Chiropractors are not medical doctors, but they get a lot of training and need a graduate degree to practice. Their treatments are usually safe but may not be right for every person.

Chiropractors attend graduate-level health colleges to treat bones, nerves, muscles, and ligament disorders. While chiropractors are widely known for treating back and neck pain, they also treat bone and soft tissue conditions.

In this article, we explore the myths and truths of chiropractic care. We also describe chiropractors’ training, the safety of these treatments, and the research behind the practice.

A common myth is that chiropractors do not undergo a significant amount of training. In fact, they typically complete about 8 years of higher education before they are licensed.

Chiropractors tend to have 4 years of undergraduate education. They usually complete college with a degree in biology or kinesiology after having taken courses in sciences, such as biology, chemistry, psychology, and physics.

They then attend a chiropractic graduate program. On average, these involve 4 years of education with a total of 4,200 instructional hours in course credits.

Chiropractic program specifics

Divided by year, a chiropractic graduate program usually involves:

  • First year: Courses in general anatomy, chiropractic principles, biochemistry, and spinal anatomy.
  • Second year: Courses in chiropractic procedures, pathology, clinical orthopedics, imaging interpretation, and research methods.
  • Third year: Courses in clinical internships, integrated chiropractic care, pediatrics, dermatology, practice management, and ethics and jurisprudence.
  • Fourth year: A clinical internship in which a student studies under a chiropractor and completes rotations in a hospital or veterans’ clinic.

Other studies often accompany those mentioned above.

After completing the educational and training requirements, an aspiring chiropractor in the United States will sit for their state licensing board.

Once they have obtained licensure and certification from the board, they will become a doctor of chiropractic.

Chiropractors often receive additional training and certification in a wide variety of specialties, including nutrition, sports medicine, and orthopedic rehabilitation.

Another common myth is that a chiropractor merely cracks a person’s back or bones.

Professionals center chiropractic care around spinal manipulation. However, they also study the spine and how its structures are related to the body’s function.

What do chiropractors attempt to heal?

A majority of a chiropractor’s work involves making adjustments to heal:

They may also provide services such as postural testing and analysis, as well as others designed to promote nutrition and healthful exercise.

Does it work?

Research suggests that chiropractic care can effectively relieve various types of acute and chronic pain — including neck pain, back pain, and certain types of headaches.

Studies have found that chiropractic therapy can benefit people with low back pain similarly to nonsteroidal anti-inflammatory drugs (NSAIDs.)

Patients with back pain who receive chiropractic care may also be less likely to use opioids for pain relief.

In clinical studies, researchers found chiropractic therapy reduced low back pain intensity and disability compared with a control group.

People sometimes use chiropractic care in conjunction with standard medical care, such as physical therapy, pharmacological treatment, and other therapies.

Like other forms of treatment, chiropractic care will not benefit all injuries. Doctors should tailor sessions to a person’s needs, and a licensed chiropractor should perform the procedure.

Chiropractic treatment may help reduce pain and disability in people with certain acute and chronic conditions, including:

Low back pain

Research on chiropractic therapy suggests it is an effective form of therapy for acute low back pain, which is pain that lasts for a few days or weeks.

Spinal manipulation therapy is associated with modest improvements in pain and function in patients with acute low back pain.

In a 2018 study, patients with low back pain who received usual medical care plus chiropractic care reported moderate improvements in pain intensity and disability compared with patients who received usual medical care without chiropractic care.

Neck pain

Neck pain is the second most prevalent health complaint reported by people seeking chiropractic care.

Research suggests chiropractic care may provide pain relief for people experiencing both chronic and acute neck pain.

Chiropractors use various techniques when treating neck pain — including thoracic manipulation, massage manipulation, and neck mobilization.

Chiropractic techniques for neck pain may be most successful when people use them as a complementary treatment alongside manual therapy, stretching, and exercise.

Headaches

Some evidence suggests chiropractic therapy — specifically spinal manipulation — can improve migraine headaches and cervicogenic headaches.

Osteoarthritis

Chiropractic therapy is safe for people with back and neck pain from osteoarthritis, and people sometimes use it as a complementary treatment alongside traditional therapy.

However, doctors should not carry out chiropractic manipulations on joints that are actively inflamed.

Asthma

Some people with asthma may benefit from using chiropractic treatment as a complementary therapy, but they should not use it as a replacement for traditional treatment.

A 2018 review included 17 years of studies involving spinal manipulation or mobilization.

The studies investigated the effects of these treatments on chronic lower back pain, and the authors concluded that the chiropractic methods were likely to reduce pain and improve function.

A 2017 review examined the effectiveness of spinal manipulation in treating lower back pain. The authors concluded that treatment improved both function and pain in patients with acute low back pain.

The American College of Physicians recommends those with lower back pain use a variety of non-pharmacological treatments, including spinal manipulation.

Researchers generally agree that they need more studies to determine the ideal length and frequency of chiropractic sessions and to identify what injuries may benefit from specific treatments.

One of the most common sources of contention regarding chiropractic treatments concerns safety.

A person may experience side effects of spinal manipulation, including:

There have been occasional reports of long-term danger related to chiropractic care.

The European Spine Journal reports that a rare complication of spinal manipulations is cauda equina syndrome, which involves nerve damage in the lower spinal cord. However, people have only reported a few cases of this.

According to the American Chiropractic Association, most discomfort and soreness subsides within 24 hours of spinal manipulation.

The World Health Organization (WHO) states that it is unsafe for people with certain health conditions to undergo chiropractic manipulation. These conditions include:

An aspiring chiropractor must spend thousands of hours studying before obtaining a license. In 2020, an estimated 51,400 chiropractors were practicing in the U.S., according to the Bureau of Labor Statistics.

Chiropractic care is a drug-free, non-invasive, and affordable form of therapy that may treat some musculoskeletal problems. While this form of alternative medicine may not benefit everyone, professionals generally consider it to be safe for most people.