Chiropractors, especially in America, have a reputation for unnecessarily treating patients.[6] In many circumstances the focus seems to be put on economics instead of health care.[6] Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could possibly present a risk to patients.[4] Some chiropractors are concerned by the routine unjustified claims chiropractors have made.[4] A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence, while 28% of chiropractor websites advocate lower back pain care, which has some sound evidence.[197]
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. 
Among people seeking back pain relief alternatives, most choose chiropractic treatment. About 22 million Americans visit chiropractors annually. Of these, 7.7 million, or 35%, are seeking relief from back pain from various causes, including accidents, sports injuries, and muscle strains. Other complaints include pain in the neck, arms, and legs, and headaches.
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