When it comes to treatment for aches and pains, chiropractors have successfully adjusted their way into America’s mainstream: Roughly half of U.S. adults report having been seen by a chiropractor while nearly two-thirds think chiropractic adjustments can help with back pain.
Studies suggest chiropractic adjustment, specifically spinal manipulation, is a safe and moderately effective non-drug intervention for low back pain alongside standard medical care, earning it an endorsement from the American College of Physicians (ACP).
What Are Chiropractic Adjustments?
Chiropractic adjustments are a type of manual therapy—often spinal manipulation—performed by a doctor of chiropractic (D.C.), or a chiropractor.
Chiropractors have battled a lot of stigma since the profession was founded in 1895. In 1963, the American Medical Association (AMA) even formed the Committee on Quackery to try to “contain and eliminate chiropractic,” prohibiting its members from consulting with chiropractors.
While the negative stigma associated with chiropractors likely still exists in some circles, in the medical community, spinal manipulation is now considered an effective and recommended treatment for chronic lower back pain.
As licensed practitioners, chiropractors undergo at least four years of graduate-level education from an accredited school of chiropractic. They also must pass the National Board of Chiropractic Examiners exam and maintain certifications with the state in which they practice.
The goal of chiropractic adjustments depends on the reason for treatment, but it’s often focused on pain reduction, increased range of motion, muscular-skeletal and/or nervous system function and overall well-being.
“As a baby, you develop physically through your activity,” says Ron Boesch, executive dean of clinics at Palmer College of Chiropractic in Davenport, Iowa. “As we get older, we can mess that up by sitting in an office or a classroom. A chiropractor’s job is to make sure that you’re moving to the best of your ability and that your body can function.”
Chiropractors offer many different kinds of adjustments, or manual manipulations, to joints and other parts of the musculoskeletal system. The most common adjustment is spinal manipulation, which involves a hands-on technique to apply varying amounts of force, or thrust, to the spine.
Other techniques may involve:
- Manual or electronic instruments: You chiropractor may perform instrument-assisted adjustments using tools like an activator adjusting instrument, which delivers low-force impulses to the spine, or use methods like transcutaneous electrical nerve stimulation, which uses low-voltage electrical currents applied to the body to reduce pain.
- Soft tissue techniques applied to the muscle: Chiropractors often utilize several hands-on or instrument-assisted manipulation techniques of the muscles, fascia, tendons and ligaments, similar to massage, that aim to break down scar tissue and reduce muscle restriction.
- Stretching and exercise: Your chiropractor may recommend specific exercises to further alleviate pain, gain further mobility and strengthen weak muscles.
- Adjustments to the extremities: Your chiropractor may perform adjustments specific to your arms, legs, hands and feet.
What to Expect From a Chiropractic Adjustment Appointment
When you arrive at your appointment, expect to fill out paperwork and head to an exam room where you’ll discuss your health history and the reason for your visit.
Your chiropractor may order diagnostic tests—like an X-ray or MRI—to help determine the structural cause of your issue. They may also refer you to a different medical professional if they determine you need medical attention beyond their scope of practice.
If your provider decides to perform a chiropractic adjustment, you may be asked to lie on a table. The actual adjustment can often be done in a matter of minutes, but the entire consultation will be a bit longer.
During the adjustment, you may hear some cracking or popping noises, which is normal. The noise comes from small pockets of air being released from your joints. However, if you experience pain or discomfort while you’re being adjusted, tell your chiropractor immediately.
After your adjustment, your provider will discuss their findings and how your body responded to the adjustment. Then, you and your chiropractor decide on a treatment plan together.
Chiropractic Adjustment Benefits
There’s an array of health benefits associated with chiropractic adjustments, but most haven’t been subjected to the kinds of large scientific studies necessary to confirm them.
“There are some other conditions that chiropractors have had success with, but right now, we don’t have evidence for many of those conditions,” says Robert Vining, associate dean of clinical research at Palmer College of Chiropractic. “We know that some people report improvements in things like asthma, but we don’t understand the mechanisms.”
The benefits of chiropractic adjustments that are supported by available scientific evidence include:
Back Pain Relief
Multiple studies confirm that chiropractic adjustments may offer moderate, short-term pain relief in the back.
“The strongest research is in the area of musculoskeletal conditions involving the spine,” says Vining.
One study looked at the effects of adding chiropractic care to standard medical interventions (medication, physical therapy, pain clinic referral) for low back pain and found the group receiving chiropractic care fared better than the control group in terms of reported pain intensity, disability and greater satisfaction.
Additionally, a 2016 systematic review of six studies that evaluated chiropractic care for the treatment of low back pain found moderate evidence that chiropractic intervention is as effective as physical therapy.
Studies suggest chiropractic adjustments may offer migraine relief. A 2019 review of six studies that focused on evaluating the effectiveness of spinal manipulation concluded that it may help reduce both migraine days and intensity. However, more research is needed.
Risks and Side Effects of Chiropractic Adjustments
Side effects of chiropractic adjustments are generally mild. For spinal manipulation, in particular, they may include:
- Mild to moderate pain or discomfort
Call a doctor if you experience any of the following symptoms after a chiropractic adjustment:
- Severe pain
- Numbness or tingling
- Headache that doesn’t go away
Severe complications are very rare, but they can include worsening pain, injury and nerve damage. Additionally, chiropractic care is not recommended for everyone—such as people with certain cancers, severe osteoporosis or an increased risk of stroke—so be sure to speak with your primary care provider first.
How Often Should I Get a Chiropractic Adjustment?
The frequency of your chiropractic adjustments depends on your reasons for seeking chiropractic care, your individual chiropractor and how you respond to treatment.
For instance, people who experience chronic pain might visit the chiropractor more often than someone seeking help for an acute issue. Although, if a chiropractor can alleviate your pain in one visit, they may still ask you to return for at least one follow-up appointment.
Some chiropractic patients prefer to see a chiropractor regularly to keep their joints aligned, prevent injury and maintain flexibility, or because they feel it contributes to their overall sense of health.
How Much Do Chiropractic Adjustments Cost?
Chiropractic adjustment cost varies depending on your location, your reason for care, your provider and your treatment plan. It varies widely and can range anywhere from $30 to $300 a visit.
Chiropractic care is covered by many health insurance providers. Check with your health provider for specific information about your plan. Though some chiropractors don’t take health insurance, you may be eligible for reimbursement. Many health savings accounts (HSAs) can be used for chiropractic care.
Medicare Part B covers chiropractic adjustments that are considered medically necessary, but it’s important to verify you meet the strict criteria for coverage. Medicaid also covers chiropractic adjustments in some cases, though coverage varies by state. Additionally, U.S. veterans can receive chiropractic adjustments at many Veteran Association facilities nationwide.
How to Choose a Chiropractor
When deciding on a chiropractor, it’s helpful to understand that there are generally two schools of thought among the profession:
- Mechanistic chiropractors assess individual bodily systems—like the skeletal system and the nervous system—separately. Currently available scientific research supports this approach, and it more closely aligns with Western, or allopathic, medicine. Mechanists can be a great choice for quick appointments to help with pain relief.
- Vitalistic chiropractors assess patients holistically. They also believe the body possesses an innate ability to heal, which is one of the founding principles of the chiropractic profession. J. Anya Harris, a doctor of chiropractic in Asheville, North Carolina, says if a chiropractor is a vitalist, you’ll likely notice keywords like “holistic” or “wellness” on their website or at their office. A vitalist herself, Harris also offers other modalities in her office like sound healing and energy work. If you’re interested in an integrated, holistic, wellness-oriented approach, a vitalistic chiropractor could be a good fit for you.
- Majority in U.S. Say Chiropractic Works for Neck, Back Pain. Gallup. Accessed 08/31/2021.
- Goertz CM, Long CR, Vining RD, Pohlman KA, Walter J, Coulter I. Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial. JAMA Network Open. 2018;1(1):e180105.
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