Primarily, chiropractic focuses on the diagnosis and treatment of neuromuscular disorders, with an emphasis on care that includes manual adjustments, spinal manipulation, and mobilization. Chiropractic is considered a form of primary care, as patients can choose to see a Doctor of Chiropractic without a referral.
A 2010 meta-analysis reviewed numerous published studies to evaluate the strength of scientific evidence for manual treatment of both musculoskeletal (MSK) and non-musculoskeletal (non-MSK) conditions.
Lead author Gert Bronfort reviewed 49 systematic reviews and 16 evidence-based clinical guidelines. He and his co-authors concluded that spinal manipulative therapy (SMT) and mobilization are effective in adults for acute, subacute, and chronic low back pain; migraine and cervicogenic headaches; cervicogenic dizziness; and several extremity joint conditions. They also found that thoracic manipulation and mobilization are effective for acute and subacute neck pain.
At that time, the evidence for several other conditions was considered inconclusive—meaning the available research was not yet consistent or extensive enough to support a firm recommendation. This included cervical manipulation or mobilization alone for neck pain, as well as SMT and mobilization for mid-back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults.
In a 2014 follow-up review, lead author Christine Clar reported moderate evidence for manipulation or mobilization combined with exercise for rotator cuff disorders, spinal mobilization for cervicogenic headache, and mobilization for certain headache disorders.
In the years since, additional research has continued to explore many of these conditions. For some—such as neck pain—evidence has become more supportive, particularly when spinal manipulation is used as part of a broader, multimodal approach. However, as with many areas of healthcare, results can vary depending on the individual and the specific condition.
As further research is published, the understanding of where chiropractic care is most effective will continue to evolve, and the range of conditions that may benefit will likely expand.
