Does Chiropractic Adjustment Work? A Doctor's Opinion on Back, Neck Treatments and More

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Does Chiropractic Adjustment Work? A Doctor’s Opinion on Back, Neck Treatments and More

Are chiropractic adjustments a scam, quackery or proven to work? A doctor looks at the evidence. Included: treatment for back pain, neck pain, more.

Does Chiropractic Adjustment Work? A Doctor's Opinion on Back, Neck Treatments and More | The Survival Doctorby Andrea E. Gordon, M.D.

[Editor's note: This article was originally hosted on MyFamilyDoctorMag.com, our sister site.
It's now featured here as part of our new general-health section.]

Mention chiropractic treatment in a room full of doctors and you’ll hear responses ranging from, “That will give you a stroke!” to, “Helped me when nothing else could.” So what is this therapy and why is it so controversial?

Chiropractic Vs. Conventional Medical Beliefs

Chiropractors believe bones can get subtly out of line and cause muscle spasms or nerve irritation. This causes the pain. Realigning the bones by manipulations called adjustments supposedly helps relieve it.

Several difficulties face researchers when looking at whether chiropractic treatment works. Some chiropractors claim to treat many other kinds of problems, such as asthma and menstrual cramps. And some combine supplements with spinal manipulation.

Is Chiropractic Adjustment Proven to Work for Other Problems?
  • Bed-wetting: Weak evidence suggests it may work.
  • Fibromyalgia pain: Weak evidence suggests it may work.
  • Colic: According to one study, manipulation might work better than simethicone (Gas-X, Mylanta Gas Relief), but no better than just being held by a nurse.
  • Carpal tunnel syndrome: It doesn’t seem to help.
  • Asthma: We don’t have enough evidence to decide.

Chiropractors’ assumptions also differ from those in conventional medicine. If you’re taught that the skull bones are fused, you’ll likely view anyone claiming to adjust them with suspicion. Further, most chiropractors claim their adjustments do more than just relieve pain; they allow the body to function better. If nerves aren’t being pinched, all messages they transmit, from digestion to muscle relaxation to hormonal activation, can proceed more normally.

But chiropractic treatment’s increasing popularity has exposed physicians more to it. And relatively recent research has demonstrated that it does work for some things. These changes have helped soften doctors’ opinions.

Does Chiropractic Treatment for Back Pain Work?

Back pain is perhaps the most common reason for seeking chiropractic adjustment.

  • For short-term back pain, some studies have shown that it can be as effective as or more effective than conventional treatment.
  • For long-term back pain, a 2004 analysis published by the respected Cochrane Collaboration found that chiropractic adjustments were as good as but not better than other treatments like physical therapy, exercise or pain medication.
Does Chiropractic Treatment for Neck Pain Work?

Neck pain and headaches are other complaints chiropractors commonly treat. A 2005 Cochrane review concluded that chiropractic manipulation for neck pain helped when combined with exercise but not when done without.

The Survival Doctor's Guides to Wounds and BurnsThis brings up the issue of risk versus benefit. Neck adjustments do present a rare risk of stroke. And if you’re not really benefiting, the questions is whether even a minimal risk is too high.

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What Are the Risks of Chiropractic Treatment?

Other than the rare risk of stroke from neck adjustments, the other risks of chiropractic adjustment are minimal—usually some soreness. If something isn’t improving, there is a risk of missing another diagnosis, so you should see your primary-care provider.

What’s My Opinion?

I recommend chiropractic adjustments for many of my patients with:

  • Low-back pain, especially sacroiliac-joint dysfunction, which occurs where the hip and back join together. It can be hard to treat.
  • Neck pain that doesn’t respond to conventional therapy.

Many people have poor posture or habits, and I’ve found chiropractic treatment is one of the ways the resultant problems can be addressed.


ANDREA E. GORDON, M.D.,
is a board-certified family doctor practicing integrative medicine and teaching at Tufts University Family Medicine Residency at Cambridge Health Alliance in Malden, Mass. She’s also an assistant professor of family medicine at Tufts University School of Medicine.

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Original version appeared in September/October 2006 edition of My Family Doctor magazine. This general health-care information is not meant as individual advice. Please see our disclaimer.

  • Jason

    I just had my 1st Chiropractic neck and spine adjustment today. After reading all of this I am frankly scared. But I have some kind of Undiagnosed (In 7 years 4 rheumatologists,5 PCP’s, an oncologist and 2 dermatologists) Auto immune disease or so they say. I have even been to Baylor College of Medicine and no luck. Just take these drugs and you’ll be fine. I AM NOT FINE! I am 37 years old and have always been in athlete shape. No I mean professional athlete shape. After all the prednisones and different drugs they have tried on me within a year I have gotten completley out of shape and become progressivly worse. What do you people want us to do just sit here suffer and die?? I have a condition thats called erythema nodosum. there are roughly 38 causes for it. If doctors were so ready to help us get better than why out of all those doctors they have only tested me for 7 of the things that cause this. Wow way to think outside of the box docs. LOL . But you dont have a problem prescibing us multiple side effect drugs, but cant do some simple tests. WOW. How can you prescribe us drugs for a condition that you dont even know what it is?? The last straw was Methotrexate. You have to be either smoking crack or a mental patient if you think Im going to take some low dosed chemo therapy drug that causes Lymphoma cancer as a side effect when you truthfully haven’t even done your due diligence. Maybe if these doctors didnt treat us like numbers and actually tried to solve the problem, we wouldn’t have to go to alternative measure to try to find out what the heck is wrong. How would one of these doctors feel if it was their child or parent that was being overlooked like that. Canada???? Ha I’m an American and your both trying to kill us all. How is it that 2 superpowers countries have a worse medical system then say a small country like Cuba?? Why do we have to go to different countries to figure things out that our oh say great countries doctors can?? You mean to tell me that you can send a rover to mars and find a way to split an atom to blow up an entire civilization off the planet but you cant figure out how to cure arthritis and erythema nodosum nodules??? Really? I’m sure if President Obama was in the same positions as us you would have a diagnosis and a solution immediatley. Hell look at Magic Johnson and HIV in the 1980′s. I’m just saying. We trust our doctors from the jump, but as with any bad relationship, you keep violating our trust over and over we are gonna look at you apprehensivly. If your a doctor reading this….Help your patients spend more time trying to heal them. Sometimes the solution is simple but overlooked. Look up human nature because alot of the problems doctors are having with people is a Human nature response to not being cared for properly. I know its about money but dam…If you cant give your patients adequate care than you need to cut some of those patients and send them to another doctor so you can spend more time helping figure their health out and less time in the Bahamas. So you lost $50,000 dollars for the year doing that. You made $400,000 already youll be fine. And best of all you can leave this planet knowing you truly helped people. Not shoveled them thru like sheep!!

  • Claudia Abela

    I have been suffering from severe lower back pain, which is not physical such as “lifting somethint to heavy”. It’s deep inside and hurts the worst when at rest or laying on my back even on my side. It appears but not my medical opinion (since i have no medical background) to be ankylosing spondylitis. But doctors keep giving me the run around and only shoving drug after drug in my face. granted, Itake the drugs for relief, as the pain is so strong.Keep in mind, I tolerate pain a great deal becasue i don’t trust many doctors and i fear meds, because of their long list of adverse side effects. So i reason, deal with the one pain, than with the 10 other ailments i’ll get with meds…but at this point i very willingly take meds because of this unbearable pain! But still fearing what will happen to me next because of side effects!!! Help?

    • Vikram

      Hi Claudia,
      I suggest you to visit a Chairo, I was suffring from back pain from last 20 years and have seen lot doctors but midical science’s ablity to correct skeltal imbalances is only seems dependent on some streaching excercises or muscle relaxnt’s , I have seen visibile changes in my body structure and much more releived from my chronic pain for first time in life only after 4 visits to chairo. hope it will help
      if you want more information do contact me my email is vikramgupta.in@gmail.com

      • Claudia Abela

        Thank you for your valued opinion. I actually did see a chiropractor- and my pain has decreased dramatically. My onlu hurdle or hardship now is that insurance doesn’t pay for it…we are too poor to continually pay for those services. I guess it all can’t be fixed huh. The government quickly covers meds and surgeries, but preventative care which has been proven to work doesn’t get covered. If it is not one thing it’s another. I thank you for taking the time to reply. Please enjoy the rest of your day.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      All drugs, herbs or anything that affects the body has some potential side effects. You always have to weigh the risks vs benefits. Perhaps you could join an internet support group, try physical therapy, or a chiropractor.

      • Claudia Abela

        I definitely will try those avenues. Thank you so much.

  • Keith Pinster

    I’ve been going to Chiros for 35 years. I have experienced bad ones and excellent ones. I have a twisted T-5 (yes, I’ve seen the x-rays) in my middle back and a herniated disk in my lower back. When I do something stupid and throw my back out, it can get bad enough that I am crawling between my bed and my chair. So far EVERY medical dr that I’ve gone to gives me pain meds and muscle relaxers. It takes several days just to get me back on my feet. With my current chiro, 1 visit will get me back on my feet and it usually takes about 3 to clear it up completely. Pain meds are great for covering up the pain, but it does nothing to actually fix the problem. Why would an MD think that masking pain was a valid way to healing? Plus, let’s ask, are there side effects to pain killers like Vicodin? Why do you think they are so regulated? For my pain management, I am only allowed 20 in a 6 MONTH period. That’s not even 1 a day. Are their side effects to adjustments by Chiros? Yes, I CAN WALK AGAIN!

    Don’t get me wrong, I know there are bone-poppers and quacks out there, just like in every other profession in the world (including MDs), but judging the entire practice based on a few bad practitioners is throwing the baby out with the bath water.

    • Claudia Abela

      WELL SAID!!!!!!!!!

  • Guest

    What makes chiropractic doctors different from conventional doctors is that they don’t diagnose you with a condition and therefore you can never really be “cured” of anything. The necessity of seeing a chiropractor and the benefits of the treatment are entirely subjective, which means the patient is actually acting in the role of the doctor. Personally, I have seen a chiropractor for back pain and found the adjustments to be beneficial in the same way that massaging a Charlie Horse is beneficial to a leg cramp. But I don’t consider massage therapists to be doctors and I don’t think seeing a chiropractor is ever necessary for good health.

  • X_mayor

    Nick Fousner is right. Chiropractic adjustment such as QSM3 and NUCCA chiropractic techniques by Russell Friedman of Alternahealth Solutions cost me and my daughter of almost 5k. After a couple of months of treatment nothing happened. I would give credit though to the muscle work or the type of massage I paid separately from 5k which was administered by Greg did help to manage the pain we have fom time to time during the treatment period. The PhD Friedman, upon learning we are discontinuing the treatment because I no longer have available funds became rude and never spent longer time than usual “adjusting” my neck by making the clicking sound of his wrists even though I still have 3 prepaid visits in my plan. That proves our point, chiropractic practice is not real alternative medicine. My mother’s old age alternative meds of boiling green tea leaves work better without costing 5k! It was also unfortunate that this PhD of Chiropractic medicine cannot be exposed of his malpractice because he is not a medical doctor. It also explains why he is not in any type of medical insurance. If we could only utilize the person doing the muscle work whenever we need the type of massage he does will be of great help to us in managing the pain without taking pills, which is what alternative medicine is all about.

  • Rick Edwards DC

    Here’s some interesting information, I don’t have the exact time line , mid 1950s I believe when MDS formed a “Board of quackery” specifically aimed at eliminating Chiropractic. They were subsequently taken to court by a group of 5 Illinois Chiros who soundly defeated their efforts. Obviously if Chiropractic didn’t work the efforts by the AMA would have run them out a long time ago as they tried to do. There are about 110,000 deaths/year by what are called “Real doctors” (MDS) and in my 20 years of practice have heard of one by a chiro Most people come to see me because the MDS have failed to do anything with their pain, chronic or acute. To Mr Fousner I would say this, I recently treated a patient who was promised by an MD that her post hepatic neuralgia pain would be relieved by a 110,000$ spinal stimulator. It failed, MISERABLY she then drove 7 hours to see me and within a week I gave her at least 50% relief and this was after 3 years, 2 pain specialists & hundreds of thousands of YOUR tax dollars in medicare being taken by this doctor not doing anything for her. Funny thing is people will let an MD do that and go right back to them but if a chiro did anything like cost you a few hundred dollars we then are all black balled. Now you ran into a bad Chiro, don’t try and tell me you’ve never run into a bad MD. I have a treatment which is very effective in treating chronic pain, including fibromyalgia, which by the way the mayo clinic refused to treat on a specific patient of mine who came to me afterwards and who is now 80% improved. does that patient care what any study says ? No she just lives a better life and that my friend is what being a doctor is all about MD, DC, DO or DOM

    • Claudia Abela

      I recently reported an MD for prescribing meds for GERD- which I had no symptoms of, but yet did not address current issue, an inflammed pancreas. As i understand it, when problems with pancreas, it must be assesed immediately! Damage to the pancreas occurs fast, and then it is too late! Now i have 2 MD’s who both disagree with each other regarding my issue now, severe lower back pain…one says put heat, the other says heat is bad, place ice. They both give me different meds. AND they both say it is just muscle spasm…thsi is my body, I know what I feel, and it is not a spasm (have had that before). No x-rays orderd, no MRI’s ordered…etc… Again, if it happens to be a herniated disc (what will be my damages for untreated), what if it is a pinched nerve (i will have severe nerve damage- and in some case paralization) or if it is ankylosing spondylitis, i face the possibility of fusion!

  • Damon

    Close but not quite. Neck adjustments add no more risk to a stroke than going to a hair salon or sitting in an MD’s office waiting for them to return. The point is, there is no proof in the cause of strokes and any association is still at 1 in 5 million adjustments.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Damon, I don’t think you could say it was as safe a sitting in a waiting room or going to a hair salon. As with all treatments and risks, patients need the most current knowledge so they can make their own decision. And the final decision on how much risk for neck adjustments is still out. That’s mostly due to not knowing whether the manipulation actually caused the stroke or the person was going to have it anyway. Various studies have the risk at anywhere from 1 in 400,000 to, yes, 1 in 5 million. So, I think Dr. Gordon’s statement that there is a “rare risk of stroke” from neck manipulations is spot on.

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  • Bill Kleinsturn

    Thank you, Dr. Gordon. I also found your article to be fair and fact based.

  • Nick Fousner

    Seems to me that Medical Doctors is based on scientific facts, where Chiropractors are more on “belief”. I found this out when I went to a DC for some back pain and he told me I had to come in three times a week for two months.

    Plus, he said I should “detox” and sold me additional supplements. After a week an a half and several hundred dollars down the drain I stopped going. I knew I had been taken.

    I should have seen the clues when throughout the first appointment all he kept saying was that MD’s were no good. Seemed like I was at a timeshare sales meeting. And yes, I guess I was sold and “idea” rather then solutions.

    A quick visit to my regular doctor, paid my $15 co-pay and followed his recommendations and a week an a half later, pain is gone.

    Sorry, but I WAS a believer, now I’ll just stick to real science.

    • Keith Pinster

      I’m curious — have you ever heard of “malpractice insurance”? Why do you suppose dr. need to buy this? Is it because they are all absolutely perfect in their work? Have you ever been to a DMV where you witnessed someone not doing their job? How is it that you think you can judge the entirety of Chiropractic based on a single dr.? Do you really think that just because you happened to encounter a bad one, that every other one must be bad? Have you ever encounter a belligerent black person? And, if so, do you just assume that all black people are a-holes? If you do that with race, you are a racist. What is it called when you do that with a profession?

    • Damon

      WOW, you werent taken, just an idiot. You really think you can get fixed in 12 days? You failed, not the DC.