What Is a Chiropractor?

Chiropractors are licensed healthcare professionals who manually adjust the spine and use other hands-on therapies to ease pain and support overall health. Back pain, neck pain, and headaches are common reasons that people see a chiropractor.

Chiropractic care is a type of complementary medicine. It deals with the relationship between your body's structure and the way it works. Chiropractors pay special attention to the connection between your spine and nervous system.

This article focuses on the kinds of health conditions chiropractors often treat. It also explains what a chiropractic session might include.

What Do Chiropractors Do?

Nerves in your spinal cord branch out to all parts of the body. Chiropractic care is based on the belief that if the bones in the spine aren't lined up well, the nerves won't be able to send signals to the brain and other parts of your body as they should— and that your health could suffer as a result.

Chiropractors use their hands (and sometimes special tools) to line up the bones in your spine to promote general health. This is known as manipulation.

Some medical doctors question this method, but it has become more mainstream over the years. The Centers for Disease Control and Prevention (CDC) reports that in 2017, 10% of adults saw a chiropractor—up from 9% in 2012.

Chiropractors also counsel patients on:

• Diet
• Nutrition
• Exercise
• Healthy habits
• Ways to modify work behaviors

What Conditions Do Chiropractors Treat?

Chiropractic care is most often used to treat health conditions that affect nerves, muscles, and bones, including those discussed below.

Medical and chiropractic researchers are working together to explore the effects of this kind of care.

Back Pain

Many people use chiropractic to treat lower back pain. It can be used for acute (sudden and severe) or chronic (long-term) pain.

The pain could stem from an injury, a disc problem, pinched nerve, or arthritis.

Neck Pain

The structure of neck, or cervical spine, makes it vulnerable to injury. Common causes of neck pain include:

• Whiplash
• Osteoarthritis
• Disc disease
• Poor posture

Chiropractors adjust the neck to:

• Improve mobility
• Restore range of motion
• Increase the movement of nearby muscles

Headaches

Chiropractic may help tension headaches, migraines, and other headaches that begin in the neck.

For pain of this type, chiropractors use low-load craniocervical mobilization. This treatment of the head and neck uses less force than what's used on the back.

Chiropractic Modalities

Chiropractic got its start in 1895. A self-taught practitioner named David Palmer sought a way to treat disease without drugs.

He turned to the ancient art of manual medicine. The term chiropractic is based on the Greek words cheir (hand) and praxis (practice), and it refers to treatment done by hand.

Today, there are more than 100 different chiropractic techniques. Many overlap. Some differ only slightly from others. Spinal manipulation is the cornerstone of chiropractic care, but other specialty techniques are also used.

Spinal Manipulation

This is what what most people call a chiropractic adjustment. A chiropractor applies a controlled force to the joints in and around the spine using their hands or a small instrument.

The goal is to place your body into a position that improves your ability to move. This position should help the whole body function better.

Flexion Distraction Therapy

This technique involves a special table with sections that can be raised slightly. When the chiropractor presses on your back, the raised part of the table drops.

The movement of the table helps to align your spine. The goal is to take pressure off disc bulges and spinal nerves.

Spinal Decompression

Spinal decompression is a type of motorized traction. It's often used to treat disc injuries.

The goal is to gently separate the vertebrae to create a vacuum between them. When the bulging discs pull back, there's less pressure on nerves and other parts of your spine.

Manipulation Under Anesthesia

Manipulation under anesthesia (MUA) can be used to relieve chronic neck and back pain when other treatments haven't worked.

After you are sedated, the chiropractor stretches and mobilizes your spine in ways that might be too painful if you were awake and alert.

The treatment can be useful if you have muscle spasms or scar tissue.

Additional Therapies

Chiropractic treatments may be used along with:

• Heat or ice
• Electrical stimulation
• Orthotic shoe supports
• Exercises
• Counseling about diet, weight loss, and other lifestyle factors
• Nutritional supplements

Chiropractors don't use drugs or surgery. If your chiropractor spots a fracture or sees signs of a disease, they will refer you to a medical physician or specialist.

How Are Chiropractors Trained?

To be admitted to a chiropractic college, you need at least 90-semester hour credits of undergraduate study, mostly in the sciences.

Doctors of Chiropractic (D.C.) graduate from four-year doctoral programs. The curriculum includes at least 4,200 hours of classroom, lab, and clinical internship. Most D.C. programs have as many classroom hours as allopathic (MD) and osteopathic (DO) medical schools. 

Chiropractic is regulated by each state and the District of Columbia. All states require a Doctor of Chiropractic degree from an accredited college.

Exams administered by the National Board of Chiropractic Examiners (NBCE) are required before a chiropractor can be licensed. To keep their license, chiropractors must earn continuing education (CE) credits each year through state-approved programs.

The kinds of services a chiropractor can offer—for example, selling dietary supplements or using acupuncture and homeopathy—varies by state.

Specializations

Some chiropractors complete an extra two- to three-year residency in specialized fields. These fields include:

• Radiology: This involves training to read X-rays, magnetic resonance imaging (MRI), computed tomography (CT), sonography, and positron emission tomography (PET scan). Chiropractic radiologists often focus on the musculoskeletal system.
• Rehabilitation: This involves helping people recover from injuries, especially those to the back, legs, feet, or arms. The goal is often to build strength, endurance, balance, and motor control.
• Clinical nutrition: Some chiropractors take courses to earn a certificate from either the American Clinical Board of Nutrition or Chiropractic Board of Clinical Nutrition. They can offer in-depth dietary advice.
• Internist: This specialty focuses on conditions that go beyond joints and muscles. It can include autoimmune diseases, gastrointestinal disorders, eczema, and infections.
• Neurology: This focuses on nonsurgical treatment options for neuromuscular and orthopedic issues. Specialists adjust the spine, arms, and legs as a way to send messages to specific areas of the brain. Subspecialties take two more years of training. Examples are chiropractic neurology, brain injury rehabilitation, and vestibular rehabilitation to improve balance.
• Forensics: This field focuses on exams needed for criminal investigations and legal cases. These specialists offer expert opinions in court.
• Sports medicine: This involves sports-related injuries. It focuses on preventing and recovering from injury without surgeries or medication.
• Acupuncture: Training is in acupuncture, a traditional Chinese medicine (TCM) treatment. It involves placing small needles into specific points on the body.
• Pediatrics and pregnancy: This specialty involves children and their growing spines. It also includes spinal care before and after giving birth.

Before Your Visit

Your healthcare provider may refer you to a chiropractor if you have back, neck, or other joint pain.

If your healthcare provider can't refer you to a specific chiropractor, ask family and friends for recommendations. You can also use the American Chiropractic Association's online tool to find one near you.

To find out if a chiropractor is licensed or if there have been any complaints against them, search your state licensing board's website. The NCBE has a list of links to state boards to get you started.

Insurance Coverage

Many insurance plans cover chiropractic care. In fact, chiropractic care is covered by insurance plans more often than alternative treatments like acupuncture and massage.

A 2012 study by the National Center for Complementary and Integrative Health found that about 60% of adults seeing a chiropractor had insurance coverage. Partial coverage (41%) was more common than complete coverage (19%). 

Before your visit, check with your plan to see:

• How much coverage you have
• If you need a referral
• If there's a limit on the number visits or overall cost

Medicare Part B covers chiropractic visits. However, it will not cover some services or tests ordered by a chiropractor, such as X-rays. At least 24 states cover chiropractic under Medicaid.

Preparation

For your first visit:

• Wear comfortable clothing (T-shirt, athletic pants, leggings)
• Wear sneakers or sturdy flats
• Avoid skirts and dresses
• Avoid stiff jeans or dress clothes that are hard to bend in
• Remove all jewelry

You chiropractor will press on your body during treatment, so you may want to use the restroom before your visit. You might also want to avoid eating beforehand.

What to Expect

A chiropractor visit is similar to seeing other healthcare providers. Still, there are a few differences.

The office and intake forms may be familiar. You'll probably notice that the treatment tables are different. They allow for specific positioning and movement during adjustments.

The chiropractor will start by taking your history. The physical exam will include your whole spine.

For example, if you have low back pain, the chiropractor will also examine your neck. That's because changes in one part of your spine can lead to irritations in other places. The chiropractor is looking for misalignments called subluxations.

The physical exam typically includes:

• Range of motion tests
• Palpation (pressing on certain areas)
• Reflex testing
• Muscle strength comparisons
• Neurological and orthopedic tests

Imaging or lab tests such as MRI, CT scans, or X-rays may be needed to confirm a diagnosis. Once you have a diagnosis, treatment can start.

How Long Can Treatment Take?

You may need several visits to see improvement. If you have a chronic issue, such as back pain, you may need ongoing maintenance care even if your symptoms improve.

There aren't established standards for maintenance care. Your recommendations will vary based on the chiropractor, your health conditions, and how well you respond to treatment. It may range from two appointments per year to monthly sessions or more.

Research on maintenance care is limited and there are mixed results. Some studies suggest better outcomes—including fewer painful days—for people who have preventive care compared to those who only seek care when symptoms come back or get worse.

Summary

Chiropractic care is a hands-on, drug-free therapy. It's used to treat back pain, headaches, neck pain, and other health conditions. To ease pain, increase mobility, and improve your health, chiropractors bring the bones of your spine into proper alignment.

In a typical visit, a chiropractor may use manual pressure, a segmented table, or traction to adjust your spine.

Chiropractors train a similar length of time to medical and osteopathic doctors. Some specialize, just as MDs and DOs do.