What Research Shows

What Research Shows About Chiropractic

A growing list of research studies and reviews demonstrate that the services provided by chiropractors are not only clinically effective and safe but also cost effective.  Following are excerpts and summaries from a few of those studies. The evidence supports the natural, whole-body, nondrug approach of chiropractic for a variety of conditions.

Featured Research

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. Learn more. 
 
Kazis et al. (2019), BMJ Open
 

For Acute and Chronic Pain

“Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). If pharmacologic treatment is desired, clinicians and patients should select nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence).”

American College of Physicians (2017)

"For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation (low-quality evidence)."

American College of Physicians (2017)

“Many treatments are available for low back pain. Often exercises and physical therapy can help. Some people benefit from chiropractic therapy or acupuncture.”

Goodman et al. (2013), Journal of the American Medical Association  

“[Chiropractic Manipulative Therapy] in conjunction with [standard medical care] offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute low back pain."

 Goertz et al. (2013), Spine 

In Comparison to Other Treatments 

Chiropractic users had 64% lower odds of receiving an opioid prescription than non users.
 
The results of a clinical trial showed that chiropractic care combined with usual medical care for low back pain provides greater pain relief and a greater reduction in disability than medical care alone. The study, which featured 750 active-duty members of the military, is one of the largest comparative effectiveness trials between usual medical care and chiropractic care ever conducted.
 
 

"Manual-thrust manipulation provides greater short-term reductions in self-reported disability and pain compared with usual medical care. 94% of the manual-thrust manipulation group achieved greater than 30% reduction in pain compared with 69% of usual medical care."

 Schneider et al (2015), Spine 

"Reduced odds of surgery were observed for...those whose first provider was a chiropractor. 42.7% of workers [with back injuries] who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor."

Keeney et al (2012), Spine 

For Headaches

“Six to eight sessions of upper cervical and upper thoracic manipulation were shown to be more effective than mobilization and exercise in patients with CH, and the effects were maintained at 3 months.”

Dunning et al. (2016) BMC Musculoskeletal Disorders

“There was a linear dose-response relationship between [spinal manipulative therapy] visits and days with [cervicogenic headache]. For the highest and most effective dose of 18 SMT visits, CGH days were reduced by half and about 3 more days per month than for the light-massage control.”

Haas et al. (2018) Spine

“On average, [spinal manipulative therapy]+[home exercise and advice (or HEA)] resulted in better clinical outcomes and lower total societal costs relative to [supervised rehabilitative exercise]+HEA and HEA alone… .”

Leininger et. al. (2016) Spine

For Neck Pain

In a study funded by NIH’s National Center for Complementary and Alternative Medicine to test the effectiveness of different approaches for treating mechanical neck pain, 272 participants were divided into three groups that received either spinal manipulative therapy (SMT) from a doctor of chiropractic (DC), pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with DCs and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups continued to report at least a 75 percent reduction in pain; compared to just 38 percent pain reduction among those who took medication.

Bronfort et al. (2012), Annals of Internal Medicine

Care for Seniors 

Older Medicare patients with chronic low back pain and other medical problems who received spinal manipulation from a chiropractic physician had lower costs of care and shorter episodes of back pain than patients in other treatment groups. Patients who received a combination of chiropractic and medical care had the next lowest Medicare costs, and patients who received medical care only incurred the highest costs.         

Weeks et al (2016), Journal of Manipulative and Physiological Therapeutics

"This study provides evidence of a protective effect of chiropractic care against 1-year declines in functional and self-rated health among Medicare beneficiaries with spine conditions, and indications that chiropractic users have higher satisfaction with follow-up care and information provided about what is wrong with them.”

Weigel et. al. (2014) Journal of Manipulative and Physiological Therapeutics

Cost Effectiveness

Findings from a study utilizing data from the North Carolina State Health Plan collected between 2000-2009 show that care by a doctor of chiropractic (DC) alone or DC care in conjunction with care by a medical doctor (MD)  incurred “appreciably fewer charges” for uncomplicated lower back pain than MD care with or without care by a physical therapist. 

Hurwitz et al. (2016), Journal of Manipulative and Physiological Therapeutics 

Older Medicare patients with chronic low back pain and other medical problems who received spinal manipulation from a chiropractic physician had lower costs of care and shorter episodes of back pain than patients in other treatment groups. Patients who received a combination of chiropractic and medical care had the next lowest Medicare costs, and patients who received medical care only incurred the highest costs.

Weeks et al (2016), Journal of Manipulative and Physiological Therapeutics

Low back pain initiated with a doctor of chiropractic (DC) saves 20 to 40 percent on health care costs when compared with care initiated through a medical doctor (MD), according to a study that analyzed data from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two-year span. The study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee. They also concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.

Liliedahl et al (2010), Journal of Manipulative and Physiological Therapeutics

Patient Satisfaction

Researchers analyzing the prevalence, patterns and predictors of chiropractic utilization in the U.S. general population found that, "Back pain and neck pain were the most prevalent health problems for chiropractic consultations and the majority of users reported chiropractic helping a great deal with their health problem and improving overall health or well-being." 

  Adams et al (2017) Spine 

To find more evidence supporting chiropractic services, visit the World Federation of Chiropractic's Reading List and the Clinical Compass for both guidelines and research.

 

Questions? Contact ACA.