Chiropractic Care

In the United States, chiropractic care is delivered by licensed chiropractors who attain a Doctor of Chiropractic (DC) degree.

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

In the United States, chiropractic care is delivered by licensed chiropractors who attain a Doctor of Chiropractic (DC) degree. Chiropractors receive clinical training through an accredited, doctoral-level professional program. Most chiropractic training programs are 3-4 years in length. Training includes coursework in basic sciences, clinical sciences, and clinical skills. Clerkship hours are completed in a variety of settings (e.g., campus-based clinics, private offices, hospital-based clinics, federally qualified health centers, and other community-based clinics). All chiropractors in the US are required to pass a four-part series of national board examinations before being eligible for state licensure. 

Some chiropractors may continue their training after graduation through a limited number of residency training programs, with the US Department of Veterans Affairs Integrated Clinical Practice Chiropractic Residency program being the most established and well-known.