Chronic Pain

Chiropractic Therapy to Help Chronic Pain

Joseph Bennington-Castro
By Medically Reviewed by 
Reviewed:
Medically Reviewed
Man receiving chiropractic therapy for chronic pain
Chiropractors help patients realign the spine and increase range of motion, which may have downstream benefits. Alamy; Canva; Everyday Health
The word “chiropractic” stems from the Greek words cheir (hand) and praxis (practice), which aptly describes this treatment approach. Chiropractic therapy (or chiropractic care) is a type of manual or hands-on therapy performed by a licensed chiropractor (doctor of chiropractic, or DC) to improve musculoskeletal health.

How It Works

Chiropractors perform adjustments or manipulations to the spine and sometimes other parts of the body to correct alignment, improve motion and physical function, and support the body's ability to heal itself.

It's believed that realigning the spine reduces pressure on the central nervous system. Chiropractors use their hands or an instrument to adjust specific parts of the body with a sudden controlled force.

RELATED: 8 Great Pain Relievers You Aren't Using 

Chiropractors also use mobilization to increase the body's range of motion. This technique involves slow manipulation, movement, and stretching of joints and muscles.

Chronic Pain Symptom Relief

Scientists have been studying the effectiveness of chiropractic care for various types of pain for many years.

Low back pain The most promising research is on low back pain, which has shown spinal manipulation therapy (SMT) is as effective as other common therapies, like exercise therapy, standard medical care, or physiotherapy.

Systematic reviews have shown that chiropractic therapy significantly reduces chronic low back pain and disability compared with other active therapies for at least six months;

is effective for acute and chronic low back pain when used in conjunction with other interventions like self-management advice and exercise;

and has similar effects on short-term pain relief as other recommended therapies, but a slightly better improvement on function.

Migraine symptoms, cervicogenic headache Low back pain isn't the only type of pain for which chiropractic therapy is effective. Some reviews have found that chiropractic care improves episodic and chronic migraines and cervicogenic headaches (pain on side of your head or face),

and it may reduce migraine pain and days.

Neck pain There's also some evidence for chiropractic care to treat neck pain. One study found that SMT is more effective than medication in both the short and long term to treat acute and subacute pain,

and a literature review found weak evidence that spinal manipulation provides short-term relief from acute or chronic neck pain.

Research also shows that patients, at least, appear to be satisfied with their care.

Sciatica Additional research suggests spinal manipulation may help with sciatica (pain associated with the sciatic nerve).

General Health and Wellness Benefits

Chiropractic therapy focuses on treating disorders of the musculoskeletal and nervous systems. It's most often used to treat various types of pain.

According to the American Chiropractic Association, chiropractors use spinal manipulation to "restore joint mobility by manually applying a controlled force into joints that have become hypomobile — or restricted in their movement — as a result of a tissue injury." By restoring joint mobility, chiropractors help relieve pain and muscle tightness, which allows tissues to heal.

There is no data to show that chiropractic therapy, in and of itself, improves general health. And research does not support using chiropractic therapy for nonmusculoskeletal disorders.

Pain relief from chiropractic adjustments may have other secondary benefits as well, particularly improving depression (depression and pain are intimately linked) and daily physical activity, which may have a cascading positive effect on general health.

Other Conditions That Chiropractic Care May Benefit

Multiple sclerosis (MS) Some people with multiple sclerosis (MS) report feeling positive effects from chiropractic care. What little research has been done on the topic suggests chiropractic care may help with chronic pain in patients with MS,

and that most people who had chiropractic care for MS would recommend the treatment to other MS patients.

Hip pain, back pain from osteoarthritis (OA) Research also suggests chiropractic therapy may have some pain relief benefits for osteoarthritis-based lower back pain

and hip pain.

Doctors do not recommend chiropractic care for ankylosing spondylitis, but more research is needed. It may be effective, however, for inactive ankylosing spondylitis.

A global summit of biomedical researchers and chiropractic researchers and organizations was convened in 2019 to evaluate if the published research shows evidence that chiropractic therapy can help nonmusculoskeletal disorders, like infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. The majority concluded that the research does not support a benefit for these conditions. The stronger evidence for chiropractic care is treatment and management of musculoskeletal disorders as of now.

How to Find Chiropractic Therapy

Only a licensed chiropractor — a doctor of chiropractic, or DC — should perform chiropractic adjustments. In all 50 states and the District of Columbia, chiropractors must be an accredited DC and pass special state exams, exams administered by the National Board of Chiropractic Examiners, or both to practice.

In order to become a DC, you have to complete on average three years of undergraduate instruction to be admitted to a program and then four years of training to graduate as a DC.

Institutions that award the DC are accredited by the federally recognized Council on Chiropractic Education.

You can find a DC by getting a referral from someone you trust, using your insurance policy's search function, or using the American Chiropractic Association's Find a Doctor search tool.

What to Expect

During your first visit to a DC, you will likely discuss your present condition and health history, and then undergo a physical examination. Your chiropractor might order imaging or lab tests to determine what may be causing your issue(s). They may refer you to a different medical professional if necessary for your condition.

Your chiropractor will then explain your condition, develop a treatment plan, and review the risks and benefits of the treatment.

If your chiropractor decides you need an adjustment, you may be asked to sit or lie on a table. During the adjustment, you may hear cracking or popping noises as pockets of air are released from your joints.

As with any good workout, you may experience fatigue or pain in the parts of the body that were adjusted for up to a few days.

Based on your treatment plan, you likely will require multiple visits. It's key to find a chiropractor that you feel comfortable with and — as with any health provider, such as a primary care doctor or PT — to build a therapeutic relationship with them. This enables them to get to know you beyond just your symptoms, and help you potentially heal at a deeper level. Chiropractic care has a holistic core philosophy, and is aligned with a biopsychosocial model of care.

Fees: Is Chiropractic Therapy Expensive? Will Insurance Cover It?

Chiropractic care is included in most insurance plans, including:

  • Major medical plans
  • Workers' compensation
  • Medicare (Part B covers visits that are medically necessary)
  • Some Medicaid plans
  • Blue Cross Blue Shield plans

Chiropractic therapy is also offered at many Veteran Association facilities.

Prices varies widely depending on your:

  • Health insurance plan
  • Location
  • Provider
  • Treatment plan
If your chiropractor does not accept insurance (or your insurance), you may be eligible for reimbursement. You may be able to use money from your health savings account for chiropractic care.

Considerations

Chiropractic care is generally safe and has small risks.

Chiropractic care is not recommended for ankylosing spondylitis.

It's also not recommended for people with certain cancers, certain spinal conditions (congenital and developed), severe osteoporosis, chronic coagulation defect, aortic aneurysm and dissection, long-term use of anticoagulant therapy, or an increased risk of stroke.

The majority of chiropractors will ask about and screen you for any contraindications you may have before you start treatment.

Chiropractic adjustments are generally considered safe during pregnancy. Studies have not linked the practice to an increased risk of miscarriage. But it's a good idea to check with your healthcare provider before getting chiropractic care.

You should call your doctor if you experience severe pain, numbness, or an unyielding headache after a session.

Some reports have associated chiropractic care and high-velocity adjustments with stroke or vertebral artery dissection, but the injuries are extremely rare, according to the American Chiropractic Association.

Most larger population studies have not supported an increased risk for the general population, but that doesn't take into consideration your individual risks, so it’s best to discuss with your primary care doctor and chiropractor if you have any concerns before you start treatment on your neck region.

Editorial Sources and Fact-Checking

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