A chiropractor focuses on treating the spine by using their hands to examine and treat problems related to the spinal bones, muscles, joints and nerves.
The focus of a chiropractor’s treatment is usually chiropractic manipulation, also called chiropractic adjustment.
In addition, most chiropractors work with their patients to improve their pain and function via therapies, such as exercise, nutrition, ergonomics, massage, activity modification and general wellness.
In This Article:
Training and Licensing Required for a Chiropractor
A chiropractor is a doctor who is trained and licensed as a Doctor of Chiropractic. This degree is different from a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO).
A Doctor of Chiropractic (DC) is required to complete the following to practice in the U.S.:
- Pass the National Board of Chiropractic Examiners exam
- Obtain a state license
- Many states also require chiropractors to pass an exam about state-specific laws, and all states require practicing chiropractors to take continuing education classes.
- Complete a Doctor of Chiropractic (DC) degree from an accredited school. Institutions that award the DC degree are accredited by the Council on Chiropractic Education, which is recognized as an accrediting agency by the U.S. Secretary of Education.
- Chiropractic education includes classes in basic sciences, such as anatomy and physiology, and supervised clinical experience to learn skills such as spinal assessment, adjustment techniques, and clinical diagnoses.
- Some chiropractors complete postgraduate education in specialized fields, such as orthopedics or sports medicine.
Unlike a Medical Doctor or Doctor of Osteopathic Medicine, chiropractors do not prescribe medications, perform injections or surgery. Instead, chiropractors focus on manual therapy, spinal adjustments, and holistic care to manage pain, improve mobility, and encourage long-term healing.
What Does a Chiropractor Do?
Chiropractic care is a hands-on approach to musculoskeletal health that typically uses spinal adjustments to restore movement, reduce pain, and improve function.
One of the most common techniques used is spinal manipulation, which can produce an audible popping sound. However, gentler methods are also available for those who prefer them or have specific health considerations.
A chiropractic adjustment typically includes:
- High-velocity, low-amplitude (HVLA) thrust: The chiropractor uses their hands to apply a quick, controlled force to a vertebra to improve mobility.
- Audible joint cavitation: A popping sound, similar to cracking knuckles, caused by the release of gases (oxygen, nitrogen, and carbon dioxide) within the joint, reducing pressure.
- Post-adjustment sensation: Many patients feel relief immediately, though minor discomfort may occur if muscles are tense or in spasm.
Spinal Adjustment: High-Velocity, Low-Amplitude (HVLA)
HVLA spinal manipulation is one of the most studied chiropractic methods, particularly for back and neck pain. Some common HVLA techniques include:
- Diversified Technique: A widely used approach involving a short, quick thrust over a restricted joint to restore motion.
- Gonstead Adjustment: Similar to the diversified technique but with highly specific joint evaluation and precise body positioning, often using specialized chairs or tables.
- Thompson Terminal Point (Drop) Technique: Involves a special table with drop sections that assist in the adjustment, reducing the need for forceful manipulation. This method may or may not produce an audible pop.
Spinal Mobilization: A Gentle Type of Spinal Adjustment
For patients who prefer or require a gentler approach, spinal mobilization can be an effective alternative.
Unlike HVLA techniques, spinal mobilization involves slow, controlled movements to a joint’s firm endpoint rather than a quick thrust.
Chiropractors may choose spinal mobilization for:
- Patient preference: Some individuals are uncomfortable with or prefer to avoid traditional high-velocity spinal manipulation. They are more comfortable with the slow, controlled manipulation.
- Sensitive nervous systems: Patients prone to muscle spasms may respond better to a gentler approach.
- Medical contraindications: Conditions such as osteoporosis, bone pathology, deformities, or some types of spinal arthritis may require low-force techniques.
- Acute pain cases: Patients experiencing severe pain may benefit from a less forceful technique.
- Obesity: Positioning for HVLA manipulation can be challenging, making low-force methods more practical.
Is the Pop Necessary for a Successful Adjustment?
While some patients and clinicians associate the audible pop with a successful adjustment, research has not confirmed that it is required for therapeutic benefits. The key goal of chiropractic care is to restore joint function and alleviate pain, whether or not a cavitation sound occurs.
Spinal Mobilization and Chiropractic Therapies
Chiropractors use various spinal mobilization techniques to restore spinal alignment and alleviate pain. Some commonly used gentle spinal mobilization methods include:
- Activator Method: The Activator Method uses a hand-held, spring-loaded tool that delivers low-force impulses to specific spinal areas, often combined with muscle testing and leg length evaluation.
- Cox Flexion-Distraction: A gentle, rhythmic stretching of the lower spine to adjust vertebrae and relieve pain.
- Toggle Drop: A hands-on technique where the chiropractor applies a firm, quick thrust while using a specialized drop table to assist the adjustment.
- McKenzie Technique: The McKenzie Method is used for both diagnostic and therapeutic purposes. It is a movement-based therapy helping patients find positions and movements that reduce sciatica, neck pain, and lower back pain.
- Release Work: The chiropractor applies gentle pressure with their fingertips to realign misaligned vertebrae.
- Sacro-Occipital Technique (SOT): The chiropractor places wedges under the patient’s pelvis to facilitate gravity-assisted spinal realignment.
Other mobilization techniques include massage therapy, Applied Kinesiology, Receptor-Tonus Technique, Cranio-Sacral Therapy, and NUCCA.
Chiropractic Adjustment Side Effects
Most patients experience only mild soreness in the spinal joints or muscles after a chiropractic adjustment. If this aching or soreness occurs, it is usually within the first few hours after the adjustment and does not last more than 24 hours. Applying an ice pack can help relieve discomfort quickly.
