Chiropractic Care

Chiropractic care is a multi-component, non-drug approach involving diagnosis, treatment, and management by a licensed chiropractor for musculoskeletal pain conditions.

Chiropractic Care – Evidence Rating: Low to Moderate Quality

Evidence describing chiropractic care and spinal manipulative therapy (SMT) comes from multiple systematic reviews, especially for low back pain and neck pain, citing low to moderate quality evidence of effectiveness. These reviews draw from a mix of study designs, including randomized controlled trials, cohort studies, and observational studies. While there are a number of randomized controlled trials evaluating chiropractic care and SMT, most are rated low to moderate quality due to the inherent difficulty in blinding participants to the intervention. The body of real-world evidence plays a significant role in its widespread use - common for interventions with established efficacy and patient satisfaction like chiropractic care. While chiropractic care and spinal manipulation are often recommended in various clinical practice guidelines for spinal pain conditions, evidence on translation and implementation into practice is an opportunity for further study.

Evidence-based Scale

Chiropractic care involves multiple treatment strategies delivered by a licensed chiropractor to treat musculoskeletal pain. The most common treatment strategy of chiropractic care is spinal manipulation, which involves the use of controlled force by the chiropractor to the spine to improve mobility and function. However, chiropractic care also includes a broader range of both passive and active care treatment strategies - including other manual therapies, needling therapies (acupuncture, dry-needling), therapeutic exercise, and patient education and self-management guidance.

Chiropractic care treatment plans may begin with a combination of passive and active care, ideally transitioning to increasingly active care and self-management strategies over time, as this empowers patients and can lead to improved long-term outcomes and self-efficacy in managing their condition. When these evidence-based treatment approaches are delivered through a multi-component approach, chiropractic care has been associated with improved pain, function, and disability for musculoskeletal conditions, the most studied being acute, subacute, and chronic low back pain. The evidence for how to implement chiropractic care aligns with its broader, real-word use as a health service rather than focusing on specific treatment strategies within chiropractic practice.