Chiropractic care has been associated with improvements in pain, function, and disability, most commonly for acute, subacute, and chronic low back pain. Clinical practice guidelines in the management of low back pain support spinal manipulation. Some evidence indicates spinal manipulation has modest positive effects on pain and function in patients with acute low back pain after six weeks. For patients with chronic low back pain, chiropractic pain has been shown to provide some short-term pain relief but is not more effective than other interventions frequently used for low back pain management. 

For patients with neck pain, spinal manipulative therapy may reduce pain and improve function, based on low to moderate quality evidence. For patients with headaches (specifically tension-type and cervicogenic headaches), chiropractic care and spinal manipulation may effectively reduce headache pain intensity, frequency, and disability based on low to moderate quality evidence.

Chiropractic care has been associated with reduced use of opioids and other pain medications across several observational studies. 

Among patients with non-cancer pain, chiropractic care users were 64% less likely to receive an opioid prescription than those who did not. In a study of VA patients receiving chiropractic care, the percentage of patients receiving opioid prescriptions was lower in each of three 30-day windows following an initial chiropractic visit than it was before. 

Studies show reduced use of short-term and long-term opioids for patients who see a chiropractor to initiate care for low back pain. For patients with neck pain, similar associations have been found with reduced short-term and long-term opioid use. Another study found that patients who received chiropractic care within 30 days of newly seeking healthcare for low back pain (irrespective of the initial provider seen) had a reduction in any opioid use and long-term opioid use.

In one study of patients receiving the same baseline dose of opioids, those who received chiropractic care were less likely to be prescribed higher-dose opioids compared to those not receiving chiropractic care at three, six, nine, and twelve months.

Other retrospective cohort studies of patients who receive chiropractic care have identified similar trends of decreased likelihood of being prescribed tramadol, benzodiazepines, and gabapentin.

The existing evidence around the use of interventions common in chiropractic care for patients with co-occurring acute pain and opioid use disorder is limited and of lower quality, highlighting an opportunity for future research.

Patients receiving chiropractic care for a new episode of low back pain are less likely to receive advanced imaging studies or a spinal surgery consultation than those initiating care in primary care. In one study of patients newly receiving care for neck pain, there were significantly reduced odds of receiving plain film radiographs, computed tomography or magnetic resonance imaging of the cervical spine, therapeutic injections, or major surgery when initiating care with a chiropractor compared to initiating care with a primary care provider, emergency medicine provider, or orthopedist. Another study of patients newly receiving care for low back pain found chiropractic care to be one of the most common entry points and associated with reduced likelihood of imaging, hospitalization, and surgery. 

Patients receiving chiropractic care generally report being highly satisfied with the care received. National surveys of patients show high patient satisfaction with the effectiveness, quality, and value of the care they received. Respondents highlighted feeling that they have been listened to by their chiropractor, acknowledging convenient and quick access to care that was compassionate and well-explained.