What chiropractors can help with – and what patients should know

Chiropractic care has evolved significantly from its controversial beginnings, moving towards mainstream acceptance within the healthcare landscape. Initially dismissed by some as quackery, largely due to its founder's claims in the late 1800s, the profession now sees about 11% of U.S. adults seeking its services, primarily for pain management. Many leading health systems incorporate chiropractic care, and national guidelines frequently recommend spinal adjustments as a first-line treatment for back pain.

Practitioners, who often refer to themselves as doctors, undergo a four-year program focusing on basic sciences, nutrition counseling, and the techniques of manual adjustments. These adjustments involve applying pressure to joints to stretch the small muscles connecting vertebrae. The audible 'popping' sound during an adjustment is attributed to gas release from joint fluid and is not considered the primary goal of the treatment. After completing their training, chiropractors must pass a national board exam to obtain state licensure.

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The popping sound heard during this adjustment is a result of gas being released from the fluid that surrounds your joints. While satisfying, Lauretti said the sound is not the goal of the adjustment.

However, the legal and practical scope of chiropractic practice differs widely across states. For instance, chiropractors in Oregon are permitted to perform tasks like delivering babies and minor surgical procedures such as stitching skin tags. In contrast, New York imposes stricter regulations, confining chiropractors primarily to treating spinal conditions. Insurance coverage also varies, with many insurers covering adjustments and nutrition counseling, while Medicare coverage is more restrictive, often limited to adjustments alone, though chiropractors are actively lobbying for broader coverage.

Despite its growing legitimacy, the profession still faces scrutiny regarding its adherence to scientific evidence. While robust evidence supports the effectiveness of chiropractic adjustments for mild to moderate pain, some chiropractors are criticized for promoting unproven treatments for serious diseases or selling costly supplements without solid scientific backing. The American Chiropractic Association acknowledges that a minority of practitioners deviate from evidence-based methods, though critics argue this is more widespread. This divergence fuels ongoing debate about the profession's commitment to science-backed care versus its historical anti-establishment roots.

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The American Chiropractic Association says that a minority of providers diverge from evidence-based practices, though critics of the industry say it’s more common.