Evidence for its effectiveness 

To be able to judge whether any health treatment is safe and effective, we need evidence.

Evidence on a treatment is gathered by conducting fair scientific tests.

Chiropractic is a health profession, rather than a single treatment. Evidence about chiropractic generally refers to one or more of the treatments that chiropractors can offer.

Studies that examine health treatments, including treatments offered by chiropractors, can reach different conclusions on whether the treatments are safe and effective. This can happen for various reasons, including differences in the design of the study, bias or simply chance. When this happens, more high-quality research is needed to determine whether the treatment is effective and safe.

Positive evidence

There is good evidence available that chiropractic is an effective treatment for persistent lower back pain.

This means that scientific trials conducted to investigate the effect of chiropractic on lower back pain found that it did have a beneficial effect.

A 2011 Cochrane review of studies of chiropractic intervention – treatments offered by chiropractors, including spinal manipulation – found that it is not possible to confirm or refute that chiropractic treatments are any more effective than conventional treatments for persistent lower back pain.

Conventional treatments include painkillers, exercise and physiotherapy. Physiotherapists may sometimes offer a similar treatment approach to chiropractors.

Some positive evidence

There is some, mostly poor-quality, evidence that manipulation of bones, joints and soft tissue, as practised by chiropractors, may be an effective treatment for some other musculoskeletal problems. These include:

  • acute (new-onset) back pain
  • acute and sub-acute neck pain
  • chronic neck pain when combined with exercise
  • shoulder girdle pain
  • frozen shoulder 
  • tennis elbow – when treatment is combined with exercise
  • hip osteoarthritis
  • knee osteoarthritis – some kinds of knee pain and some kinds of heel pain
  • migraine and headache originating from neck problems

This evidence is not conclusive, and therefore isn't strong enough to form the basis of a recommendation to use the treatment for these conditions.

More high-quality research is needed to determine whether manual treatments are effective for these health conditions.

Inconclusive or no evidence

Despite being used by some practitioners, there is a lack of good-quality evidence on the effectiveness of chiropractic treatments for other conditions, including:

This means that fair tests into the effectiveness of chiropractic treatments for these conditions have not been conducted.

Chiropractic is not recommended as a treatment option for these conditions, due to the lack of evidence. You should follow the treatment options recommended by your doctor or other healthcare professional.


Page last reviewed: 20/08/2014

Next review due: 20/08/2017