Cortisone shots are a common medical intervention used to quickly reduce inflammation in specific areas of the body, such as joints or tendons, by injecting a corticosteroid medication. This approach is often considered for conditions like tendinitis, arthritis, or back pain when other non-invasive treatments have not provided sufficient relief. Chiropractic care, in contrast, focuses on the diagnosis and hands-on treatment of mechanical disorders of the musculoskeletal system, particularly the spine. The public often seeks to understand the boundaries between these two distinct approaches, wondering if the non-surgical field of chiropractic includes this type of pharmacological, invasive procedure.
The Scope of Chiropractic Practice and Injections
Chiropractors, who hold a Doctor of Chiropractic (DC) degree, operate under state-defined scopes of practice that strictly prohibit the administration of injectable medications, including cortisone shots. Chiropractic is fundamentally a non-surgical and non-pharmacological health profession. This means it does not involve the use of prescription drugs or invasive procedures to treat patients, a distinction maintained across the vast majority of jurisdictions globally.
The practice centers on manual adjustments and physical therapies aimed at restoring mobility and function, primarily to the spine and other joints. Cortisone is a synthetic corticosteroid that must be prescribed and administered by a professional with a medical license and specific training in sterile injection techniques. Since a DC’s training does not encompass pharmaceutical prescribing rights or the necessary skills for safely injecting medication, these actions fall outside their legal and educational authority.
State laws explicitly forbid the administration or prescribing of any drug or medicine by a chiropractor, including substances delivered by injection. While a few states allow chiropractors to administer non-drug injections, such as certain vitamins or nutritional supplements, these are rare exceptions and do not include pharmaceutical agents like cortisone.
Professional Licensing and Authority for Administering Injections
The authority to administer cortisone shots is reserved for licensed healthcare professionals trained in pharmacology, anatomy, and sterile injection procedures. This group includes Medical Doctors (MDs) and Doctors of Osteopathic Medicine (DOs), along with certain advanced practice providers. Orthopedic surgeons, rheumatologists, pain management specialists, and primary care physicians frequently perform these injections.
These professionals undergo extensive medical education covering the systemic effects of corticosteroids, potential adverse reactions, and techniques for precisely targeting injection sites to minimize risk. Physician Assistants (PAs) and Nurse Practitioners (NPs) are also commonly authorized to administer cortisone shots. Their ability to do so depends on specific state practice laws and their individual clinical competency.
Common Pain Management Treatments Offered by Chiropractors
Since chiropractors cannot administer cortisone shots, they utilize a range of non-invasive, drug-free modalities to address musculoskeletal pain and inflammation. The most recognized treatment is spinal manipulation, or the chiropractic adjustment, which involves applying a controlled force to a joint to restore proper alignment and movement. This technique is frequently used to alleviate pain and pressure on spinal nerves.
Chiropractors incorporate various soft tissue therapies, such as myofascial release, trigger point therapy, and therapeutic massage, to address muscle tightness, spasms, and scar tissue. These hands-on methods improve local circulation and reduce tension in the muscles and connective tissues, complementing joint adjustments. A comprehensive chiropractic treatment plan also includes therapeutic exercises, stretches, and lifestyle recommendations. These elements are tailored to improve joint stability and flexibility, helping patients manage pain and prevent future injury.