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Chiropractic

By Steven Novella, MD, Assistant Professor of Neurology, Yale University School of Medicine

In chiropractic, the relationship between the structure of the spine and the function of the nervous system is seen as key to maintaining or restoring health. The main method for correcting this relationship is spinal manipulation. Chiropractors may also provide physical therapies (such as heat and cold, electrical stimulation, and rehabilitation strategies), massage, or acupressure or recommend exercises or lifestyle changes. They may recommend ways that people can rearrange things in their work environment to make them easier and safer to use (ergonomic changes). Such changes can help prevent problems such as back pain.

Some chiropractors (called straight chiropractors) believe that a nonphysical, scientifically inaccessible life force unites mind and body, interconnects all living beings, and is the underpinning of health (called vitalism). They use spinal manipulation to correct supposed misalignments in the backbones (vertebrae) in an attempt to restore the flow of this life force. These chiropractors believe that this method can heal most disorders. Other chiropractors reject this belief. Some use only therapies based on scientific evidence, and some use a mixture of various therapies.

No scientific evidence supports the existence of a universal life force.

Medicinal claims

Chiropractic is being actively studied. Problems treated by chiropractic include low back pain, various headache disorders (although effectiveness is not always clear), neck pain, and pain caused by compressed nerves.

Past clinical trials (studies to determine the safety and effectiveness of treatments in people) have shown chiropractic to be effective only for short-term relief of low back pain. Conventional medical practice guidelines include chiropractic as a treatment option for sudden low back pain that persists despite measures people take on their own. Treatments continued beyond 3 months may not provide added benefit.

Did You Know...

  • Chiropractic has been shown to be effective only for short-term relief of low back pain.

The usefulness of manipulation for conditions not directly related to the musculoskeletal system (such as asthma, colic, and ear infections in children) has not been established. The few studies that have been done suggest that manipulation is not effective for these disorders.

Possible side effects

Serious complications resulting from spinal manipulation, such as low back pain, damage to cervical nerves, and damage to arteries in the neck, are rare. Other side effects may include discomfort, headache, and fatigue, which usually disappear within 24 hours. Spinal manipulation is not recommended for people who have any of the following:

  • Symptoms of nerve damage or malfunction (neuropathy), such as loss of sensation or strength in one or more limbs

  • Previous spinal surgery

  • Blood vessel disorders

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