2010 Cochrane review found no current evidence to support or refute a clinically significant difference between the effects of combined chiropractic interventions and other interventions for chronic or mixed duration low back pain.[98] A 2010 systematic review found that most studies suggest SMT achieves equivalent or superior improvement in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up.[99] Specific guidelines concerning the treatment of nonspecific (i.e., unknown cause) low back pain are inconsistent between countries.[100]
A small study of just 7 patients with pain as the only symptom of spontaneous cervical artery dissection. There was disconcerting variety in presentation, but the pain was consistently severe, unfamiliar, unilateral, and mostly sudden onset. “Cervicocephalic arterial dissection should be suspected when patients complain of intense unilateral posterior cervical and occipital pain or temporal pain.”
Chiropractic is well established in the United States, Canada, and Australia.[18] It overlaps with other manual-therapy professions such as osteopathy and physical therapy.[19] Most who seek chiropractic care do so for low back pain.[20] Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues.[4] Many chiropractors describe themselves as primary care providers,[4][21] but the chiropractic clinical training does not support the requirements to be considered primary care providers,[2] so their role on primary care is limited and disputed.[2][21] Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "innate intelligence", and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[22]
The nerve roots stem from the spinal cord like tree branches through foramen in the vertebrae. Each nerve root transmits signals (nerve impulses) to and from the brain, shoulders, arms, and chest. A vascular system of 4 arteries and veins run through the neck to circulate blood between the brain and the heart. Joints, muscles, and ligaments facilitate movement and serve to stabilize the structure.

All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted spinal cord injury. To be safe, always check with your medical doctor to make sure your condition will benefit from chiropractic or other pain relief alternatives. 
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