The Natural Solution: 10 Surprising Facts About Chiropractic Care You Need to Know

Reading time: 5 minutes

The world of healthcare is vast and varied, with many different specialties and practitioners. One area that is often overlooked is chiropractic care. But what exactly is a chiropractor, and what do they do? 

This blog will dive into the world of chiropractic care and explore the various aspects, from the basics of what a chiropractor does and what a chiropractic adjustment is to the conditions chiropractors can help with and their safety record. After learning these ten surprising facts, you'll better understand the role of chiropractors in the healthcare field and whether chiropractic care may be right for you.

1. What Is a Chiropractor? 

A chiropractor, or Doctor of Chiropractic (DC), is a licensed doctor who focuses on the diagnosis and natural treatment of nerve, muscle, and joint disorders, with an emphasis on manual manipulation or “adjustments” to the spine. 

2. What Is a Chiropractic Adjustment? 

 
 

A spinal adjustment, also known as chiropractic spinal manipulation, is a procedure used by chiropractors to help alleviate pain and improve muscle and joint function. Spinal adjustments rely upon the use of the chiropractor's hands, or a small instrument, to gently apply a controlled, sudden force to a joint. Sometimes a unique table is used to assist with the adjustment. 

Spinal adjustments improve the range of motion, reduce muscle spasms, and decrease pain. Adjustments are most frequently done to the spine but can also be performed to other joints, such as the hips, shoulders, and knees.

3. What Does a Chiropractor Do Besides Adjustments?

In addition to spinal adjustments, chiropractic treatment may include various other techniques and therapies. Chiropractic treatments can consist of:

 
 
  • Soft tissue therapy: Techniques such as massage and stretching to help loosen tight muscles and improve flexibility.

  • Therapy modalities: Physical modalities like hot, cold, ultrasound, e-stim, laser, vibration, and traction to ease discomfort and facilitate manual therapy.

  • Rehabilitation exercises: Specific exercises and stretches to help strengthen and stabilize the muscles and joints and improve overall function.

  • Lifestyle counseling: Guiding how to maintain a healthy lifestyle, including proper posture and ergonomics, stress management, and other lifestyle changes that can help prevent pain and injury.

  • Nutritional counseling: Advice on the best diet and supplements to support recovery and overall health.

4. Are Chiropractors Doctors? 

The short answer to “is a chiropractor a doctor” is YES. The education required to be a chiropractor includes a four-year doctoral program at a chiropractic college, including the same basic sciences as other physicians, plus extensive training in diagnosing and treating muscle, nerve, and joint conditions. After completing their education, chiropractors must pass a rigorous examination and be licensed by a state board in order to practice. 

Chiropractic care relies upon conservative natural treatments, and most chiropractors do not prescribe drugs or perform surgery. However, chiropractors practice in conjunction with other healthcare professionals to provide comprehensive care to patients.

5. Does Chiropractic Work?

Analysis from a large chiropractic network dataset shows that patients who receive chiropractic care typically see significant improvement in their condition within one month of starting treatment. (123,124)

 
 

6. What Conditions Do Chiropractors Help?

Many people who seek chiropractic treatment are looking for relief from chronic pain conditions, such as lower back pain or neck pain. But chiropractic treatment can also help you prevent injuries and resolve painful conditions from your head (like headaches) to your feet (like plantar fasciitis.) 

Over 100 research studies have shown that manual therapy, including chiropractic manipulation, is effective for various nerve, muscle, and joint disorders. (1-122)

 
 

7. When to See a Chiropractor

Millions of patients trust chiropractic for neck pain, headaches, back pain, sciatica, and many other common muscle and joint issues. Abundant research, including several authoritative medical “practice guidelines,” endorse chiropractic care for life’s most painful problems.

Chiropractor for back pain

For most patients with acute, subacute, or chronic low back pain, clinicians and patients should initially select non-pharmacologic treatment, specifically including spinal manipulation. (125)

Source: American College of Physicians/ Annals of Internal Medicine

Chiropractor for sciatica

"Our findings suggest receiving chiropractic spinal manipulative therapy compared with other care for newly diagnosed lumbar disc herniation and lumbosacral radiculopathy [i.e., sciatica] is associated with significantly reduced odds of [disc surgery] over 2-year follow-up." (126) 

Source: British Medical Journal analysis of 101 million patient records

Chiropractor for headaches

“Spinal manipulation may be an effective therapeutic technique to reduce migraine [headache] days and pain/intensity.” (127)

Source: The American Headache Society/ Journal of Head & Face Pain

8. Benefits of Chiropractic Care 

In addition to practical solutions, chiropractic benefits also include high patient satisfaction. One recent survey of more than 630,000 presentations found that a staggering 99% of chiropractic patients rate their care as either excellent or good. (123) This is a solid testament to the dedication and skill of chiropractors in providing safe and effective treatment for a wide range of conditions.

 
 

Not surprisingly, the same study found that chiropractic patients are highly likely to refer, with a 96.7% likelihood to recommend their chiropractor to friends and family. (123) This confirms that chiropractic patients not only feel better after receiving care but also have a strong trust and belief in the effectiveness of their treatment. 

 
 

9. Are Chiropractors Safe?

Chiropractic care, including neck adjusting, has been extensively studied and found to be a safe treatment option. (128-133) The risk of serious complications from chiropractic care is very low, and chiropractors are highly trained to use a variety of conservative techniques to ensure the safety of their patients. The Journal of the American Medical Association recently reported: 

“…spinal manipulative therapy was associated with improvements in pain and function with only transient minor musculoskeletal harms [i.e., soreness]” (134)

10. What’s The Cost of Chiropractic Care? 

Significant research has shown that chiropractic care is an exceptionally affordable form of healthcare.

 
 

Many insurance plans, including Medicare and Medicaid, cover chiropractic care, and out-of-pocket patient costs are often relatively low. Additionally, many chiropractors offer flexible payment plans to make care more accessible. 

Many patients find that the cost of chiropractic care is outweighed by the benefits, as it can help to reduce the need for more expensive forms of care such as surgery or long-term use of medication, including opioids. 

 
 

Compared to traditional medical or physical therapy treatments, chiropractic care is a cost-effective option for managing pain and promoting overall health and well-being.

Conclusion

This overview of the world of chiropractic care uncovered several important facts:

  • Chiropractors are licensed doctors focusing on the natural treatment of nerve, muscle, and joint disorders.

  • Chiropractors use spinal adjustments, or spinal manipulation, along with other tools like soft tissue massage, therapy modalities, and rehabilitation exercises to help alleviate pain and improve function. 

  • Research supports the effectiveness and safety of chiropractic care in treating a wide range of conditions.

  • Patients are overwhelmingly satisfied with the care they receive from chiropractors.

Check out this Natural Solutions video to learn more about chiropractic care.

 
 

Overall, chiropractic care can be a powerful tool in the quest for optimal health and wellness. It's a natural and non-invasive way to help reduce pain and improve overall function. 

It’s not surprising that authorities like the American College of Physicians, the FDA, and the CDC have recognized the value of non-pharmacologic therapies, including chiropractic care. (125,138,139) 

So, if you're looking for a safe, natural, and drug-free way to address your health, chiropractic treatment may be worth considering.


Are you a chiropractor?

Click here to access resources on this topic that you can share with your patients.

  • 1. Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropractic & osteopathy. 2010 Dec;18(1):1-33. Link

    2. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of internal medicine. 2017 Apr 4;166(7):514-30. Link

    3. Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MØ, Fournier G, Højgaard B, Jensen MB, Jensen LD. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. European Spine Journal. 2018 Jan 1;27(1):60-75. Link

    4. Haldeman S, Dagenais S. What have we learned about the evidence-informed management of chronic low back pain?. The Spine Journal. 2008 Jan 1;8(1):266-77. Link

    5. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, Owens DK. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of internal medicine. 2007 Oct 2;147(7):478-91. Link

    6. von Heymann WJ, Schloemer P, Timm J, Muehlbauer B. Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparison with diclofenac and placebo. Spine. 2013 Apr 1;38(7):540-8. Link

    7. Cecchi F, Molino-Lova R, Chiti M, Pasquini G, Paperini A, Conti AA, Macchi C. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clinical rehabilitation. 2010 Jan;24(1):26-36. Link

    8. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. The spine journal. 2004 May 1;4(3):335-56. Link

    9. Dagenais S, Gay RE, Tricco AC, Freeman MD, Mayer JM. NASS contemporary concepts in spine care: spinal manipulation therapy for acute low back pain. The Spine Journal. 2010 Oct 1;10(10):918-40. Link

    10. Skelly AC, Chou R, Dettori JR, Turner JA, Friedly JL, Rundell SD, Fu R, Brodt ED, Wasson N, Kantner S, Ferguson AJ. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update. Link

    11. Giles LG, Muller R. Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine. 2003 Jul 15;28(14):1490-502. Link

    12. Von Heymann WJ, Schloemer P, Timm J, Muehlbauer B. Spinal HVLA-manipulation in acute nonspecific LBP: A double blinded randomized controlled trial in comparison with diclofenac and placebo. Spine. 2012.

    13. Bishop PB, Quon JA, Fisher CG, Dvorak MF. The Chiropractic Hospital-based Interventions Research Outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain. The Spine Journal. 2010 Dec 1;10(12):1055-64. Link

    14. Wilkey A, Gregory M, Byfield D, McCarthy PW. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. The Journal of Alternative and Complementary Medicine. 2008 Jun 1;14(5):465-73. Link

    15. Parkin-Smith GF, Norman IJ, Briggs E, Angier E, Wood TG, Brantingham JW. A structured protocol of evidence-based conservative care compared with usual care for acute nonspecific low back pain: a randomized clinical trial. Archives of physical medicine and rehabilitation. 2012 Jan 1;93(1):11-20. Link

    16. Aure OF, Nilsen JH, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine. 2003 Mar 15;28(6):525-31. Link

    17. Paige NM, Miake-Lye IM, Booth MS, Beroes JM, Mardian AS, Dougherty P, Branson R, Tang B, Morton SC, Shekelle PG. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. Jama. 2017 Apr 11;317(14):1451-60. Link

    18. Coulter ID, Crawford C, Hurwitz EL, Vernon H, Khorsan R, Booth MS, Herman PM. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal. 2018 May 1;18(5):866-79. Link

    19. 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 May 18;1(1):e180105-. Link

    20. Astin JA, Ernst E. The effectiveness of spinal manipulation for the treatment of headache disorders: a systematic review of randomized clinical trials. Cephalalgia. 2002 Oct;22(8):617-23. Link

    21. Rist PM, Bernstein C, Kowalski M, Osypiuk K, Connor JP, Vining R, Long CR, Macklin EA, Wayne PM. Multimodal chiropractic care for migraine: A pilot randomized controlled trial. Cephalalgia. 2020 Oct 13:0333102420963844. Link

    22. Brønfort G, Nilsson N, Haas M, Evans RL, Goldsmith CH, Assendelft WJ, Bouter LM. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database of Systematic Reviews. 2004(3). Link

    23. Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. Link

    24. Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of manipulative and physiological therapeutics. 2000 Feb 1;23(2):91-5. Link

    25. Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, Shaw L, Watkin R, White E. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of manipulative and physiological therapeutics. 2011 Jun 1;34(5):274-89. Link

    26. Harris SP. Chiropractic management of a patient with migraine headache. Journal of chiropractic medicine. 2005;4(1):25. Link

    27. Biondi DM. Physical treatments for headache: a structured review. Headache: The Journal of Head and Face Pain. 2005 Jun;45(6):738-46. Link

    28. Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L. Efficacy of spinal manipulation for chronic headache: a systematic review. Journal of manipulative and physiological therapeutics. 2001 Sep 1;24(7):457-66. Link

    29. Noudeh YJ, Vatankhah N, Baradaran HR. Reduction of current migraine headache pain following neck massage and spinal manipulation. International journal of therapeutic massage & bodywork. 2012;5(1):5. Link

    30. Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002 Sep 1;27(17):1835-43. Link

    31. McCrory, Penzlen, Hasselblad, Gray. Duke Evidence Report (2001).

    32. Antonia GC. Efficacy of manual and manipulative therapy in the perception of pain and cervical motion in patients with tension-type headache: a randomized, controlled clinical trial. Journal of chiropractic medicine. 2014 Mar 1;13(1):4-13. Link

    33. Dunning JR, Butts R, Mourad F, Young I, Fernandez-de-las Peñas C, Hagins M, Stanislawski T, Donley J, Buck D, Hooks TR, Cleland JA. Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial. BMC musculoskeletal disorders. 2016 Dec;17(1):64. Link

    34. Garcia JD, Arnold S, Tetley K, Voight K, Frank RA. Mobilization and manipulation of the cervical spine in patients with cervicogenic headache: any scientific evidence?. Frontiers in neurology. 2016 Mar 21;7:40. Link

    35. Varatharajan S, Ferguson B, Chrobak K, Shergill Y, Cote P, Wong JJ, Yu H, Shearer HM, Southerst D, Sutton D, Randhawa K. Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. European spine journal. 2016 Jul 1;25(7):1971-99. Link

    36. Malo-Urriés M, Tricás-Moreno JM, Estébanez-de-Miguel E, Hidalgo-García C, Carrasco-Uribarren A, Cabanillas-Barea S. Immediate Effects of Upper Cervical Translatoric Mobilization on Cervical Mobility and Pressure Pain Threshold in Patients With Cervicogenic Headache: A Randomized Controlled Trial. Journal of manipulative and physiological therapeutics. 2017 Nov 1;40(9):649-58. Link

    37. Haas M, Bronfort G, Evans R, Schulz C, Vavrek D, Takaki L, Hanson L, Leininger B, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. The Spine Journal. 2018 Oct 1;18(10):1741-54. Link

    38. Malo-Urriés M, Tricás-Moreno JM, Estébanez-de-Miguel E, Hidalgo-García C, Carrasco-Uribarren A, Cabanillas-Barea S. Immediate Effects of Upper Cervical Translatoric Mobilization on Cervical Mobility and Pressure Pain Threshold in Patients With Cervicogenic Headache: A Randomized Controlled Trial. Journal of manipulative and physiological therapeutics. 2017 Nov 1;40(9):649-58. Link

    39. Skelly AC, Chou R, Dettori JR, Turner JA, Friedly JL, Rundell SD, Fu R, Brodt ED, Wasson N, Kantner S, Ferguson AJ. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update. Link

    40. Fernandez M, Moore C, Tan J, Lian D, Nguyen J, Bacon A, Christie B, Shen I, Waldie T, Simonet D, Bussières A. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta?analysis. European Journal of Pain. 2020 Jul 4. Link

    41. Dunning J, Butts R, Zacharko N, Fandry K, Young I, Wheeler K, Day J, Fernández-de-las-Peñas C. Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multi-center randomized clinical trial. The Spine Journal. 2020 Oct 13. Link

    42. Abaspour O, Akbari M. Relationship between echogenicity of deep cervical muscles and pain laterality in subjects suffering from cervicogenic headache. CRANIO®. 2021 Jan 7:1-8. Link

    43. Govind J, Bogduk N. Sources of Cervicogenic Headache Among the Upper Cervical Synovial Joints. Pain Med. 2021 Jan 23:pnaa469. doi: 10.1093/pm/pnaa469. Epub ahead of print. PMID: 33484154. Link

    44. Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Manual therapy. 2005 Feb 1;10(1):4-13. Link

    45. Yaseen K, Hendrick P, Ismail A, Felemban M, Alshehri MA. The effectiveness of manual therapy in treating cervicogenic dizziness: a systematic review. Journal of physical therapy science. 2018;30(1):96-102. Link

    46. Jin X, Du HG, Qiao ZK, Huang Q, Chen WJ. The efficiency and safety of manual therapy for cervicogenic cephalic syndrome (CCS): A systematic review and meta-analysis. Medicine. 2021 Feb 26;100(8). Link

    47. Vernon H, Humphreys K, Hagino C. Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized clinical trials. Journal of Manipulative and Physiological Therapeutics. 2007 Mar 1;30(3):215-27. Link

    48. Korthals-de Bos IB, Müllner M, Hoving JL, van Tulder MW, Rutten-van Mölken MP, Adèr HJ, de Vet HC, Koes BW, Vondeling H, Bouter LM. Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trialCommentary: Bootstrapping simplifies appreciation of statistical inferences. Bmj. 2003 Apr 26;326(7395):911-4. Link

    49. Hoving JL, Koes BW, de Vet HC, van der Windt DA, Assendelft WJ, van Mameren H, Devillé WL, Pool JJ, Scholten RJ, Bouter LM. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain: a randomized, controlled trial. Annals of internal medicine. 2002 May 21;136(10):713-22. Link

    50. Swenson RS. Therapeutic modalities in the management of nonspecific neck pain. Physical medicine and rehabilitation clinics of North America. 2003 Aug;14(3):605-27. Link

    51. Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Annals of internal medicine. 2012 Jan 3;156(1_Part_1):1-0. Link

    52. Leaver AM, Maher CG, Herbert RD, Latimer J, McAuley JH, Jull G, Refshauge KM. A randomized controlled trial comparing manipulation with mobilization for recent onset neck pain. Archives of physical medicine and rehabilitation. 2010 Sep 1;91(9):1313-8. Link

    53. Puentedura EJ, Landers MR, Cleland JA, Mintken P, Huijbregts P, Fernandez-De-Las-Peñas C. Thoracic spine thrust manipulation versus cervical spine thrust manipulation in patients with acute neck pain: a randomized clinical trial. journal of orthopaedic & sports physical therapy. 2011 Apr;41(4):208-20. Link

    54. Dunning JR, Cleland JA, Waldrop MA, Arnot C, Young I, Turner M, Sigurdsson G. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. journal of orthopaedic & sports physical therapy. 2012 Jan;42(1):5-18. Link

    55. Walker MJ, Boyles RE, Young BA, Strunce JB, Garber MB, Whitman JM, Deyle G, Wainner RS. The effectiveness of manual physical therapy and exercise for mechanical neck pain: a randomized clinical trial. Spine. 2008 Oct 15;33(22):2371-8. Link

    56. Boyles RE, Walker MJ, Young BA, Strunce JB, Wainner RS. The addition of cervical thrust manipulations to a manual physical therapy approach in patients treated for mechanical neck pain: a secondary analysis. journal of orthopaedic & sports physical therapy. 2010 Mar;40(3):133-40. Link

    57. Martínez-Segura R, Fernández-de-las-Peñas C, Ruiz-Sáez M, López-Jiménez C, Rodríguez-Blanco C. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. Journal of manipulative and physiological therapeutics. 2006 Sep 1;29(7):511-7. Link

    58. Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Dec;21(1):1-0. Link

    59. Saayman L, Hay C, Abrahamse H. Chiropractic manipulative therapy and low-level laser therapy in the management of cervical facet dysfunction: a randomized controlled study. Journal of manipulative and physiological therapeutics. 2011 Mar 1;34(3):153-63. Link

    60. Wong JJ, Shearer HM, Mior S, Jacobs C, Côté P, Randhawa K, Yu H, Southerst D, Varatharajan S, Sutton D, van der Velde G. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. The Spine Journal. 2016 Dec 1;16(12):1598-630. Link

    61. Gorrell LM, Beath K, Engel RM. Manual and instrument applied cervical manipulation for mechanical neck pain: a randomized controlled trial. Journal of manipulative and physiological therapeutics. 2016 Jun 1;39(5):319-29. Link

    62. Wong JJ, Shearer HM, Mior S, Jacobs C, Côté P, Randhawa K, Yu H, Southerst D, Varatharajan S, Sutton D, van der Velde G. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. The Spine Journal. 2016 Dec 1;16(12):1598-630. Link

    63. Groeneweg R, van Assen L, Kropman H, Leopold H, Mulder J, Smits-Engelsman BC, Ostelo RW, Oostendorp RA, van Tulder MW. Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial. Chiropractic & manual therapies. 2017 Dec;25(1):12. Link

    64. Whalen W, Farabaugh RJ, Hawk C, Minkalis AL, Lauretti W, Crivelli LS, Wyatt L, Sheppard M, Walters SA. Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain. Journal of Manipulative and Physiological Therapeutics. 2019 Dec 20. Link

    65. Bussieres AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Hayden J, Hendrickson B, Hincapie C, Page I, Passmore S, Srbely J. The treatment of neck pain–associated disorders and whiplash-associated disorders: a clinical practice guideline. Journal of manipulative and physiological therapeutics. 2016 Oct 1;39(8):523-64. Link

    66. Southerst D, Yu H, Randhawa K, Côté P, D’Angelo K, Shearer HM, Wong JJ, Sutton D, Varatharajan S, Goldgrub R, Dion S. The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Chiropractic & manual therapies. 2015 Dec;23(1):1-7. Link

    67. Crosbie J, Kilbreath SL, Hollmann L, York S. Scapulohumeral rhythm and associated spinal motion. Clinical biomechanics. 2008 Feb 1;23(2):184-92. Link

    68. Strunce JB, Walker MJ, Boyles RE, Young BA. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. Journal of Manual & Manipulative Therapy. 2009 Dec 1;17(4):230-6. Link

    69. Walser RF, Meserve BB, Boucher TR. The effectiveness of thoracic spine manipulation for the management of musculoskeletal conditions: a systematic review and meta-analysis of randomized clinical trials. Journal of Manual & Manipulative Therapy. 2009 Dec 1;17(4):237-46. Link

    70. Muth S, Barbe MF, Lauer R, McClure P. The effects of thoracic spine manipulation in subjects with signs of rotator cuff tendinopathy. Journal of orthopaedic & sports physical therapy. 2012 Dec;42(12):1005-16. Link

    71. Kardouni JR, Shaffer SW, Pidcoe PE, Finucane SD, Cheatham SA, Michener LA. Immediate changes in pressure pain sensitivity after thoracic spinal manipulative therapy in patients with subacromial impingement syndrome: a randomized controlled study. Manual therapy. 2015 Aug 1;20(4):540-6. Link

    72. Haik MN, Alburquerque-Sendín F, Silva CZ, Siqueira-Junior AL, Ribeiro IL, Camargo PR. Scapular kinematics pre–and post–thoracic thrust manipulation in individuals with and without shoulder impingement symptoms: a randomized controlled study. journal of orthopaedic & sports physical therapy. 2014 Jul;44(7):475-87. Link

    73. Boyles RE, Ritland BM, Miracle BM, Barclay DM, Faul MS, Moore JH, Koppenhaver SL, Wainner RS. The short-term effects of thoracic spine thrust manipulation on patients with shoulder impingement syndrome. Manual therapy. 2009 Aug 1;14(4):375-80. Link

    74. Vinuesa-Montoya S, Aguilar-Ferrándiz ME, Matarán-Peñarrocha GA, Fernández-Sánchez M, Fernández-Espinar EM, Castro-Sánchez AM. A preliminary randomized clinical trial on the effect of cervicothoracic manipulation plus supervised exercises vs a home exercise program for the treatment of shoulder impingement. Journal of chiropractic medicine. 2017 Jun 1;16(2):85-93. Link

    75. Belón-Perez P, Cuesta-Vargas AI. Immediate Effects of Thoracic Spine Manipulation Upon Shoulder Functionality in Patients With Sutured Rotator Cuff Repair: A Prospective Study. Journal of manipulative and physiological therapeutics. 2018 Sep 1;41(7):589-95. Link

    76. Dunning J, Butts R, Fernández-de-Las-Peñas C, Walsh S, Goult C, Gillett B, Arias-Buria JL, Garcia J, Young IA. Spinal Manipulation and Electrical Dry Needling in Patients With Subacromial Pain Syndrome: A Multicenter Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy. 2020 Aug 28(0):1-46. Link

    77. Souza TA. Differential diagnosis and management for the chiropractor: protocols and algorithms. Jones & Bartlett Publishers; 2009 Oct 7.

    78. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. British journal of sports medicine. 2005 Jul 1;39(7):411-22. Link

    79. Vicenzino B, Paungmali A, Buratowski S, Wright A. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Manual therapy. 2001 Nov 1;6(4):205-12. Link

    80. Cleland JA, Flynn TW, Palmer JA. Incorporation of manual therapy directed at the cervicothoracic spine in patients with lateral epicondylalgia: a pilot clinical trial. Journal of manual & manipulative therapy. 2005 Jul 1;13(3):143-51. Link

    81. Cleland JA, Whitman JM, Fritz JM. Effectiveness of manual physical therapy to the cervical spine in the management of lateral epicondylalgia: a retrospective analysis. Journal of Orthopaedic & Sports Physical Therapy. 2004 Nov;34(11):713-24. Link

    82. Fernández-Carnero J, Fernández-de-las-Peñas C, Cleland JA. Immediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia. Journal of manipulative and physiological therapeutics. 2008 Nov 1;31(9):675-81. Link

    83. Javier González-Iglesias, Joshua A. Cleland, Maria del Rosario Gutierrez-Vega, and Cesar Fernández-de-las-Peñas, Multimodal Management Of Lateral Epicondylalgia In Rock Climbers :A prospective Case Series J Manipulative Physiol Ther 2011;34:635-642. Manchanda G, Grover D. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal. 2008;2(1):16-25. Link

    84. Struijs PA, Damen PJ, Bakker EW, Blankevoort L, Assendelft WJ, van Dijk CN. Manipulation of the wrist for management of lateral epicondylitis: a randomized pilot study. Physical therapy. 2003 Jul 1;83(7):608-16. Link

    85. Lucado AM, Dale RB, Vincent J, Day JM. Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis. Journal of Hand Therapy. 2018 Apr 26. Link

    86. Zunke P, Auffarth A, Hitzl W, Moursy M. The effect of manLinkual therapy to the thoracic spine on pain-free grip and sympathetic activity in patients with lateral epicondylalgia humeri. A randomized, sample sized planned, placebo-controlled, patient-blinded monocentric trial. BMC Musculoskeletal Disorders. 2020 Dec;21(1):1-1. Link

    87. Reyhan AC, Sindel D, Dereli EE. The effects of Mulligan’s mobilization with movement technique in patients with lateral epicondylitis. Journal of Back and Musculoskeletal Rehabilitation. 2020 Jan 1(Preprint):1-9. Link

    88. Zunke P, Auffarth A, Hitzl W, Moursy M. The effect of manual therapy to the thoracic spine on pain-free grip and sympathetic activity in patients with lateral epicondylalgia humeri. A randomized, sample sized planned, placebo-controlled, patient-blinded monocentric trial. BMC Musculoskeletal Disorders. 2020 Dec;21(1):1-1. Link

    89. Ahmed A, Ibrar M, Arsh A, Wali S, Hayat S, Abass S. Comparing the effectiveness of Mulligan mobilization versus Cyriax approach in the management of patients with subacute lateral epicondylitis. Journal of the Pakistan Medical Association. 2020 Oct 15:1-1. Link

    90. Page MJ, O’Connor D, Pitt V, Massy, Westropp N. Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane Database of Systematic Reviews. 2012(6). Link

    91. Sault JD, Jayaseelan DJ, Mischke JJ, Post AA. The Utilization of Joint Mobilization As Part of a Comprehensive Program to Manage Carpal Tunnel Syndrome: A Systematic Review. Journal of Manipulative and Physiological Therapeutics. 2020 Aug 26. Link

    92. Brantingham JW, Williams AM, Parkin-Smith GF, Weston P, Wood T. A controlled, prospective pilot study of the possible effects of chiropractic manipulation in the treatment of osteo-arthritis of the hip. European Journal Of Chiropractic. 2003;51(3):149-66.

    93. Hoskins W, McHardy A, Pollard H, Windsham R, Onley R. Chiropractic treatment of lower extremity conditions: a literature review. Journal of manipulative and physiological therapeutics. 2006 Oct 1;29(8):658-71. Link

    94. Brantingham JW, Bonnefin D, Perle SM, Cassa TK, Globe G, Pribicevic M, Hicks M, Korporaal C. Manipulative therapy for lower extremity conditions: update of a literature review. Journal of manipulative and physiological therapeutics. 2012 Feb 1;35(2):127-66. Link

    95. MacDonald CW, Whitman JM, Cleland JA, Smith M, Hoeksma HL. Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2006 Aug;36(8):588-99. Link

    96. Brantingham JW, Globe GA, Cassa TK, Globe D, Pollard H, Lee F, Bates C, Jensen M, Mayer S, Korporaal C, de Luca K. Research & Science. A Single-Group Pre-Test, Post-Test Design Using Full Kinetic Chain Manipulative Therapy with Rehabilitation in the Treatment of 27 Patients with Hip Osteoarthritis. Journal of the American Chiropractic Association. 2010 Aug 1;47(6). Link

    97. Brantingham JW, Globe GA, Cassa TK, Globe D, Pollard H, Lee F, Bates C, Jensen M, Mayer S, Korporaal C, de Luca K. Research & Science. A Single-Group Pre-Test, Post-Test Design Using Full Kinetic Chain Manipulative Therapy with Rehabilitation in the Treatment of 27 Patients with Hip Osteoarthritis. Journal of the American Chiropractic Association. 2010 Aug 1;47(6). Link

    98. De Luca K, Pollard H, Brantingham J, Globe G, Cassa T. Chiropractic management of the kinetic chain for the treatment of hip osteoarthritis: an Australian case series. Journal of manipulative and physiological therapeutics. 2010 Jul 1;33(6):474-9. Link

    99. Brantingham JW, Parkin-Smith G, Cassa TK, Globe GA, Globe D, Pollard H, deLuca K, Jensen M, Mayer S, Korporaal C. Full kinetic chain manual and manipulative therapy plus exercise compared with targeted manual and manipulative therapy plus exercise for symptomatic osteoarthritis of the hip: a randomized controlled trial. Archives of physical medicine and rehabilitation. 2012 Feb 1;93(2):259-67. Link

    100. Abbott JH, Robertson MC, Chapple C, Pinto D, Wright AA, de la Barra SL, Baxter GD, Theis JC, Campbell AJ, MOA Trial Team. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness. Osteoarthritis and Cartilage. 2013 Apr 1;21(4):525-34. Link

    101. Zhang W, Moskowitz R, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. 2008;16:137-162.

    102. Poulsen E, Hartvigsen J, Christensen HW, Roos EM, Vach W, Overgaard S. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis and Cartilage. 2013 Oct 1;21(10):1494-503. Link

    103. French HP, Cusack T, Brennan A, Caffrey A, Conroy R, Cuddy V, FitzGerald OM, Gilsenan C, Kane D, O’Connell PG, White B. Exercise and manual physiotherapy arthritis research trial (EMPART) for osteoarthritis of the hip: a multicenter randomized controlled trial. Archives of physical medicine and rehabilitation. 2013 Feb 1;94(2):302-14. Link

    104. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis care & research. 2012 Apr;64(4):465-74. Link

    105. De Luca K, Pollard H, Brantingham J, Globe G, Cassa T. A randomized controlled trial of chiropractic management of the lower limb kinetic chain for the treatment of hip osteoarthritis: a study protocol. Journal of chiropractic medicine. 2011 Jun 1;10(2):86-92. Link

    106. Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis and cartilage. 2010 Apr 1;18(4):476-99. Link

    107. Vaarbakken K, Elisabeth Ljunggren A. Superior effect of forceful compared with standard traction mobilizations in hip disability?. Advances in physiotherapy. 2007 Jan 1;9(3):117-28. Link

    108. Dwyer L, Parkin-Smith GF, Brantingham JW, Korporaal C, Cassa TK, Globe G, Bonnefin D, Tong V. Manual and manipulative therapy in addition to rehabilitation for osteoarthritis of the knee: assessor-blind randomized pilot trial. Journal of manipulative and physiological therapeutics. 2015 Jan 1;38(1):1-21. Link

    109. Dimou ES, Brantingham JW, Wood T. A randomized, controlled trial (with blinded observer) of chiropractic manipulation and Achilles stretching vs. orthotics for the treatment of plantar fasciitis. Journal of the American Chiropractic Association. 2004 Sep 1;41(9). Link

    110. Bleakley CM, McDonough SM, MacAuley DC. Some conservative strategies are effective when added to controlled mobilisation with external support after acute ankle sprain: a systematic review. Australian Journal of Physiotherapy. 2008 Jan 1;54(1):7-20. Link

    111. Green T, Refshauge K, Crosbie J, Adams R. A randomized controlled trial of a passive accessory joint mobilization on acute ankle inversion sprains. Physical therapy. 2001 Apr 1;81(4):984-94. Link

    112. Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. Journal of Orthopaedic & Sports Physical Therapy. 2002 Apr;32(4):166-73. Link

    113. van der Wees PJ, Lenssen AF, Hendriks EJ, Stomp DJ, Dekker J, de Bie RA. Effectiveness of exercise therapy and manual mobilisation in acute ankle sprain and functional instability: a systematic review. Australian Journal of Physiotherapy. 2006 Jan 1;52(1):27-37. Link

    114. Eisenhart AW, Gaeta TJ, Yens DP. Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries. The Journal of the American Osteopathic Association. 2003 Sep 1;103(9):417-21.

    115. Loudon JK, Reiman MP, Sylvain J. The efficacy of manual joint mobilisation/manipulation in treatment of lateral ankle sprains: a systematic review. Br J Sports Med. 2014 Mar 1;48(5):365-70. Link

    116. Fraser JJ, Saliba SA, Hart JM, Park JS, Hertel J. Effects of midfoot joint mobilization on ankle-foot morphology and function following acute ankle sprain. A crossover clinical trial. Musculoskeletal Science and Practice. 2020 Apr 1;46:102130. Link

    117. Weerasekara I, Osmotherly P, Snodgrass S, Marquez J, de Zoete R, Rivett DA. Clinical benefits of joint mobilization on ankle sprains: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation. 2018 Jul 1;99(7):1395-412. Link

    118. Gogate N, Satpute K, Hall T. The effectiveness of mobilization with movement on pain, balance and function following acute and sub acute inversion ankle sprain–A randomized, placebo controlled trial. Physical Therapy in Sport. 2020 Dec 23. Link

    119. Nguyen AP, Pitance L, Mahaudens P, Detrembleur C, David Y, Hall T, Hidalgo B. Effects of Mulligan Mobilization with Movement in Subacute Lateral Ankle Sprains: A Pragmatic Randomized Trial. Journal of Manual & Manipulative Therapy. 2021 Feb 28:1-2. Link

    120. Brantingham JW, Cassa TK, Bonnefin D, Pribicevic M, Robb A, Pollard H, Tong V, Korporaal C. Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review. Journal of manipulative and physiological therapeutics. 2013 Mar 1;36(3):143-201. Link

    121. Pilar Mansilla-Ferragut, DO, César Fernández-de-las Peñas, DO, PhD, Francisco Alburquerque-Sendi`n, DO, PhD, Joshua A. Cleland, PhD, and Juan José Boscá-Gandi. DO J Manipulative Physiol Ther 2009;32:101-106

    122. Reynolds B, Puentedura EJ, Kolber MJ, Cleland JA. Effectiveness of cervical spine high velocity low amplitude thrust added to behavioral education, soft tissue mobilization, and exercise in individuals with temporomandibular disorder (TMD) with myalgia: A randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2020 Jan 6(0):1-40. Link

    123. Bertelsman T. 2021 Chiropractic Outcomes & Patient Satisfaction Synopsis. Accessed online 12/22/2022. Link

    124. Bertelsman TJ, Steele BC, Gower JG. 2021 ChiroUp Network Dataset: Statistical Reporting of 631,970 Clinical Diagnoses Collected from 2212 Evidence-Based Chiropractic Providers Between July 2019- June 2021. Accessed on 07/30/2021 from Link

    125. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians*. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of internal medicine. 2017 Apr 4;166(7):514-30. Link

    126. Trager RJ, Daniels CJ, Perez JA, Casselberry RM, Dusek JA. Association between chiropractic spinal manipulation and lumbar discectomy in adults with lumbar disc herniation and radiculopathy: retrospective cohort study using United States’ data. BMJ Open. 2022 Dec 1;12(12):e068262. Link

    127. Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The impact of spinal manipulation on migraine pain and disability: a systematic review and meta‐analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. Link

    128. Cassidy, J. David et al. Risk of Carotid Stroke after Chiropractic Care: A Population-Based Case-Crossover Study. Journal of Stroke and Cerebrovascular Diseases, Volume 26, Issue 4 , 842 – 850

    129. Whedon JM, Petersen CL, Li Z, Schoelkopf WJ, Haldeman S, MacKenzie TA, Lurie JD. Association between cervical artery dissection and spinal manipulative therapy–a medicare claims analysis. BMC geriatrics. 2022 Dec;22(1):1-9. Link

    130. Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66–99. Spine. 2015 Feb 15;40(4):264.

    131. Chaibi A et al. A risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: A comprehensive review. Ann Med. 2019 Mar 19:1-27.

    132. Kosloff TM, Elto D, Tao J, Bannister WM. Chiropractic care and the risk of vertebrobasilar stroke: results of a case–control study in U.S. commercial and Medicare Advantage populations. Chiropractic & Manual Therapies (2015) 23:19

    133. Cassidy JD et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population based case-control and case-crossover study. Spine 2008 Feb 15;33(4 Suppl):S176-83

    134. Paige NM, Miake-Lye IM, Booth MS, Beroes JM, Mardian AS, Dougherty P, Branson R, Tang B, Morton SC, Shekelle PG. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. JAMA. 2017 Apr 11;317(14):1451-60.

    135. Liliedahl RL, Finch MD, Axene DV, Goertz CM. Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer. Journal of manipulative and physiological therapeutics. 2010 Nov 1;33(9):640-3. Link

    136. Houweling TA, Braga AV, Hausheer T, Vogelsang M, Peterson C, Humphreys BK. First-contact care with a medical vs chiropractic provider after consultation with a Swiss telemedicine provider: comparison of outcomes, patient satisfaction, and health care costs in spinal, hip, and shoulder pain patients. Journal of manipulative and physiological therapeutics. 2015 Sep 1;38(7):477-83. Link

    137. Corcoran KL, Bastian LA, Gunderson CG, Steffens C, Brackett A, Lisi AJ. Association between chiropractic use and opioid receipt among patients with spinal pain: a systematic review and meta-analysis. Pain Medicine. 2020 Feb 1;21(2):e139-45. Link

    138. FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain. May 2017. Accessed on May 12, 2017 8.

    139. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain- United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49.

Tim Bertelsman

Dr. Tim Bertelsman is the co-founder of ChiroUp. He graduated with honors from Logan College of Chiropractic and has been practicing in Belleville, IL since 1992. He has lectured nationally on various clinical and business topics and has been published extensively. Dr. Bertelsman has served in several leadership positions and is the former president of the Illinois Chiropractic Society. He also received ICS Chiropractor of the Year in 2019.

Previous
Previous

Are Chiropractors Safe?