NCHM Key Facts and Figures

Keep Moving: Key Messages and Facts

Recent changes in lifestyle such as the shift to remote work and online education have led to people moving less, exacerbating the existing trend toward increased inactivity. As a result, some are experiencing back pain, neck pain and other musculoskeletal problems.   

  • A poll conducted by the American Chiropractic Association in 2020 found that more than 90 percent of respondents said their patients or people they knew were experiencing more musculoskeletal issues since having to remain at home more.1
  • Even before the coronavirus pandemic, there has been a trend toward inactivity in the U.S. and around the world caused in part by sedentary occupations, motorized transportation and increased use of technology.2
  • More than half of all U.S. adults fail to meet the surgeon general’s physical activity recommendations.3
  • More than 4 in 10 Americans are obese, according to the National Center for Health Statistics.4

Getting enough movement and physical activity on a regular basis provides a wide range of benefits to our musculoskeletal and overall health.

  • Adults should get 150 minutes of moderate-intensity aerobic activity each week – that’s about 30 minutes of activity five days a week.5
  • Children and teenagers should be physically active for at least 60 minutes each day.6
  • People over 65 should strive for 150 minutes of moderate-intensity aerobic activity each week in addition to two days a week of muscle- and balance-strengthening activities.6
  • Research shows that physical activity helps to alleviate pain and improve function and symptoms in a wide range of musculoskeletal conditions.7
  • Physical activity helps to strengthen our muscles, bones and joints.8
  • Physical activity reduces our risk of cardiovascular disease and diabetes even beyond what weight loss alone can do.5
  • Along with physical activity, a healthy lifestyle includes balancing what you eat and drink, getting adequate sleep and managing stress.6 

Movement and physical activity enhance not only our physical health but also our mental health and feelings of well-being.

  • The number of Americans suffering from anxiety and depression has more than tripled during the COVID-19 pandemic.9
  • Physical activity reduces stress and anxiety, improving our ability to engage in normal activities and get a restful night of sleep.10
  • Physical activity lowers the body’s stress hormone levels and stimulates the production of endorphins, which are known to be the body’s natural pain killer and mood booster.11
  • Physical activity increases oxygen and nutrient delivery to the brain, which enhances our focus and concentration.12

Staying active is especially important as we get older because it contributes to greater muscle and bone strength, which in turn reduces the risk of falls.

  • Deaths from falls among seniors are 75 and over have increased three-fold in recent years and total about 25,000 annually.13
  • Movement and physical activity can improve muscle strength and balance, which helps reduce the risk of falls in the elderly.14
  • An active lifestyle, leading to a higher level of physical fitness, is related to better spinal control in middle-aged men and women.15
  • Bone mass usually peaks in the third decade of life, but physical activity can improve the strength of our bones at any age.16

Low back pain is one of the most disabling musculoskeletal conditions, leading in some cases to chronic pain, lost productivity and addiction to pain medications.

  • Low back pain is the single leading cause of disability worldwide.17
  • Back pain is one of the most common reasons for missed work. One-half of all working Americans admit to having back pain symptoms each year.18
  • Back pain alone accounts for more than 264 million lost U.S. workdays in one year.19
  • Experts estimate that as much as 80% of the population will experience back pain at some time in their lives.20
  • Low back pain costs Americans at least $50 billion in health care costs each year21—factor in lost wages and decreased productivity and that figure easily rises to more than $100 billion.22
  • Back pain is one of the leading reasons why people are prescribed opioids.23 As many as one in four people who receive prescription opioids long term for non-cancer pain struggle with addiction.24

Chiropractic offers a safe nondrug, noninvasive approach to managing back pain and other musculoskeletal conditions and enhancing overall health.

  • In March 2020, the U.S. Department of Homeland Security identified chiropractors as part of the essential healthcare workforce.25
  • In 2017, the American College of Physicians (ACP) updated its guideline for the treatment of acute and chronic low back pain to recommend first using noninvasive, nondrug treatments—including spinal manipulation—before resorting to over-the-counter and prescription drugs.26
  • In January 2015, the Joint Commission, the organization that accredits every major hospital in the United States, recognized the value of nondrug approaches by adding chiropractic care to its pain management standard.27
  • Almost 80 percent of Americans prefer to first use options other than prescription drugs for their pain.28
  • Patients who saw a chiropractor as their initial provider for low back pain (LBP) had 90% decreased odds of both early and long-term opioid use.29



  1. ACA Facebook Poll,, April 21, 2020.
  2. Guthold et al. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Global Health, Sept. 2018; doi
  3. Eijsvogels T. Exercise is medicine. At any dose? JAMA 2015, Nov. 10; 314 (18); 1915-16.
  4. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. 2020.
  5. Centers for Disease Control and Prevention, “Physical Activity for a Healthy Weight,” Accessed July 28, 2020.
  6. Centers for Disease Control and Prevention, “Finding a Balance,” Accessed July 28, 2020.
  7. Booth et al. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal Care. 2017;15:413–421. doi: 10.1002/msc.1191.
  8. Centers for Disease Control and Prevention, “Physical Activity Basics,” Accessed Aug. 17, 2021
  9. Ginty EE, Presskreischer R, Han H, Barry CL. Psychological distress and loneliness reported by US adults in 2018 and April 2020. JAMA. 2020;324(1):93–94. doi:10.1001/jama.2020.9740.
  10. Centers for Disease Control and Prevention, “Benefits of Physical Activity”, accessed Aug. 17, 2021.
  11. Harvard Health Publishing, “Exercising to Relax,”, accessed April 2021.
  12. Walden University, “Mental Benefits of Exercise,”, accessed April 2021.
  13. Hartholt KA, Lee R, Burns ER, van Beeck EF. Mortality from falls among US adults aged 75 years or older, 2000-2016. JAMA. 2019;321(21):2131–2133. doi:10.1001/jama.2019.4185
  14. Liu-Ambrose T, Davis JC, Best JR, et al. Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall: A randomized clinical trial. JAMA. 2019;321(21):2092–2100. doi:10.1001/jama.2019.5795
  15. Aasa U et al. Physical activity might be of greater Importance for good spinal control than if you have had pain or not. Spine 2015; 40:1926–1933.
  16. National Institutes for Health, “Exercise for Your Bone Health,”, accessed Aug. 17, 2021.
  17. Hoy D, March L, Brooks P, et al The global burden of low back pain: estimates from the Global Burden of Disease 2010 study Annals of the Rheumatic Diseases Published Online First: 24 March 2014. doi: 10.1136/annrheumdis-2013-204428
  18. Vallfors B. Acute, subacute and chronic low back pain: Clinical symptoms, absenteeism and working environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
  19. U.S. Bone and Joint Initiative, The hidden impact of musculoskeletal disorders on Americans, 2018,, accessed Aug. 27. 2021.
  20. Rubin Dl. Epidemiology and risk factors for spine pain. Neurol Clin. 2007; May; 25(2):353-71.
  21. In Project Briefs: Back pain patient outcomes assessment team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  22. Katz JN. Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. J Bone Joint Surg Am. 2006; 88(suppl 2): 21-24.
  23. Mojtabai RNational trends in long-term use of prescription opioidsPharmacoepidemiology and Drug Safety, 2017; doi 10.1002/pds.4278.
  24. Boscarino JA et al. Risk factors for drug dependence among out-patients on opioid therapy in a large U.S. health-care system. Addiction 2010;105:1776–82. http://dx.doi. org/10.1111/j.1360-0443.2010.03052.
  25. American Chiropractic Association, “Department of Homeland Security Identifies Chiropractors as Essential Service Providers,” March 31, 2020.
  26. Qaseem A et al. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi: 10.7326/M16-2367.
  27. “Clarification of the Pain Management Standard,” The Joint Commission, 2015:
  28. “Americans Prefer Drug-Free Pain Management Over Opioids,” Gallup-Palmer College of Chiropractic Annual Survey of Americans,
  29. Kazis LE, Ameli O, Rothendler J, et al. Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid useBMJ Open 2019;9:e028633. doi: 10.1136/bmjopen-2018-028633.