Chiropractic 

Introduction 

Chiropractic and the NHS

Use of chiropractic in the NHS is limited. Your GP or practice nurse can tell you more about the availability of NHS chiropractic in your area.

Currently, the National Institute for Health and Care Excellence (NICE) recommends spinal manipulation (as practised by chiropractors) as a treatment option for one condition: persistent lower back pain. Read the 2009 NICE guidelines on low back pain.

Most people who use a chiropractor pay for private treatment. The cost of chiropractic varies and depends on the length of a particular chiropractic session. On average, a 30-minute session will cost £20-£35 and an hour's session £40-£80.

History of chiropractic

Chiropractic was founded as a health profession in the US in 1895 by a Canadian called Daniel David Palmer, who had no conventional medical training.

Palmer argued that most human disease is caused by misalignments of the spine that apply pressure on surrounding nerves. He called these misalignments "subluxations" (a term also used in conventional medicine, where it has a different meaning) and believed that they blocked the flow of a natural energy, or "life force", through the body. Correcting these subluxations, he argued, could restore the proper flow of energy, and so restore health. Thus, he saw chiropractic spinal manipulation as a treatment for 95% of all health conditions.

Since its early days, chiropractic has fought for acceptance as a legitimate health profession. In the early 20th century, Palmer came close to declaring chiropractic a religion, at least partly due to difficulties in obtaining legal rights to practise in the US.

More recently, elements within the profession have sought to place chiropractic on a more scientific footing through research to establish an evidence base for its principles and practice.

Today, Palmer's ideas do not always form the basis on which chiropractors practise, but this varies widely between individual chiropractors. The GCC says that the idea that subluxations are responsible for illness "is not supported by any clinical research evidence" and that this idea should be taught as a historical concept and not a current theoretical model.

Chiropractors, says the GCC, are "concerned with the framework of the muscles and bones that support the body (the musculoskeletal system)" and with treating health conditions by helping the musculoskeletal system to work properly.

Nonetheless, some UK chiropractors continue to claim that they can improve a range of health conditions by correcting subluxations. 

According to the General Chiropractic Council, chiropractic is "a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health".

Chiropractors (practitioners of chiropractic) use their hands to treat disorders of the bones, muscles and joints. Treatments that involve use of the hands in this way are called "manual therapies".

Chiropractors use a range of techniques, with an emphasis on manipulation of the spine. They may also offer advice on diet, exercise and lifestyle, and rehabilitation programmes that involve exercises to do in your own time. Some chiropractors may also offer other treatments, such as acupuncture.

Learn more about what happens in chiropractic.

Chiropractic is part of complementary and alternative medicine (CAM). This means that chiropractic is different in important ways from treatments that are part of conventional western medicine.

Some uses of chiropractic treatments are based on ideas and an evidence base that are not recognised by the majority of independent scientists.

Uses

Many chiropractors only treat conditions related to the spine, such as lower back or neck pain.

Some chiropractors, however, treat a wider range of conditions, including asthma, infant colic, irritable bowel syndrome and many others.

The General Chiropractic Council says that the care provided by chiropractors should be "informed by the best available evidence, the preferences of the patient, and the expertise of practitioners".

See common uses of chiropractic for more.

The availability of chiropractic on the NHS is limited (see box, left). Most chiropractic patients pay for private treatment.

Does it work?

Chiropractic is a healthcare profession, and not a single treatment. Evidence about chiropractic generally refers to one or more of the treatments that chiropractors offer.

There is good evidence that spinal manipulation – as practised by chiropractors – can be an effective treatment for persistent lower back pain. Conventional treatments for lower back pain include painkillers, exercise and physiotherapy.

There is some, mostly poor quality, evidence that that spinal manipulation is an effective treatment for some other musculoskeletal conditions involving the bones, joints and soft tissue. The evidence on spinal manipulation is not strong enough in these cases to form the basis of a recommendation to use the treatment.

There is no evidence that treatments offered by chiropractors are effective for other conditions.

There is also no scientific evidence to support the idea that most illness is caused by misalignment of the spine.

For more information, see evidence for chiropractic.




Page last reviewed: 01/05/2012

Next review due: 01/05/2014

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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User795625 said on 15 August 2013

Two paragraphs are untrue and are even contradicted in future following paragraphs.

"Some uses be of chiropractic treatments are based on ideas and an evidence base that are not recognised by the majority of independent scientists
...
"Some chiropractors, however, treat a wider range of conditions, including asthma, infant colic, irritable bowel syndrome and many others."

To be registered as a Chiropractor one must follow the code of practice. The code of practice from the General Chiropractic Council states that the care provided by chiropractors should be "informed by the best available evidence, the preferences of the patient, and the expertise of practitioners".

Due to this regulation, Chiropractic care is only allowed to exist following the best available evidence.
No single chiropractor following the code will claim to treat "asthma, infant colic, irritable bowel syndrome or others" as these statements are not supported by the best available evidence.

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dancer21 said on 07 May 2013

im 17, female.
for about 8 months, my back always feels the need to click, and it will get to a point that it is so tense, it makes my neck seize up and fill with lots of knots. it does bring a lot of pain. however, once someone has massaged the knots and clicked my back for me, it goes away until it needs to be clicked again. surely that is not healthy and something should be done about it??

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Salsasalsa said on 23 March 2013

Once again mis informed NHS rubbish, wrote by people that would rather take a pill or are paid to promote the drug companies multi million pound empire by telling the general public lies about how they should treat their symptoms! If we don't start looking toward holistic practices like chiropractic the NHS will very soon be a distant memory!

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