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Chiropractic Science and Safety

Chiropractic is not pseudoscience, it is a licensed, evidence-based healthcare profession grounded in anatomy, biomechanics, and neurophysiology, with randomized trials and guideline endorsements. The 1987 Wilk v. AMA antitrust decision documented a long-standing, anti-competitive campaign against chiropractic which is why misconceptions persist. Safety data are equally clear: chiropractors have among the lowest malpractice premiums in healthcare, and large population studies show no excess risk of vertebrobasilar stroke compared with visits to primary-care physicians. Coupled with a growing body of peer-reviewed research, the record affirms chiropractic as a legitimate, safe, and scientifically supported avenue of care.

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Chiropractic: Science and Safety

Chiropractic has often been misunderstood and unfairly labeled as “pseudoscience,” leading many to ask questions like, “Are chiropractors real doctors?” and “Is chiropractic safe?” In reality, chiropractic is a licensed healthcare profession grounded in science and focused on the relationship between the spine and the nervous system. This comprehensive review will present evidence to dispute the claim that chiropractic is pseudoscience and highlight the strong safety profile of chiropractic care. We draw on high-quality research and historical facts to demonstrate that chiropractic is both scientifically sound and remarkably safe. The discussion is divided into two parts: (1) Scientific Foundations of Chiropractic, and (2) Chiropractic Safety Profile.

Chiropractic was founded in 1895 by D.D. Palmer and has since grown into a licensed healthcare field, with practitioners designated as Doctors of Chiropractic (D.C.) after extensive graduate training. Far from being fringe, chiropractic is now “largely mainstream” in the U.S. health care spectrum journalofethics.ama-assn.org. Chiropractors are licensed in all 50 states and many countries, and insurance companies (including Medicare and private health plans) routinely cover chiropractic services. In fact, health insurers – who are highly cost-conscious – have found value in chiropractic care and include it in plans, which indicates its legitimacy and effectiveness. Studies show that most U.S. insurance plans provide at least partial coverage for chiropractic, and adding chiropractic benefits can reduce overall healthcare expenditures pmc.ncbi.nlm.nih.gov. For example, a large study of over 1.7 million health plan members found that those with chiropractic coverage had lower annual healthcare costs (including 13% lower medical costs for back-pain patients) and fewer costly interventions like spinal imaging or hospitalization pmc.ncbi.nlm.nih.gov. This cost-effectiveness is one reason insurers continue to reimburse chiropractic – if chiropractic were “not real” or ineffective, insurance companies would be the first to refuse payment.

Chiropractic’s journey to mainstream acceptance was hard-fought. Notably, the 1987 Wilk v. AMA trial exposed how the American Medical Association (AMA) had for decades engaged in a campaign to label chiropractic as an “unscientific cult” and to “contain and eliminate” the chiropractic profession. In that antitrust case, federal judge Susan Getzendanner found the AMA guilty of conspiring to destroy chiropractic competition in violation of the Sherman Act. Internal AMA documents revealed that the campaign against chiropractic was driven not purely by concerns over science, but by a desire to reduce competition for financial reasons journalofethics.ama-assn.org. The AMA’s so-called Committee on Quackery, active until the late 1970s, sought to marginalize chiropractors and other “irregular” practitioners in order to maintain the medical profession’s monopoly and profits journalofethics.ama-assn.org. This medical opposition was not because chiropractic lacked science – indeed, the trial judge noted that the evidence did not prove chiropractic to be invalid – rather, the AMA’s actions were anti-competitive. As a result of the Wilk v. AMA case, the AMA was forced to abandon its ethical ban on associating with chiropractors. The lawsuit stands as a historical testament that chiropractic was suppressed by the medical establishment for decades despite its benefits, and once those artificial barriers were removed, chiropractic care became an accepted part of the healthcare system. In short, the “pseudoscience” label was unfairly imposed on chiropractic for competitive reasons, not due to a lack of scientific basis

Scientific Evidence Supporting Chiropractic Care

Modern chiropractic is firmly grounded in science, particularly in anatomy, neurology, and musculoskeletal medicine. Chiropractors specialize in spinal adjustments with the goal of correcting misalignments or abnormal movements in the spine – traditionally termed “vertebral subluxations.” Far from a mystical concept, a vertebral subluxation has been defined in scientific literature as “a self-perpetuating central segmental motor control problem…resulting in ongoing maladaptive neural plastic changes that interfere with the central nervous system’s ability to self-regulate, adapt, repair, and heal” nature.com. In simpler terms, a spinal joint that isn’t moving correctly can upset normal nerve signaling. Chiropractic adjustments aim to restore proper motion and communication in the nervous system, allowing the body to regulate and heal itself more effectively nature.com. This principle aligns with a holistic view of health – rather than just treating symptoms with drugs or surgeries, chiropractic seeks to address the root cause by improving nervous system function naturally.

Neurophysiological Effects: The Spine–Brain Connection

One of the most compelling areas of research in chiropractic is neurophysiology – how spinal adjustments affect the nervous system and brain function. A growing body of studies (including trials using techniques like EEG and fMRI) show that chiropractic adjustments do produce objective changes in the central nervous system. For instance, research has demonstrated that chiropractic alters afferent input from the spine, leading to changes in brain function and neural plasticity nature.com. By stimulating receptors in dysfunctional spinal joints, an adjustment can modulate pain processing pathways and improve communication between the body and brain nature.com.

Multiple experiments have shown improved sensorimotor integration after chiropractic care – meaning patients have better joint position sense, balance, and muscle control post-adjustment nature.com. For example, studies documented that chiropractic enhances muscle strength and cortical drive (the brain’s control of muscles) as well as proprioception (awareness of body position) nature.com. Such findings reinforce the chiropractic tenet that spinal health affects overall nervous system health. A systematic review published in 2020 concluded that there are indeed changes in brain function in response to spinal adjustments – including activation of pain inhibitory pathways pubmed.ncbi.nlm.nih.gov chiromt.biomedcentral.co. The evidence, while still evolving, indicates that chiropractic adjustments are not simply placebo or “cracking bones,” but rather have real, measurable neurophysiological effects on the central nervous system that can help explain many of the clinical benefits observed.

Clinical Research: Pain Relief, Blood Pressure, and Quality of Life

Chiropractic is best known for treating musculoskeletal pain (like back or neck pain), and numerous high-quality studies have confirmed its efficacy for pain relief and improved function. For low back pain – one of the most common and costly health problems – chiropractic has proven effective in both research trials and clinical guidelines. For instance, the American College of Physicians’ clinical guideline recommends spinal adjustments as an appropriate first-line treatment for acute and subacute low back pain, alongside other non-drug therapies aafp.org. This guideline, published in Annals of Internal Medicine and endorsed by medical organizations, was based on evidence that spinal adjustments can provide at least mild to moderate improvement in pain and function for low back pain patients aafp.org. Similarly, a 2018 series in The Lancet on low back pain emphasized reducing drug use and noted that chiropractic is a useful component of care for most patients aafp.orgaafp.org. Beyond back pain, research supports chiropractic care for neck pain, headaches (e.g., cervicogenic headaches), and other musculoskeletal conditions – often showing outcomes comparable to standard medical care but with higher patient satisfaction and without the side effects of medications.

 

Chiropractic’s benefits may also extend beyond just pain relief. Exciting research has suggested systemic improvements from certain chiropractic interventions. A notable example is a placebo-controlled clinical trial on hypertension published in the Journal of Human Hypertension. In this study led by an M.D. hypertension specialist, 50 patients with high blood pressure and misalignment of the C1 vertebra (atlas) either received a specialized upper cervical chiropractic adjustment or a sham procedure. The results were remarkable: after a single precise atlas adjustment, patients saw an average drop in blood pressure equivalent to taking two different blood-pressure medications simultaneously uchicagomedicine.org. Both systolic and diastolic pressures decreased significantly and the improvements persisted for at least 8 weeks, with no significant change in heart rate uchicagomedicine.org. The lead author, Dr. George Bakris of the University of Chicago, stated, “This procedure has the effect of not one, but two blood-pressure medications given in combination” sciencedaily.com uchicagomedicine.org. Such a result underscores that chiropractic adjustments can have real physiological effects – in this case potentially improving cardiovascular health via neurovascular mechanisms uchicagomedicine.org. While more research is needed to generalize these findings, this study provides proof of concept that chiropractic’s impact on the nervous system may influence functions like blood pressure regulation, offering a natural complementary approach to managing hypertension.

Chiropractic care has also been associated with improvements in overall well-being and quality of life, beyond just symptom relief. Because chiropractors often take a holistic approach – addressing lifestyle, exercise, and nutrition along with spinal health – patients frequently report enhanced wellness. A recent clinical trial (published 2024 in the journal Brain Sciences) investigated outcomes like mood, sleep, and life quality in patients receiving chiropractic care. After four weeks, the chiropractic group showed significantly improved health-related quality of life compared to a control group mdpi.com. Patients had meaningful reductions in pain as well as decreases in anxiety, depression, and fatigue scores, and these improvements reached clinically important levels mdpi.com. The authors noted that many health benefits of chiropractic care likely stem from the brain and neuroplastic changes induced by adjustments, leading to better regulation of stress and pain responses mdpi.com. Furthermore, multiple studies have observed that chiropractic patients report high satisfaction and perceived improvements in overall health status. In national surveys, the majority of chiropractic users describe the care as effective, agree that chiropractors have their best interest in mind, and consider chiropractic treatment safe researchgate.net. In essence, beyond pain relief, chiropractic tends to improve patients’ function and quality of life – outcomes that matter greatly in healthcare.

Not Pseudoscience, but Scientifically Sound Holistic Care

The cumulative evidence from basic science, clinical trials, and patient surveys makes it clear that chiropractic is built on scientific principles. Spinal biomechanics and nervous system function are legitimate areas of medical science, and chiropractors have contributed extensively to research in these fields. Chiropractic care today is an evidence-based, integrative approach: it focuses on musculoskeletal alignment and nervous system health, employs diagnostics like X-rays or MRI when needed, and often works in tandem with medical practitioners (something that was forbidden decades ago but is now common). The “pseudoscience” stereotype is outdated. While like any field it has a range of practitioners and some historical debate, modern chiropractic is thoroughly invested in research and continuously refining its methods. For example, chiropractic researchers publish in high-impact journals on topics ranging from neuroplasticity to outcome cost-effectiveness. Governments and health organizations worldwide have recognized chiropractic as a legitimate health profession – indeed, the World Health Organization lists chiropractic as part of traditional and complementary medicine and encourages its integration for musculoskeletal conditions.

It’s worth noting that other once-skeptical observers have come around as the evidence has grown. Even within mainstream medicine, there is increasing openness to chiropractic: many physicians now refer patients for chiropractic care for back pain, knowing it can often help when conventional treatments fail. Insurance coverage and inclusion in guidelines further validate chiropractic’s scientific merit. And historically, recall that chiropractors were among the few “sectarian” practitioners who survived the 20th-century campaign of the AMA – not because of stubbornness alone, but because patients experienced real benefits that kept the profession alive until science caught up and corroborated many of its principles journalofethics.ama-assn.org. Natural, holistic approaches like chiropractic were indeed “beaten down by the medical model for profits” in the past journalofethics.ama-assn.org, but they have proven their worth. Today, chiropractic stands as a science-based, patient-centered form of care that offers effective solutions for pain and a pathway to improved wellness without drugs or surgery.

Part 2: The Safety Profile of Chiropractic Care

Just as important as effectiveness is the question of safety. Detractors sometimes claim that “chiropractic is dangerous,” often citing rare cases of stroke or injury. In this section, we dispel those fears with data, showing that chiropractic care has an excellent safety record – especially when compared to more invasive medical treatments. In fact, by multiple measures (malpractice rates, adverse event statistics, comparative risk analyses), chiropractic is one of the safest health interventions available.

Low Malpractice Rates and What They Indicate

One revealing indicator of safety in any healthcare field is the cost of malpractice insurance. Insurance actuaries set premiums based on risk: higher premiums mean a higher likelihood of claims (patient injuries) and larger payouts. Chiropractors consistently pay extremely low malpractice insurance premiums, especially relative to medical doctors. On average, a chiropractor’s malpractice insurance costs only a small fraction of what an M.D. must pay for comparable coverage. For example, it’s reported that chiropractic physicians pay about one-tenth (or less) the malpractice premiums of medical doctors take2healthcare.com. A typical chiropractor might pay around $1,500–$2,000 per year for liability insurance, versus tens of thousands of dollars for a primary care physician and upwards of $100,000 for high-risk specialists archetype.health. This huge gap exists because insurers have determined that the likelihood of a chiropractor seriously harming a patient is very low. If chiropractors were frequently causing strokes, paralysis, or other grave injuries, their insurance rates would skyrocket. But in reality, those outcomes are exceedingly rare (more on that below), and the insurance industry knows it. As one source aptly put it, “The medical community might be able to fool the public, but not the insurance companies. Bottom line: Chiropractic is very safe – especially when compared to the medical profession." In short, low malpractice premiums are an objective, dollars-and-cents affirmation of chiropractic safety.

Risk of Serious Adverse Events: Chiropractic vs. Other Treatments

No healthcare intervention is 100% without risk – however, the risks of chiropractic adjustments are extremely low, particularly in comparison to common medical treatments like drugs or surgery for the same conditions. The most common side effects from a chiropractic adjustment is mild and transient – like soreness which typically resolves within a few hours. These minor effects occur in a minority of patients and are comparable to the muscle soreness one might feel after starting a new exercise; they are not injuries so much as the body’s normal response to therapy.

Serious adverse events with chiropractic spinal manipulation – such as stroke (vertebral artery dissection), vertebral fracture, or nerve damage – are exceedingly rare. How rare? Extensive reviews and surveys provide perspective. A widely cited estimate by medical researcher Edzard Ernst (who has been critical of alternative therapies) concluded that the risk of a serious complication from cervical spine manipulation is between 1 in 400,000 to 1 in 2,000,000 treatments pmc.ncbi.nlm.nih.gov. Some analyses have placed the risk of stroke specifically on the order of 1 per 1–3 million neck adjustments pmc.ncbi.nlm.nih.gov. To put that in context, these odds are far lower than many routine medical interventions. For instance, long-term use of NSAID medications (like ibuprofen) carries a much higher risk of serious gastrointestinal bleeding – on the order of 1 in 1,000 patients pmc.ncbi.nlm.nih.gov. Cervical spine surgery for disc problems has a complication rate in the several-per-hundred range (multi-thousand per million) pmc.ncbi.nlm.nih.gov, and even cervical epidural injections carry risks of paralysis or stroke far higher than anything associated with a chiropractic adjustment. In comparison, chiropractic care’s risk profile is incredibly favorable, approaching that of activities like salon hair washing or exercising, which have similarly minuscule incidence of arterial injury.

The specific issue of stroke from neck adjustments has been carefully studied, and the findings debunk the notion that chiropractic adjustments cause strokes in any significant number. The concern involves vertebrobasilar artery (VBA) dissection, a rare kind of stroke that can present as neck pain. Some have noted that a person developing a VBA stroke might visit a chiropractor (or any doctor) for neck pain and then suffer the stroke, creating a false appearance that the treatment triggered it. A landmark, high-quality study published in the journal Spine examined 10 years of data and compared patients who had strokes to matched controls. The researchers found no greater risk of VBA stroke after seeing a chiropractor than after seeing a primary care physician pmc.ncbi.nlm.nih.gov. In younger patients (<45 years), stroke victims were slightly more likely to have had a healthcare visit (chiropractic or medical) for neck pain prior to the stroke, which suggests that the stroke was already in progress, causing neck pain, and led the person to seek care, rather than the care causing the stroke pmc.ncbi.nlm.nih.gov. The study’s conclusion was unambiguous: “We found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care... The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke.”pmc.ncbi.nlm.nih.gov. This evidence strongly implies that chiropractic neck adjustments are not a significant cause of stroke, and that unfortunate coincidences are to blame for past anecdotal claims. Indeed, neurologists note that spontaneous dissections can happen without any trauma at all, and trivial events (turning one’s head while backing up a car, for example) have precipitated such strokes in some cases. The bottom line: the probability of a catastrophic arterial injury from a skilled chiropractic adjustment is extremely low – on the order of being struck by lightning – whereas the benefits of relief from pain and restoration of mobility are well-documented for millions of patients.

When comparing chiropractic to other treatments for the same ailments, its safety advantage becomes even clearer. Consider low back pain: the main medical alternatives are pain medications (like NSAIDs or opioids) or surgeries (like discectomy or spinal fusion in severe cases). Opioid painkillers, in particular, pose massive risks – from addiction and overdose (the opioid crisis has made this tragically obvious), to side effects like respiratory depression and hormonal dysregulation. Chiropractic, by providing effective drug-free pain relief, can drastically reduce patients’ reliance on opioids. Recent studies have shown that patients with spinal pain who see a chiropractor are significantly less likely to fill an opioid prescription – one large study found a 50% reduction in odds of opioid use when chiropractic care was pursued pubmed.ncbi.nlm.nih.gov. Even more striking, a 2025 retrospective study of over 744,000 patients with sciatica found that those who initially received chiropractic care had 71% lower risk of experiencing an opioid-related adverse event (overdose, addiction, etc.) in the following year, compared to those who received usual medical care medicalxpress.com. They were also 32% less likely to be prescribed any opioids at all medicalxpress.com. In other words, chiropractic not only is safe on its own, but actively contributes to greater safety by reducing exposure to dangerous medications.

Surgery for back or neck pain, while sometimes necessary, carries well-known risks: infections, blood clots, nerve injury, failed back surgery syndrome, and even death in rare cases. The complication rates for spinal surgery can range from a few percent up to 20–40% in some fusion surgeries for complex cases. By contrast, the kinds of manual interventions chiropractors use have virtually no chance of such severe complications. It is far safer to undergo a course of chiropractic adjustments for most non-emergency back pain than to jump into surgery or long-term drug use. As one commentary noted, even everyday activities carry some risk (driving a car, taking aspirin), but all evidence indicates chiropractic is among the least risky of healthcare interventions take2healthcare.com. Chiropractic care is extremely safe.

Perspective: Non-Invasive, Conservative Care First

Healthcare experts increasingly emphasize starting with conservative care before more aggressive interventions. Chiropractic epitomizes conservative care – it is non-invasive and utilizes the body’s innate healing ability. The safety profile of chiropractic is comparable to that of physical therapy or massage, which are widely regarded as safe therapies. It’s telling that reported serious adverse events in chiropractic are so sparse that they often make news precisely because they are anomalies. Meanwhile, the daily toll of adverse events from common medical treatments (from GI bleeds due to NSAIDs to surgical mishaps) goes largely unremarked despite being statistically far more frequent.

To further ensure safety, chiropractors are trained to recognize red flags that indicate a patient needs referral or a different approach (for example, signs of fracture, infection, or severe neurological deficits). They do not hesitate to send a patient to an M.D. or the ER if something is outside their scope. Chiropractic and medicine work together to maximize patient safety – a far cry from the old days of antagonism. Many chiropractors also incorporate rehabilitative exercises, ergonomic advice, and lifestyle counseling to help patients heal and prevent recurrences, all of which carry no risk and plenty of benefit.

In summary, chiropractic is a safe option, particularly when compared to the alternatives for managing the same conditions. Its non-pharmacological, non-surgical nature means that the likelihood of serious harm is extremely low. Malpractice insurance data confirms chiropractors are in one of the safest professions. Large-scale studies find no excess risk of stroke or other catastrophic events due to chiropractic care. And by reducing reliance on riskier interventions like opioids or surgery, chiropractic actually serves as a protective approach in public health. The old adage in medicine, “First, do no harm,” aligns well with chiropractic philosophy – provide effective care with minimal risk. Chiropractic care lives up to that principle, offering patients relief with peace of mind about safety.

Conclusion

Is chiropractic pseudoscience? The clear answer, based on the evidence, is no. Chiropractic is grounded in anatomy and neurology, validated by research, and endorsed by a century of patient outcomes. It survived a concerted campaign by the AMA to discredit it, and emerged as a scientifically supported profession integrated into modern healthcare journalofethics.ama-assn.org. Chiropractors are indeed real doctors – not medical doctors, but Doctors of Chiropractic – with rigorous training in healing sciences and a focus on the musculoskeletal and nervous system. They deliver care that often succeeds where conventional medicine does not, particularly for chronic spine-related pain, all while emphasizing natural healing and patient empowerment.

Is chiropractic safe? Absolutely, and overwhelmingly so. By every measure, from low malpractice premiums to minuscule adverse event rates, chiropractic ranks as one of the safest healing arts pmc.ncbi.nlm.nih.gov. The risks of serious harm are extraordinarily low, especially when weighed against the much higher risks of the drug or surgical alternatives. Patients routinely undergo chiropractic treatment with nothing more than perhaps mild soreness, and far more often report significant improvements in pain, function, and quality of life. As the data shows, choosing chiropractic for back or neck issues can mean avoiding riskier interventions like opioids (and their devastating side effects) or surgeries that might have long recoveries.

In defending the chiropractic profession, we present facts that skeptics will find hard to ignore. Chiropractic care is supported by numerous high-quality studies – from cutting-edge neurophysiology research to randomized trials in top journals – demonstrating its efficacy in pain relief, physiological effects (such as blood pressure reduction), and enhancements in patients’ well-being uchicagomedicine.org mdpi.com. It operates on scientific principles of biomechanics and neurology, and it continues to evolve through research and evidence-based practice. Far from being an outlier, chiropractic resonates with today’s healthcare goals: provide effective care, avoid unnecessary drugs and surgeries, and focus on the whole patient for optimal health.

For those asking whether chiropractic is legitimate: the resounding conclusion is that chiropractic is a scientifically sound, safe, and valuable form of healthcare. Its blend of hands-on care, attention to the body’s structure-function relationship, and commitment to natural healing offers patients a powerful option in their health journey. As more people seek alternatives to a pill-for-every-ill medicine, chiropractic stands ready with over a century of experience and evidence to back it up. In light of the facts, the old doubts about chiropractic belong in the past. The modern chiropractor is not a rival to medicine, but a partner – providing care that is often safer, and just as effective, if not more, for many conditions. Chiropractic is here to stay, and both the science and safety record justify its growing role in contemporary healthcare.

References:

  1. Agocs, S. (2011). Chiropractic’s Fight for Survival. AMA Journal of Ethics, 13(6), 384-388. (Discusses the historical opposition by the AMA and the Wilk v. AMA case)journalofethics.ama-assn.orgjournalofethics.ama-assn.org

  2. Wilk v. American Medical Association, 671 F. Supp. 1465 (N.D. Ill. 1987). (Federal trial ruling that the AMA engaged in an illegal conspiracy to undermine chiropractic)en.wikipedia.orgen.wikipedia.org

  3. Munjal, S. et al. (2024). Neuroplastic Responses to Chiropractic Care: Broad Impacts on Pain, Mood, Sleep, and Quality of Life. Brain Sciences, 14(11), 1124. (Clinical trial showing improved quality of life, mood, and reduced pain after chiropractic care)mdpi.commdpi.com

  4. Haavik, H. et al. (2019). The effects of chiropractic spinal manipulation on central processing of pain (Scientific Reports 9, 2019). (Demonstrated that spinal adjustments modulate brain responses to pain)nature.comnature.com

  5. Bakris, G. et al. (2007). Atlas vertebra realignment and achievement of blood pressure control: a randomized pilot study. Journal of Human Hypertension, 21(5), 347-352. (Found significant blood pressure reductions from a C1 adjustment)uchicagomedicine.orguchicagomedicine.org

  6. News release – University of Chicago Medicine (2007). Special chiropractic adjustment lowers blood pressure among hypertensive patients with misaligned C1 vertebra. (Summarizes the above study’s findings equating the BP drop to two medications)uchicagomedicine.orguchicagomedicine.org

  7. Kazal, L. A. et al. (2017). ACP Practice Guideline on Noninvasive Treatments for Low Back Pain. American Family Physician, 96(6), 407-408. (ACP guideline recommending spinal manipulation as initial therapy for acute/subacute low back pain)aafp.orgaafp.org

  8. Cassidy, J. D. et al. (2008). Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. Spine, 33(4S), S176-S183. (Found no excess stroke risk from chiropractic vs. primary care; suggests patients with dissection were seeking care)pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov

  9. Church, E. (2016). The risk associated with spinal manipulation: an overview of reviews. Chiropractic & Manual Therapies, 24(1): 35. (Compiled data on adverse event incidence; estimated serious complications ~1 per 400k–million manipulations, strokes ~1 per 1.3 million neck treatments)pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov

  10. Take2 Healthcare. Is Chiropractic Safe? (Clinic article, 2020s). (Notes that MD malpractice premiums are at least 10 times higher than DC premiums, reflecting chiropractic safety)take2healthcare.comtake2healthcare.com

  11. Whedon, J. M. et al. (2018). Association Between Utilization of Chiropractic Services and Use of Prescription Opioids Among Patients with Low Back Pain. JAMA Network Open, 1(8): e185909. (Patients who saw a chiropractor had half the odds of opioid use for low back pain)pubmed.ncbi.nlm.nih.gov

  12. Trager, R. J. et al. (2025). Chiropractic spinal manipulation for sciatica and risk of opioid-related adverse events: a retrospective cohort study. PLOS ONE, 20(1): e0317663. (Chiropractic care for sciatica linked to 71% lower risk of opioid adverse events and 32% less opioid prescriptions)medicalxpress.commedicalxpress.com

  13. H.J. Ross Company (2023). Research Supports Chiropractic Care Benefits for Back Pain. (Highlights a 4-year study of 1.7 million health plan members: chiropractic coverage associated with lower overall healthcare costs and reduced back-pain related expenses)hjrosscompany.comhjrosscompany.com

  14. Coulter, I. et al. (2020). Chiropractic, Cost Effectiveness, and Healthcare Utilization. Spine, 45(3), 174-181. (Found that inclusion of chiropractic care leads to lower spine-related costs and utilization, indicating insurers benefit from chiropractic coverage)pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov

  15. Gallup-Palmer College of Chiropractic (2018). Public Perceptions of Chiropractic. Gallup Report. (National survey found majority of Americans view chiropractic favorably; 95% of recent chiropractic users rated it safe and 89% said it was effective for their needs)pearsonfamilychiropractic.comresearchgate.net

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