A D.C. is a Doctor of Chiropractic, a licensed healthcare professional who specializes in diagnosing and treating problems with the musculoskeletal and nervous systems. The “D.C.” after someone’s name means they completed a doctoral-level chiropractic program, passed a four-part national board exam, and hold a state license to practice. While they carry the title “doctor,” their training, scope of practice, and approach to treatment differ significantly from a medical doctor (M.D.) or osteopathic doctor (D.O.).
What a D.C. Actually Does
Chiropractors focus primarily on pain and dysfunction in the back, neck, and joints. The core philosophy behind chiropractic care is that the body has a built-in ability to heal itself, and that proper alignment of the spine supports that process. In practice, this means most of what a D.C. does centers on hands-on treatment of the spine and surrounding muscles.
The signature technique is spinal manipulation: the chiropractor uses their hands or a small device to apply a controlled, quick thrust to a specific joint in the spine. You may hear a popping sound during this, which is simply gas releasing from the joint fluid. This is different from spinal mobilization, a gentler technique that stays within the joint’s natural range of motion and doesn’t involve a thrust. Most chiropractors use both approaches depending on the patient and the problem.
Beyond spinal adjustments, many D.C.s also provide soft tissue therapy, corrective exercises, ergonomic advice, and lifestyle counseling related to posture and movement. They treat conditions like low back pain, neck stiffness, tension headaches, sciatica, and certain types of joint pain. Some also work with athletes on injury prevention and recovery.
Education and Board Exams
Becoming a D.C. requires completing an undergraduate degree (or at minimum the prerequisite science courses) followed by a four-year Doctor of Chiropractic program at an accredited college. The curriculum covers anatomy, physiology, pathology, microbiology, chemistry, radiology, and diagnosis. A published comparison of chiropractic and medical school curricula found the two are “more similar than dissimilar” in basic science subjects and time spent on each. The key difference is what comes after: medical students go on to residency training in hospitals, while chiropractic students complete supervised clinical rotations within chiropractic settings.
Before getting licensed, graduates must pass all four parts of the National Board of Chiropractic Examiners (NBCE) exam. Part I covers foundational sciences like anatomy, physiology, and pathology. Part II tests diagnostic skills, imaging interpretation, and chiropractic principles. Part III presents clinical scenarios requiring the student to work through a full case, from patient history to diagnosis to treatment planning. Part IV, added in 1995, is a hands-on practical exam where candidates demonstrate physical examination skills, read imaging like CT scans, and perform adjustment techniques on real patients.
Specializations Within Chiropractic
After earning a D.C. and entering practice, chiropractors can pursue board-certified specialties through additional training and examinations. The American Board of Chiropractic Specialties recognizes credentials in sports medicine, pediatrics, neurology, radiology, clinical nutrition, rehabilitation, occupational health, and acupuncture, among others. A chiropractor with a sports medicine diplomate, for example, has completed postgraduate coursework specifically in athletic injuries and performance, on top of their general chiropractic training.
How a D.C. Differs From an M.D.
The most important distinction is scope of practice. A D.C. cannot prescribe medications, perform surgery, or admit patients to a hospital. Their treatment approach is drug-free and non-surgical by design. A medical doctor or osteopathic doctor has a broader scope that includes prescribing drugs, ordering any type of diagnostic test, and performing invasive procedures.
Diagnostic authority also differs, and it varies by state. Many states allow chiropractors to order X-rays and, in some cases, MRIs. However, under Medicare rules, X-rays used in chiropractic treatment must technically be ordered by a medical doctor or osteopath, so a chiropractor would refer you to a radiologist or your primary care physician to place the order. In private insurance, the rules depend on your state and plan.
Some states designate chiropractors as primary care providers for certain insurance purposes, meaning your plan may allow you to see a D.C. as a first point of contact without a referral. Kentucky, for instance, requires health plans that include chiropractic benefits to allow licensed chiropractors to serve as participating primary chiropractic providers. But in most practical settings, a D.C. functions as a specialist for musculoskeletal complaints rather than as the doctor managing your overall health.
What the Evidence Shows
Spinal manipulation has the strongest research support for low back pain. Studies show it can produce small but meaningful improvements in both pain and physical function for acute and chronic cases. For chronic neck pain, a 2019 review of 47 trials involving over 4,400 people found that spinal manipulation or mobilization may reduce pain and improve function. A 2020 review also found that manipulation can reduce the frequency and intensity of cervicogenic headaches, the type of headache that originates from a problem in the neck.
The National Institutes of Health continues to study the mechanisms behind these effects, including research comparing how spinal manipulation and mindfulness training each influence pain processing in the body.
Safety and Side Effects
Mild side effects from spinal manipulation are common. Two large prospective studies found that 30% to 61% of patients experience temporary soreness, stiffness, or discomfort after treatment. These effects are generally short-lived, often resolving within a day or two.
Serious complications are rare but real. The most concerning risk involves manipulation of the upper spine (the neck), which in rare cases has been linked to vertebral artery dissection, a tear in one of the arteries leading to the brain that can cause a stroke. Over 200 cases of serious harm have been documented in case reports. Chiropractor associations have estimated the rate of serious events at roughly 6.4 per 10 million upper spine manipulations, but researchers have noted that under-reporting may be close to 100%, making reliable statistics difficult to pin down. If you have vascular risk factors or a history of stroke, this is worth discussing before starting neck manipulation.
What to Expect at a First Visit
A typical first appointment with a D.C. involves a health history, a physical exam focusing on your spine and posture, and possibly orthopedic or neurological screening tests like checking your reflexes and range of motion. Some chiropractors take X-rays at this visit, while others only order imaging if they suspect a specific structural issue.
After the evaluation, the chiropractor will explain their findings and propose a treatment plan. This usually involves a series of visits, often two to three times per week initially, tapering off as symptoms improve. Each session typically lasts 15 to 30 minutes. Some people feel relief after the first adjustment, while others need several sessions before noticing a difference. If your condition doesn’t improve or falls outside the chiropractor’s scope, a D.C. can refer you to a medical doctor or specialist for further evaluation.