A 2006 systematic cost-effectiveness review found that the reported cost-effectiveness of spinal manipulation in the United Kingdom compared favorably with other treatments for back pain, but that reports were based on data from clinical trials without sham controls and that the specific cost-effectiveness of the treatment (as opposed to non-specific effects) remains uncertain.[161] A 2005 American systematic review of economic evaluations of conservative treatments for low back pain found that significant quality problems in available studies meant that definite conclusions could not be drawn about the most cost-effective intervention.[162] The cost-effectiveness of maintenance chiropractic care is unknown.[12]
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.

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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.
As noted, ratings sites or websites with a certified list of doctors, like PainDoctor.com, can help verify a chiropractor’s license and give you an idea of their philosophy and practice areas. Each site has slightly different information to give you a better picture of your chiropractor before your first visit. Find the best chiropractor for you by looking for ones who share lots of information and knowledge, whether on their website or on social media.
Like their MD colleagues, doctors of chiropractic are subject to the boundaries established in state practice acts and are regulated by state licensing boards. Further, 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.  
^ Jump up to: a b Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S (2008). "Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders". Spine. 33 (4 Suppl): S123–52. doi:10.1097/BRS.0b013e3181644b1d. PMID 18204386.
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.
We achieve these results not with potent drugs or harmful muscle relaxers but with spinal decompression therapy that uses intermittent spinal traction to take stress off injured vertebral joints while concurrently hydrating your discs, Chiropractic Adjustments to facilitate proper motion in the joints, electrical stimulation to reduce muscular and nerve pain in localized areas and much more.

Sharp, shooting pains are mostly neurological false alarms about relatively trivial musculoskeletal troubles: your brain reacting over-protectively to real-but-trivial irritations in and around the spine. The brain takes these much more seriously than it really needs to, but evolution has honed us to be oversensitive in this way. That’s not to say that the brain is always over-reacting, but it usually is. Most of the time, a sharp pain is a warning you can ignore.


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]
The next step in the process was an X-ray. Having an X-ray done of your spine can help the chiropractor determine your treatment plan and can aid in the adjustment. That said, not all chiropractors will recommend an X-ray at your appointment. It turns out some chiropractors say that X-rays should be part of routine chiropractic care, while others argue X-rays aren't necessary for every patient. When researching potential chiropractors, feel free to ask if they recommend X-rays for all patients and how the X-rays can benefit your treatment plan.
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