Jump up ^ Lewis RA, Williams NH, Sutton AJ, Burton K, Din NU, Matar HE, Hendry M, Phillips CJ, Nafees S, Fitzsimmons D, Rickard I, Wilkinson C (2013). "Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses". Spine Journal. 15 (6): 1461–77. doi:10.1016/j.spinee.2013.08.049. PMID 24412033.
Doctors of Chiropractic (DCs) – often referred to as chiropractors or chiropractic physicians – practice a hands-on, drug-free 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. 

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]


Chiropractic is a form of alternative medicine mostly concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine.[1][2] Proponents claim that such disorders affect general health via the nervous system,[2] through vertebral subluxation, claims which are demonstrably false. The main chiropractic treatment technique involves manual therapy, especially spinal manipulation therapy (SMT), manipulations of other joints and soft tissues.[3] Its foundation is at odds with mainstream medicine, and chiropractic is sustained by pseudoscientific ideas such as subluxation and "innate intelligence" that reject science.[4][5][6][7][8] Chiropractors are not medical doctors.[9]
Most people believe that chiropractors treat back pain. That is true, but there is so much more that chiropractic care can achieve. Because chiropractors help to remove pressure from the nervous system, they can also influence many other conditions. It is common to hear chiropractic patients say that they came in for back pain and their headaches got better.
Headache. A 2011 systematic review found evidence that suggests that chiropractic SMT might be as effective as propranolol or topiramate in the prevention of migraine headaches.[110] A 2011 systematic review found evidence that does not support the use of SM for the treatment of migraine headaches.[111] A 2006 review found no rigorous evidence supporting SM or other manual therapies for tension headache.[112] A 2005 review found that the evidence was weak for effectiveness of chiropractic manipulation for tension headache, and that it was probably more effective for tension headache than for migraine.[113] A 2004 Cochrane review found evidence that suggests SM may be effective for migraine, tension headache and cervicogenic headache.[114]
Chiropractic was founded in 1895 by Daniel David (D.D.) Palmer in Davenport, Iowa. Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease.[215] The first chiropractic patient of D.D. Palmer was Harvey Lillard, a worker in the building where Palmer's office was located.[37] He claimed that he had severely reduced hearing for 17 years, which started soon following a "pop" in his spine.[37] A few days following his adjustment, Lillard claimed his hearing was almost completely restored.[37] Chiropractic competed with its predecessor osteopathy, another medical system based on magnetic healing and bonesetting; both systems were founded by charismatic midwesterners in opposition to the conventional medicine of the day, and both postulated that manipulation improved health.[215] Although initially keeping chiropractic a family secret, in 1898 Palmer began teaching it to a few students at his new Palmer School of Chiropractic.[23] One student, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.[23]
Straight chiropractors adhere to the philosophical principles set forth by D.D. and B.J. Palmer, and retain metaphysical definitions and vitalistic qualities.[37] Straight chiropractors believe that vertebral subluxation leads to interference with an "innate intelligence" exerted via the human nervous system and is a primary underlying risk factor for many diseases.[37] Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary for chiropractic treatment.[37] Thus, straight chiropractors are concerned primarily with the detection and correction of vertebral subluxation via adjustment and do not "mix" other types of therapies into their practice style.[37] Their philosophy and explanations are metaphysical in nature and they prefer to use traditional chiropractic lexicon terminology (e.g., perform spinal analysis, detect subluxation, correct with adjustment).[22] They prefer to remain separate and distinct from mainstream health care.[22] Although considered the minority group, "they have been able to transform their status as purists and heirs of the lineage into influence dramatically out of proportion to their numbers."[22]

Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.
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