A chiropractor is a licensed healthcare provider who specializes in diagnosing and treating problems with the spine, joints, and muscles. Most people visit one for back pain, neck pain, or headaches. Chiropractors use hands-on techniques, primarily spinal adjustments, to restore joint mobility, reduce pain, and improve function without surgery or medication.
Core Focus: Spine and Musculoskeletal Care
Chiropractic care is built around the spine. Across legislation, education, and clinical practice worldwide, spine care is the defining focus of the profession. A national survey by the National Board of Chiropractic Examiners found that spinal complaints account for about 54% of the conditions chiropractors see, followed by extremity problems like shoulder or knee pain (17%) and headaches or facial pain (12%).
While some chiropractors take a broader wellness approach, the profession’s identity has been shaped by its expertise in spinal and musculoskeletal disorders. That means chiropractors spend most of their time working with people who have pain or stiffness in their back, neck, shoulders, hips, or joints.
What Happens During a Visit
Your first appointment looks a lot like visiting any other healthcare provider. The chiropractor will take a detailed health history, ask about your symptoms, and perform a physical exam. Depending on your situation, they may include orthopedic or neurological tests to pinpoint the source of your pain. Some chiropractors order X-rays or refer you for imaging if they suspect something beyond a routine musculoskeletal issue.
After the evaluation, the chiropractor explains what they’ve found and lays out a treatment plan. This typically includes how many visits they recommend and what techniques they’ll use. Treatment often begins during the first visit.
The Adjustment
The centerpiece of chiropractic care is the spinal adjustment, sometimes called spinal manipulation. The chiropractor uses their hands to apply a quick, controlled force to a specific joint. This is known as a high-velocity, low-amplitude thrust. The goal is to restore normal movement to a joint that’s stiff or misaligned. You’ll often hear a popping sound during the adjustment, which is simply gas releasing from the joint fluid.
Not every chiropractor uses the same approach. Some use instrument-assisted techniques, such as the Activator Method, which delivers a quick, low-force impulse through a handheld device. Because the instrument moves faster than the body can tense up in response, it can be effective for patients who prefer a gentler approach or who have conditions that make manual adjustments less appropriate. The force is highly localized and doesn’t require twisting or bending the joint into extreme positions.
Beyond the Adjustment
Most chiropractors do more than adjust your spine. Many incorporate soft tissue therapies like massage or myofascial release to loosen tight muscles around problem areas. Therapeutic exercises are a growing part of chiropractic care. Your chiropractor may prescribe a home exercise routine designed to strengthen supporting muscles, improve flexibility, and prevent your pain from coming back. Research shows that combining spinal manipulation with exercise produces better outcomes than either approach alone, particularly for chronic neck and back pain.
Conditions With Good Evidence
Chiropractic care has its strongest evidence base for a handful of common musculoskeletal problems. Spinal manipulation is an effective option for acute, subacute, and chronic low back pain. It’s also effective for acute and subacute neck pain, and for chronic neck pain when combined with exercise. For whiplash injuries, manipulation paired with exercise has shown effectiveness during the acute phase.
The evidence for headaches is more specific. Spinal manipulation works well for migraines and cervicogenic headaches (headaches that originate from the neck), but the evidence for tension-type headaches remains inconclusive. Beyond the spine, chiropractic treatment has shown effectiveness for shoulder girdle pain, frozen shoulder, tennis elbow, hip and knee osteoarthritis, kneecap pain, and plantar fasciitis.
For nonmusculoskeletal conditions, the evidence is thin. The one exception is cervicogenic dizziness, a type of dizziness triggered by neck problems, where spinal manipulation has positive support. Claims about chiropractic care treating conditions like asthma, allergies, or digestive issues don’t have reliable evidence behind them.
Where Chiropractic Fits in Healthcare
The American College of Physicians recommends non-drug treatments, including spinal manipulation, as a first-line approach for low back pain before turning to medication. This puts chiropractors in a natural role as what some healthcare systems call “primary spine practitioners,” providers who handle spine-related pain using the conservative approaches that guidelines recommend trying first.
Chiropractors typically practice independently, but a growing number work within multidisciplinary teams alongside physicians, physical therapists, and other providers. In these settings, patients are often referred to a chiropractor by a primary care doctor or nurse practitioner for problems like chronic neck tension, headaches, or repetitive strain injuries. Outside of these collaborative environments, communication between chiropractors and medical doctors is often limited, which can lead to fragmented care. If you’re seeing both a chiropractor and a physician, it’s worth making sure they’re aware of each other’s treatment plans.
Safety and Side Effects
Most side effects from chiropractic adjustments are mild and temporary. Studies show that 30% to 61% of patients experience some kind of reaction after treatment. The most common ones are local soreness (15%), headache (20%), stiffness (20%), radiating discomfort (12%), and fatigue (12%). These typically resolve within a day or two.
Serious complications are rare but have been documented. The most concerning is vertebral artery dissection, a tear in an artery running through the neck, which can lead to stroke. Over 200 cases have been reported in the medical literature, but the actual incidence rate remains unknown. Chiropractor estimates put the risk at roughly 6.4 per 10 million manipulations of the upper spine and 1 per 100 million for the lower spine. The risk is highest with neck adjustments, which is one reason some practitioners use instrument-assisted methods or mobilization techniques for the cervical spine instead of high-velocity thrusts.
Education and Licensing
Chiropractors earn a Doctor of Chiropractic (DC) degree, which requires at least three years of undergraduate study followed by three and a half to five years of graduate-level training. Accredited programs require a minimum of 4,200 instructional hours covering three phases: basic sciences like anatomy, biochemistry, and physiology; clinical and chiropractic sciences; and supervised clinical internships where students treat real patients under the guidance of licensed chiropractors.
After graduating, chiropractors must pass a four-part national board exam administered by the National Board of Chiropractic Examiners. Most states require passing scores on all or part of this exam, plus a state-level test covering that state’s specific scope of practice rules. Licensing also involves a criminal background check and personal references. All but one state requires chiropractors to earn continuing education credits each year to keep their license active.