Chiropractors diagnose and treat problems with your muscles, joints, and spine, primarily through hands-on manipulation of the body. They are licensed healthcare providers who complete a doctoral program but do not prescribe medications or perform surgery. Their core work involves restoring joint mobility, reducing pain, and improving how your nervous system communicates with the rest of your body.
What Happens at a First Visit
A chiropractic first visit looks similar to many medical appointments. The chiropractor takes a full medical history, checks your vitals, and runs orthopedic and neurological tests to figure out what’s causing your pain or limited movement. They’ll assess your posture, range of motion, and how your spine and joints are functioning.
Chiropractors can order and interpret X-rays when needed, though they follow guidelines about when imaging is actually useful. For acute low back pain, for example, the American Chiropractic Association recommends against routine X-rays during the first six weeks unless red flags are present. Those red flags include recent falls or trauma, signs of infection or tumor, or being over age 55. The goal is to avoid unnecessary radiation while still catching anything serious. If an X-ray or MRI reveals a problem outside a chiropractor’s scope, they’ll refer you to the appropriate specialist.
The Adjustment Itself
The signature chiropractic treatment is spinal manipulation, often called an “adjustment.” The most common form uses a quick, controlled thrust applied to a specific joint. This is known in clinical terms as a high-velocity, low-amplitude thrust: a fast movement with a small range of motion designed to gap the joint surfaces apart briefly. That’s what produces the popping sound many people associate with chiropractic visits.
Not every adjustment involves that pop. Chiropractors also use gentler mobilization techniques that move joints through their range of motion more slowly, without the thrust. Some use handheld instruments that deliver a light, targeted impulse, and others use specialized tables with sections that drop slightly during the adjustment to assist the movement. The technique a chiropractor chooses depends on your condition, your comfort level, and what part of the body they’re working on.
Beyond the adjustment, chiropractors commonly use heat and cold therapy, electrical stimulation of muscles, massage, relaxation exercises, and nutritional guidance as part of a treatment plan.
How Adjustments Affect Your Body
When a chiropractor adjusts a joint, the mechanical change triggers a cascade of neurological responses. The thrust stimulates sensory receptors in your muscles and tendons, specifically the receptors that detect stretch and tension. This flood of sensory input travels to your spinal cord and brain, essentially resetting how your nervous system processes signals from that area.
One key mechanism involves a phenomenon called central facilitation, where irritated tissues send a constant low-level signal that makes your nervous system more sensitive to pain in that region. By restoring normal movement to a joint, an adjustment can quiet those background signals, which may explain why people often feel immediate relief. The manipulation also triggers reflexes in the surrounding muscles, producing both relaxing and activating effects that can improve how those muscles function.
Conditions Chiropractors Treat
Low back pain is the most common reason people visit a chiropractor, and it’s also where the strongest evidence exists. The American College of Physicians includes spinal manipulation in its clinical guidelines as a recommended first-line treatment for both acute and chronic low back pain, before turning to medication. For chronic back pain specifically, it’s listed alongside exercise, yoga, tai chi, acupuncture, and cognitive behavioral therapy as options physicians should consider before drugs.
Neck pain responds well to chiropractic care too. Studies show clinically important improvements in chronic neck pain at 6, 12, and even 104 weeks after a course of spinal manipulation or mobilization.
Headaches are another frequent reason for visits, though the evidence varies by type. Cervicogenic headaches, the kind caused by problems in the neck, show the most consistent improvement with chiropractic manipulation, with patients reporting reduced frequency and severity. Migraines also appear to respond to cervical manipulation for both chronic and episodic cases. Tension-type headaches, however, have weaker evidence supporting chiropractic treatment.
Chiropractors also treat joints beyond the spine. Shoulder pain, knee problems, and ankle injuries all fall within their scope. In one study, adults with new-onset shoulder pain who received manual manipulation experienced significant pain relief after three months and regained range of motion in the affected shoulder.
What Chiropractors Cannot Do
Chiropractors are explicitly prohibited from prescribing or administering medications, performing surgery, and practicing obstetrics. They cannot provide radiation-based treatments. These boundaries are written into state practice acts and are consistent across the profession, though specific scope-of-practice details vary somewhat by state.
Some chiropractors market their services for non-musculoskeletal conditions in children, including colic, asthma, and bedwetting. Chiropractic care is the most common form of complementary medicine used by children in the United States, but the evidence here is thin. Reviews of high-quality studies have found only limited support for chiropractic treatment of asthma, infantile colic, bedwetting, and respiratory conditions in children. There are substantial gaps in the research, and these conditions are generally better managed alongside a pediatrician.
Safety and Side Effects
The most common side effects of chiropractic adjustment are mild and short-lived. A systematic review of cervical manipulation trials found the most frequently reported reactions were temporary increases in neck pain, muscle soreness, stiffness, and headache. These resolve on their own without additional treatment.
Serious adverse events from cervical manipulation, such as arterial injury, are extremely rare. So rare, in fact, that even large randomized clinical trials aren’t able to detect them reliably. The same systematic review found no serious or moderate adverse events across the studies it analyzed, and the overall rate of any side effects in the manipulation group was statistically no different from control groups.
Training and Credentials
Chiropractors earn a Doctor of Chiropractic (DC) degree, which requires roughly 4,900 contact hours across 342 credit hours of graduate-level coursework. Programs typically span about four years. The curriculum covers anatomy, physiology, radiology, diagnosis, and clinical techniques. Students enter supervised clinical practice around their second year and spend their final quarters treating patients in outpatient settings while completing clinical examinations.
After graduating, chiropractors must pass national board exams administered by the National Board of Chiropractic Examiners and obtain a license from the state where they plan to practice. Every state in the U.S. licenses chiropractors, and most require continuing education to maintain that license.