The Science Supporting Chiropractic


Patient Satisfaction

When asked to rate their satisfaction on a 10-point scale: 87 percent of patients in the study gave their doctor of chiropractic a level of 8 or higher and 56 percent of those patients rated their chiropractor with a perfect 10.


Cost Efficacy


Conclusion:  This review identified limited evidence indicating that manual therapy techniques (eg, osteopathic spinal manipulation, physiotherapy consisting of manipulation and mobilization techniques, and chiropractic manipulation), in addition to other treatments or alone, are more cost-effective than usual GP care (alone or with exercise), spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back pain and/or disability. Similarly, one study [57] demonstrated that spinal manipulation in addition to GP care was more cost-effective than GP care alone in reducing shoulder pain and related disability.


Manga Report - The effectiveness and cost-effectiveness of Chiropractic Management of Low-back pain

Executive Summary - The Manga Report represents the largest existing analysis of scientific Literature on low-back pain to date. It has drawn national attention for the support of chiropractic treatment of low-back pain. This unbiased independent study commissioned by the Ontario Ministry of Health shows that chiropractic treatment is cost-effective, safe, has a high rate of patient satisfaction, and is more effective than medical treatment for low-back pain. The Manga Report also recommends that the management of low-back pain be moved from Medical Doctors to Doctors of Chiropractic and that hospital privileges be extended to D.C.s.


Value of Chiropractic Services at an On-Site Health Center

Conclusion: These results suggest that chiropractic services offered at on-site health centers may promote lower utilization of certain health care services, while improving musculoskeletal function.


A Hospital-Based Standardized Spine Care Pathway:  Report of a Multidisciplinary, Evidence-Based Process

A health care facility (Jordan Hospital) implemented a multidimensional spine care pathway (SCP) using the National Center for Quality Assurance (NCQA) Back Pain Recognition Program (BPRP) as its foundation. The findings for 518 consecutive patients were included. One hundred sixteen patients were seen once and triaged to specialty care; 7% of patients received magnetic resonance imagings. Four hundred thirty-two patients (83%) were classified and treated by doctors of chiropractic and/or physical therapists. Results for the patients treated by doctors of chiropractic were mean of 5.2 visits, mean cost per case of $302, mean intake pain rating score of 6.2 of 10, and mean discharge score of 1.9 of 10; 95% of patients rated their care as "excellent."


Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Headache

Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal.


Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer

Conclusion:  This study provides a unique opportunity to evaluate an insured population with open access (including identical co-pays and deductibles) and an unlimited number of visits to providers via self-referral. Our results support a growing body of evidence that chiropractic treatment of low back pain is less expensive than traditional medical care. We found that episode cost of care for LBP initiated with a DC is less expensive than care initiated through an MD. Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD. Even after risk adjusting each patient's costs, we found that episodes of care initiated with a DC are 20% less expensive than episodes initiated with an MD. Our results suggest that insurance companies that restrict access to chiropractic care for LBP may, inadvertently, be paying more for care than they would if they removed these restrictions.


Clinical Utilization and Cost Outcomes from an Integrative Medicine Independent Physician Association: An Additional 3-year Update
Summary:  A new retrospective analysis of 70,274 member-months in a 7-year period within an IPA, comparing medical management to chiropractic management, demonstrated decreases of 60.2% in-hospital admissions, 59.0% hospital days, 62.0% outpatient surgeries and procedures, and 83% pharmaceutical costs when compared with conventional medicine IPA performance. This clearly demonstrates that chiropractic nonsurgical nonpharmaceutical approaches generates reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone.



A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain.

Conclusion: The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. There is no evidence that indicates NSAID use is any more effective than cervical manipulation for neck pain.


Controversy. The Media feeds on it.

Significant research suggests that chiropractic is the safest approach available for relief from neck pain, back pain, headaches and other “musculo–skeletal” complaints. Lets review that research, and discuss how modern medicine has contributed to the Myth that chiropractic care is dangerous.


No one pays closer attention to injury statistics than Malpractice Insurance carriers.
Scott Haldeman, MD, DC reviewed malpractice claims records for a 10-year period between 1988 and 1997. In reviewing the outcomes following the application of 134.5 million cervical manipulations (commonly referred to as the chiropractic adjustment), the records indicated that there were 23 reported cases of stroke or vertebral artery dissection (VAD).  Of this group, 10 of the patients had the complicating factors of high blood pressure, use of oral contraceptives, or a history of smoking, all of which are associated with vascular disease.  The actual incidence of stroke or VAD following cervical manipulation was found to be one per 5.85 million cervical adjustments. That means that the average chiropractor could work for 1430 years (or practice 48 full chiropractic careers!) before they might be involved with this type of litigation.


College of Chiropractors of British Columbia has the following information for safety and outcomes.

Please click here to read pdf document.