Key Facts and Figures About the Chiropractic Profession

Chiropractic is a healthcare profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Doctors of chiropractic (DCs) practice a conservative approach to health care that includes patient examination, diagnosis and treatment. In addition to manual therapies such as spinal manipulation, DCs are trained to recommend therapeutic and rehabilitative exercises, and to provide nutritional, lifestyle and dietary advice. Conditions they treat include, but are not limited to, back pain, neck pain, pain in the joints of the arms or legs, and headaches.

  • There are about 70,000 chiropractors in the United States1 who are required to pass a series of four national board exams2 and become state licensed3. Roughly another 3,000 chiropractors work in academic and management roles.
  • There are about 11,000 chiropractic students4  in 19 nationally (U.S.) accredited, chiropractic doctoral graduate education programs5  across the United States, Canada and Puerto Rico, with about 2,800 chiropractors entering the workforce every year.4
  • It is estimated that chiropractors treat more than 35 million Americans (adults and children) annually.6
  • Chiropractors are educated in nationally accredited, four-year doctoral graduate school programs7  through a curriculum that includes a minimum of 4,200 hours of classroom, laboratory and clinical internship,8  with the average DC program equivalent in classroom hours to allopathic (MD) and osteopathic (DO) medical schools.9
  • There are 10 nationally accredited chiropractic residency programs in the United States, enabling doctors of chiropractic to train in integrative settings alongside their medical colleagues.10
  • Chiropractors are designated as physician-level providers in the vast majority of states11 and federal Medicare program. The essential services provided by chiropractors are also available in federal health delivery systems, including those administered by Medicaid, the U.S. Departments of Veterans Affairs and Defense, Federal Employees Health Benefits Program, Federal Workers’ Compensation, and all state workers’ compensation programs.12

A First Line of Defense Against Pain

The essential services provided by chiropractors represent a primary approach for the prevention, diagnosis and conservative (non-drug) management of back pain and spinal disorders that can help some patients reduce or avoid the need for riskier treatments, such as prescription opioid pain medications and surgery. Major clinical guidelines now support the use of non-drug treatments for pain:

  • In its Clinical Practice Guideline for Prescribing Opioids, the Centers for Disease Control and Prevention promotes “diverse approaches and varied pain management solutions” and specifically encourages use of non-opioid/non-drug therapies as a first line of treatment against subacute and chronic pain.13
  • The American College of Physicians’ low back pain treatment guideline recommends first using non-drug treatments, such as spinal manipulation [a centerpiece of chiropractic care], for acute and chronic low back pain.14
  • The Department of Defense/Veterans Administration guideline for the treatment of low back pain includes spinal manipulation as a non-drug, noninvasive option.15
  • The Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. (including every major hospital), recognizes the value of non-drug approaches and includes chiropractic in its pain management standard.16

Patient Satisfaction/Clinical Effectiveness

  • Three in four people who see a chiropractor (77%) describe chiropractic care as “very effective.”17
  • In a consumer survey, chiropractic outperformed all other back pain treatments, including prescription medication, deep-tissue massage, yoga, pilates, and over-the-counter medication therapies.18
  • Chiropractors are the highest-rated healthcare practitioner for low-back pain treatments above physical therapists, specialist physicians/MDs (neurosurgeons, neurologists, orthopaedic surgeons), and primary care physicians/MDs (family or internal medicine).19
  • Chiropractors’ collaborative, whole person-centered approach reflects the changing realities of health care delivery and fits well into Accountable Care Organization (ACO) and patient-centered, medical home (PCMH) models that offer greater clinical efficiency, patient satisfaction and cost savings.20
  • A clinical comparative trial conducted at three military medical centers found 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.21
  • In another comparative-effectiveness trial, 94% of manual-thrust manipulation (chiropractic) recipients experienced a 30% reduction in their pain, compared with only 54% of medical care recipients.22

*Find more information on research that supports chiropractic services here.

References

[1]  State of the U.S. Health Work Force, 2024, National Center for Health Workforce Analysis, Health Resources and Services Administration, November 2024. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/state-of-the-health-workforce-report-2024.pdf

[2] National Board of Chiropractic Examiners (NBCE) www.NBCE.org.

[3]  Federation of Chiropractic Licensing Boards (FCLB)www.FCLB.org

[4]  Association of Chiropractic Colleges, www.chirocolleges.org. Accessed May 2025.

[5]  Council on Chiropractic Education (CCE) www.cce-usa.orgis the agency certified by the U.S. Department of Education to accredit doctoral graduate school programs that offer the Doctor of Chiropractic (D.C.) degree. Accessed May 2025.

[6]  “One in Four Americans Sought Care for Neck and Back Pain Last Year,” Gallup.com, accessed November 2018: http://www.gallup.com/poll/194984/one-four-adults-sought-care-neck-back-pain-last-year.aspx?g_source=Well-Being&g_medium=newsfeed&g_campaign=tiles

[7]  Council on Chiropractic Education (CCE), www.cce-usa.org.

[8] Meeker, DC, MPH; Scott Haldeman, DC, PhD, MD; Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine. 2002; 136(3): 216-227. http://annals.org/article.aspx?articleid=474085

[9] Coulter, Adams, Coggan, Wilkes, Gonyea. A Comparative Study of Chiropractic and Medical Education. Alternative Therapy Health Medicine. 1998; 4:64-75.

[10] Council on Chiropractic Education (CCE) www.cce-usa.org. Accessed May 2025.

[11] American Chiropractic Association (ACA), https://www.acatoday.org/wp-content/uploads/2021/10/State_physician_status_2015.pdf.

[12] Practice Analysis of Chiropractic (2025), National Board of Chiropractic Examiners, https://www.nbce.org/practice-analysis-of-chiropractic-2025-2/.

[13] Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1.

[14] Qaseem, A., Wilt, T. J., McLean, R. M., Forciea, M. A., & for the Clinical Guidelines Committee of the American College of Physicians. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 166(7), 514. https://doi.org/10.7326/M16-2367

[15] VA/DoD Clinical Practice Guideline for Diagnosis and Treatment of Low Back Pain, Sept. 2017, www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPGPatientSummary092917.pdf

[16] Clarification of the Pain Management Standard. Joint Commission. https://www.jointcommission.org/assets/1/18/Clarification_of_the_Pain_Management__Standard.pdf

[17]  “One in Four Americans Sought Care for Neck and Back Pain Last Year,” Gallup.com, accessed November 2018: http://www.gallup.com/poll/194984/one-four-adults-sought-care-neck-back-pain-last-year.aspx?g_source=Well-Being&g_medium=newsfeed&g_campaign=tiles

[18] Consumer Reports Health Ratings Center. Back-Pain Treatments. ConsumerReports.org; July 2011.

[19] Consumer Reports Health Ratings Center. Relief for your aching back: What worked for our readers. ConsumerReports.org; March 2013.

[20] Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care. Foundation for Chiropractic Progress. May 2013.

[21] Goertz CM et al. 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;1(1):e180105.

[22] Schneider M et. al. Comparison of spinal manipulation methods and usual medical care for acute and subacute low back pain. Spine 2015; 40(4):209-217.