The inclusion of chiropractic practitioners into various collaborative health systems has increased over the past decade. The addition of chiropractic within these multi-disciplinary settings has been embraced by many as a way to manage spinal conditions, such as back and neck pain, using noninvasive therapies. However, taking a patient-centered approach to such integration involving various health care practitioners leads to new questions and challenges and requires novel research to optimize patient outcomes in these settings.

Clinical guidelines for adults with acute, subacute, and chronic low back pain support conservative management with spinal manipulative therapy (SMT). Research shows SMT is comparable to other noninvasive treatments in reducing low back pain and disability with relatively low risk for adverse events. However, the mechanisms leading to pain relief from SMT are poorly understood. Identifying therapeutic mechanisms of SMT can inform treatment strategies and lead to more effective care.